Search

Objective: Pelvic floor muscle training is effective and necessary in the prevention and treatment of pelvic floor dysfunction during pregnancy and after childbirth. But because of the high prevalence of perineal pain observed in women after childbirth, many women and caregivers fear to start pelvic floor muscle training immediately after childbirth. However, it is unknown whether pelvic floor muscle contractions (PFMC) provoke perineal pain in women shortly after childbirth. Therefore, the main objective is to study whether PFMC performed immediately after childbirth is painful or not. Study design: Observational longitudinal study. Perineal pain was assessed (16 days and 9 weeks postpartum) using a visual analogue scale (VAS 010) during PFMC and during several activities of daily living (ADL), during micturition and defecation. Descriptive statistics, Wilcoxon and McNemar tests were used. Results: A total of 233 women participated (148 primiparous and 85 multiparous). Immediately postpartum the prevalence and intensity of pain during ADL (73%; VAS 4.9 (2.3)), micturition (47%; VAS 3.4 (1.7)) and defecation (19%; VAS 3.6 (2.2)) were significantly higher (all p < 0.000) than during PFMC (8%; VAS 2.2 (0.9)). At 9 weeks postpartum, 30% experienced perineal pain during sexual intercourse (VAS 4.6 +/ 2.3) and 18% during defecation (VAS 4.7 +/ 2.3), but none during PFMC. Conclusion: Perineal pain is highly prevalent immediately after childbirth during ADL, micturition and defecation, but not during PFMC (only 8%). In case perineal pain occurs during PFMC, the intensity of pain is low (VAS 2). These results show that fear of perineal pain should not discourage women to start pelvic floor muscle training shortly after childbirth

Objective: In the medical literature, there is little known about vaginal wind, though from clinical expertise, it turns out to be a consistent and underreported problem. The aim of this review was to collect the available literature about the different aspects of vaginal wind. Study design: A systematic literature search was conducted using three databases until December 2015. The search strategy was built using relevant synonyms of vaginal wind. Study characteristics were extracted. Risk of bias, the quality of the relevant studies and the level of evidence was judged. Results: Eleven studies met the inclusion criteria. Vaginal wind occurs on random movements and during or after coitus. The prevalence ranges from one to 69%. The pathophysiology is unclear and the incidence unknown. Known risk factors are vaginal delivery and urinary incontinence. Provoking factors are coitus, digital stimulation, cunnilingus and exercising. Female sexual function is decreased. The sexual function of male partners with vaginal wind is not influenced. Overall vaginal wind leads to a decrease in the quality of live and can have cause social isolation. The treatment is related to the cause and mainly not successful. Tampons can be used for treatment as well as prevention. Conclusion: Vaginal wind is an underestimated health issue with a severe impact on sexual functioning. Adequate research is needed regarding the influence of sexual activity, weight, age, parity, the underlying pathophysiological mechanisms, prevention and treatment. (C) 2017 Elsevier B.V. All rights reserved.