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Abstract Pelvic floor dysfunctions (PFD) are highly prevalent among females who do athletics, a sport requiring jumping, strength, and running. Although educational approaches are useful options, the educational need for this particular population remains unknown. The objective of the present study was to describe the level of knowledge regarding PFD and its relationship with symptomatology and gender stereotypes in female athletes in Spain. A total of 255 female athletes completed an anonymous online survey to explore their knowledge regarding urinary incontinence (UI), pelvic organ prolapse (POP), anal incontinence (AI), and sexual dysfunction (SexD), as well as their PFD symptoms and gender stereotyped beliefs related to sport. Educational level and sports characteristics (training volume, experience, and athletic modality) were also explored. Participants demonstrated a low level of knowledge in terms of POP (52.5%), AI (64.0%), and SexD (40%), but not for UI (70.8%). The proportion of PFD complaints was 63.5% for dyspareunia, 51.8% for urine leakage, 42.4% for pelvic pain, 17.3% for AI, and 9.0% for POP, with no associations with knowledge (p > 0.05). Lower knowledge about UI and SexD was related to greater gender stereotypes (p

Introduction: Pelvic floor disorders are one of the most common morbidities in women, which have negative consequences on women's daily life. Since the total prevalence of this disorder among Iranian′s women has not been reported by appropriate tools, this study was conducted with aim to determine the prevalence of pelvic floor disorder and its risk factors. Methods: This cross-sectional study was conducted in 2021-2022 on 400 non-pregnant women of reproductive age referring to Tabriz health centers. Data related to pelvic floor disorders were collected through the Australian Pelvic Floor Questionnaire and the Sociodemographic and Obstetric Characteristics Questionnaire. Data were analyzed using SPSS software (version 26) and Chi-square test and multivariate logistic regression. P

Abstract Background This study aimed to explore the association of the second birth delivery mode and interval with maternal pelvic floor changes. Methods This prospective cohort study included women who had a first delivery and were in weeks 36–41 of a subsequent pregnancy at Panzhihua Central Hospital between July 2017 and June 2018. The primary outcomes of the study were the hiatus area at 6 months postpartum and bladder neck (mm) at rest and during a maximum Valsalva maneuver. Results There were 112 women with vaginal delivery and 182 with Cesarean section. The hiatus area and hiatus circumference decreased at all time points (all P

The editorial in the International Urogynecology Journal discusses health inequalities in urogynaecology, focusing on disparities in pelvic floor health awareness and care-seeking behaviors among women. The article highlights barriers such as lack of communication, cultural differences, financial constraints, and stigma, which contribute to these inequalities. It emphasizes the importance of addressing these disparities through patient-centered care, diversifying the healthcare workforce, and promoting education to improve access to treatment and outcomes. [Extracted from the article]

Introduction and Hypothesis: Concurrent pelvic organ and rectal prolapse have an incidence of 38%. Dynamic pelvic magnetic resonance imaging (MRI) is the modality of choice for workup. We discuss dynamic pelvic MRI indications, interpretation, and clinical application to pelvic floor disorders. Methods: The pubococcygeal line (PCL) extends from the pubic symphysis to the last coccygeal joint. The "H line" demonstrates the levator hiatus size, drawn from the inferior pubic symphysis to the posterior rectal wall at the anorectal junction. The "M line" represents vertical descent of the levator hiatus and extends perpendicularly from the PCL to the posterior aspect of the H line. With rectovaginal fascial defects, the small bowel, the peritoneum, and the sigmoid colon can prolapse. Posterior compartment abnormalities include rectocele, rectal prolapse, and descending perineal syndrome. Pelvic MRI can evaluate functional disorders such as anismus, where the anorectal angle is narrowed and associated with lack of pelvic floor descent and incomplete evacuation. Conclusions: Particularly for patients with concurrent urogynecological and colorectal complaints, previous pelvic reconstructive surgery, or when clinical symptomatology does not correlate with physical examination, dynamic pelvic MRI can impact management. It is critical for pelvic reconstructive surgeons to be familiar with this imaging modality to counsel patients and interpret radiographic findings. [ABSTRACT FROM AUTHOR]

Despite the high prevalence of pelvic floor (PF) dysfunctions in female athletes, help-seeking is low due to embarrassment and disinformation. This study evaluated the effects of a 6-week exercise program guided by a specific app, with and without intravaginal biofeedback on the PF symptoms, strength, and sonographic measures of female athletes. Compliance with the program was evaluated. Thirty-nine athletes with PF symptoms used the app with different functionalities: experimental group 1 (n = 13) (EG1: exercises, PF information, and physiotherapists contact); experimental group 2 (n = 14) (EG2: exercises with biofeedback, PF information, and physiotherapists contact); and the control group (n = 12) (CG: PF information, and physiotherapists contact). Before and after the 6 weeks, PF symptoms, strength with the Oxford scale, and sonographic measures were evaluated. EG1 and EG2 improved strength (p = 0.028 and p = 0.001, respectively) and incontinence urinary symptoms (p = 0.041 and p = 0.002, respectively) over the baseline, without between-group differences (p > 0.05). No significant differences were observed in sonography (p > 0.05). Regarding compliance, 84.6 and 71.4% of athletes from EG1 and EG2 completed the program twice per week or more. A 6-week PF exercise program guided by the app improved PF symptoms and strength of female athletes and ensured high compliance with the program but was insufficient to improve sonography.

Background: Educational and self-care measures are important for women after gynecological pelvic cancer treatment. Pelvic floor muscle training exercises (PFMT) are a conservative treatment for pelvic floor (PF) dysfunction. The purpose is to evaluate the impact of a telerehabilitation and self-care program on PF dysfunctions, reports of urinary incontinence (UI), and physical–emotional factors of participants post-treatment for gynecological pelvic cancer. Methods: Two-arm randomized clinical trial: an intervention group (IG) will evaluate the effect of a telerehabilitation program on women undergoing clinical practice of radiotherapy for the treatment of gynecological pelvic cancer and a control group (CG) will maintain the routine. Primary outcome is the prevalence of reports of UI, which will be assessed using the International Consultation on Incontinence Questionnaire—Short Form (ICIQ-SF). The secondary outcomes will be the severity and impact of UI on quality of life, location and perception of pain intensity, presence and intensity of dyspareunia, vaginal stenosis, fecal incontinence (FI), and levels of physical activity. Statistical analysis will be performed by intention-to-treat, and multivariate mixed effects analysis will be used to compare results. Discussion: Activities in the context of telerehabilitation using PFMT and self-care can represent a viable and effective solution to minimize the side effects of gynecological cancer treatment and improve women's quality of life. [ABSTRACT FROM AUTHOR]

Purpose: Utilize magnetic resonance defecography (MRD) to analyze the primary pelvic floor dysfunctions in patients with stress urinary incontinence (SUI) associated with pelvic organ prolapse (POP), and in SUI patients with asymptomatic POP. Method: We performed MRD in both SUI and POP subjects. As a primary analysis, the functional MR parameters were compared between the isolated POP and POP combined SUI groups. As a secondary analysis, the functional MR data were compared between the POP combined SUI and the SUI with asymptomatic POP (isolated SUI) groups. Results: MRD noted the main characteristics of SUI combined moderate or severe POP, including the shorter closed urethra length (1.87 cm vs. 2.50 cm, p < 0.001), more prevalent urethral hypermobility (112.31° vs. 85.67°, p = 0.003), bladder neck funneling (48.28% vs. 20.51%, p = 0.020), lower position of vesicourethral junction (2.11 cm vs. 1.67 cm, p = 0.030), and more severe prolapse of the posterior bladder wall (6.26 cm vs. 4.35 cm, p = 0.008). The isolated SUI patients showed the shortest length of the closed urethra (1.56 cm vs. 1.87 cm, p = 0.029), a larger vesicourethral angle (153.80° vs. 107.58°, p < 0.001), the more positive bladder funneling (84.85% vs. 48.28%, p = 0.002) and a special urethral opening sign (45.45% vs. 3.45%, p < 0.001). Conclusions: Patients with SUI accompanying POP primarily exhibit excessive urethral mobility and a shortened urethral closure. SUI patients with asymptomatic POP mainly show dysfunction of the urethra and bladder neck, characterized by the opening of the urethra and bladder neck and a shortened urethral closure. [ABSTRACT FROM AUTHOR]

Pelvic floor dysfunctions (PFD) are highly prevalent among females who do athletics, a sport requiring jumping, strength, and running. Although educational approaches are useful options, the educational need for this particular population remains unknown. The objective of the present study was to describe the level of knowledge regarding PFD and its relationship with symptomatology and gender stereotypes in female athletes in Spain. A total of 255 female athletes completed an anonymous online survey to explore their knowledge regarding urinary incontinence (UI), pelvic organ prolapse (POP), anal incontinence (AI), and sexual dysfunction (SexD), as well as their PFD symptoms and gender stereotyped beliefs related to sport. Educational level and sports characteristics (training volume, experience, and athletic modality) were also explored. Participants demonstrated a low level of knowledge in terms of POP (52.5%), AI (64.0%), and SexD (40%), but not for UI (70.8%). The proportion of PFD complaints was 63.5% for dyspareunia, 51.8% for urine leakage, 42.4% for pelvic pain, 17.3% for AI, and 9.0% for POP, with no associations with knowledge (p > 0.05). Lower knowledge about UI and SexD was related to greater gender stereotypes (p < 0.05) and rejection of professional healthcare (p = 0.010). As a conclusion, the level of knowledge about PFD was low in female athletes who train and compete in athletics in Spain, mainly with regard to sexual dysfunction. Although 63.5% of athletes had dyspareunia and 51.8% urinary leakages, symptomatology was not associated with level of knowledge. However, a lower level of knowledge was associated with more stereotyped beliefs and rejection of professional healthcare for PFD. These findings confirm the need to design appropriate educational interventions to disseminate information on all the types of PFD, particularly sexual contents. The potential influence of gender stereotypes makes it appropriate to include the gender perspective in these interventions. [ABSTRACT FROM AUTHOR]

• High prevalence of urinary and faecal incontinence in cystic fibrosis patients. • No relation between severity of respiratory impairment and incontinence. • Incontinence impairs quality of life and adherence to respiratory management. • Therapeutic strategy for incontinence specifically for cystic fibrosis patients. In cystic fibrosis (CF), coughing is associated with a risk of pelvic floor dysfunction. However, data on the prevalence of symptoms (stress urinary incontinence, bladder overactivity, dysuria, and faecal incontinence) are lacking in males and females with CF. The impact of incontinence on adherence to respiratory care has not been studied. We conducted a multicentre study in adults with CF followed in the North-West French CF network. Urinary disorders and their severity were assessed using the Urinary Symptom Profile (USP) self-report questionnaire; the impact of urinary disorders on general quality of life was measured using the SF-Qualiveen questionnaire; faecal incontinence was assessed using the Wexner self-report questionnaire; and the CFQ-R14+ questionnaire was used to assess quality of life. A self-administered questionnaire developed for the study assessed the impact of symptoms on respiratory care. Of the 178 people with CF included, 34 % reported stress urinary incontinence, with a large female predominance (63.5 % of females vs. 7.5 % of males), 65 % bladder overactivity (including 16 % urge incontinence) and 50 % faecal incontinence, also with a female predominance. Neither urinary nor faecal incontinence were related to the severity of the respiratory impairment (FEV1). Quality of life was particularly affected in women. Stress urinary Incontinence symptoms affected respiratory care in both sexes. The prevalence of functional urinary and faecal disorders was high in adults with CF and impacted on quality of life and respiratory care. Therefore, multidisciplinary teams must have knowledge of symptoms, the diagnostic tools and management strategies to provide specific treatment. [ABSTRACT FROM AUTHOR]

Objective The aim of the study is to determine whether the use of labor analgesia had a higher risk of pelvic floor functional problems after delivery. Study Design All primiparas who delivered at our hospital between June 2019 and May 2020 were enrolled in the study. They were divided into two groups according to their choices: delivery with labor analgesia (analgesia group, n = 76), and delivery without labor analgesia (nonanalgesia group, n = 78). The primary outcome of the study was to test the pelvic floor function by electromyography (EMG) at postpartum 6 to 8 weeks. Participants also completed questionnaires including Pelvic Floor Distress Inventory (PFDI-20), International Consultation on Incontinent Questionnaire-Short Form (ICIQ-SF), and Overactive Bladder Symptom Score (OABSS) at postpartum 6 to 8 weeks. Results Primiparas in the analgesia group experienced longer first and second stages of labor (p < 0.05), and had significantly higher PFDI-20 scores at postpartum 6 to 8 weeks (p < 0.05). But the differences in ICIQ-SF, OABSS scores, and Pelvic Organ Prolapse Quantification (POP-Q) system between the two groups were not significant (p > 0.05). No statistically significant difference was found in class II and class I muscles, scores of pretest resting baseline, and posttest resting baseline between primiparas with or without labor analgesia (p > 0.05). Conclusion Our results strongly confirmed that labor analgesia did not increase the risk of pelvic floor dysfunction up to 6 to 8 weeks after delivery, although symptom burden might be increased after labor analgesia. Key Points Labor analgesia did not increase risk of pelvic floor muscle dysfunction after delivery. There are longer first and second stages of labor in primiparas with labor analgesia. Primiparas with labor analgesia had more obvious subjective symptoms of PFD. [ABSTRACT FROM AUTHOR]

Objective: To assess the quality of life (QoL) in women following a maternal near‐miss event and to assess the women's attitude towards future fertility and their contraceptive choices. Methods: A cross‐sectional observational study was conducted in Government Medical College, Kozhikode, India among women who had experienced a near‐miss event (n = 50) between January 1, 2020 and May 31, 2021 during the peak of the COVID‐19 pandemic. The QoL was assessed using the WHO Quality of Life, BREF Version, questionnaire, which was administered to the consenting participants over phone. Information regarding desire for future fertility, contraceptive choices, and urogenital symptoms was also collected. A comparison between the short‐term and long‐term effects on the QoL was also done. Results: A maternal near‐miss event was not found to adversely affect the overall quality of life in the present study. The scores in all the four domains—physical, psychological, social relationships, and environmental—suggested good QoL, although greater variability in values were observed in the physical and psychological domains. The influence in these two domains was more pronounced following a perinatal loss and following prolonged physical morbidities. There was no difference in short‐ and long‐term QoL following a maternal near miss (MNM). The MNM did not influence the contraceptive choices and there was no subsequent pelvic floor dysfunction in most women. Conclusion: MNM was not found to adversely affect the overall subsequent QoL in the present study. There was no difference in short‐ and long‐term QoL following a MNM. Studies carried out over a longer period of time with a control group would yield more information. Synopsis: MNM was not found to affect the overall subsequent quality of life in the present study, but greater variability in scores was observed in the psychological and physical domains. Lower scores were observed in women with a perinatal loss and in those with prolonged physical morbidities. [ABSTRACT FROM AUTHOR]

Résumé: Les douleurs anorectales fonctionnelles rentrent dans le cadre plus large des douleurs pelvi-périnéales chroniques. Elles sont caractérisées par un examen clinique normal et une imagerie aspécifique. La manométrie anorectale bien que peu prescrite apporte de nombreuses informations sur les mécanismes de ces douleurs. Les principales anomalies trouvées sont représentées par une hypertonie anale de repos, des ondes ultra-lentes ainsi qu'une dyssynergie anorectale. D'autres anomalies sont parfois trouvées mais peu étudiées : troubles de la sensibilité, modification des réflexes, anomalies portant sur le muscle puborectal et/ou troubles de la statique pelvienne. L'intérêt de la manométrie anorectale dans les douleurs anorectales est donc majeur autant sur le plan physiopathologique que sur le plan thérapeutique. Une meilleure diffusion de cet examen ainsi que des études sur de plus larges effectifs participerait à l'amélioration globale des pratiques. Functional anorectal pain belongs to the broader framework of chronic pelvi-perineal pain Such pain is characterized by a normal clinical examination with non-specific imaging. Anorectal manometry is not prescribed as much as it should although it could add numerous and useful data. Main anomalies described are increased anal basal pressure, ultra-slow waves and anorectal dyssynergia. Others anomalies are sometimes described: rectal sensitivity disorders, abnormal reflex, dysfunction of the puborectalis muscle and/or pelvic floor disorders. Anorectal manometry contributions in anorectal pain are thus important both on the physiopathological and therapeutical sides. Only a better diffusion of this exam and studies with more patients will allow good quality studies and improvement in our practice. [ABSTRACT FROM AUTHOR]

Pelvic floor symptoms may occur in women with low back pain due to dysfunction of the spinal stabilization muscles. Low back pain is the most common musculoskeletal problem experienced by the mothers of children with cerebral palsy (CP). Therefore, our aim in this study was to examine pelvic floor symptoms and symptom-related quality of life in the mothers of children with CP. The study included 48 mothers of children with CP (n = 23) or without neurodevelopmental problems (n = 25). The mothers' pelvic floor symptoms and symptom-related quality of life were evaluated with the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7). PFDI-20 and PFIQ-7 scores did not differ between the two groups of mothers (p >.05). Additionally, moderately significant positive correlations were found between the age of the child with CP and duration of carrying and the PFDI-20 (r = 0.419, p =.047) and PFIQ-7 (r = 0.427, p =.042) scores. Pelvic floor symptoms and symptom-related quality of life in the mothers of children with CP were similar to those in the mothers of children without neurodevelopmental problems. As the age of the child with CP and duration of carrying increase, the urinary symptoms and urinary and colorectoanal symptoms-related quality of life in their mothers may worsen. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review aims to identify, critically appraise, and summarize current evidence regarding the feasibility and efficacy of pelvic floor muscle training in telerehabilitation. Methods: Three bibliographic databases, PubMed, Embase, and Scopus were searched from inception to October 1, 2023. Clinical trials assessing the feasibility and efficacy of pelvic floor muscle training in telerehabilitation were eligible for inclusion. The Physiotherapy Evidence Database scale and National Institutes of Health Study Quality Assessment Tool were used for methodological quality assessment. Study selection, data extraction, and quality assessment were completed by two independent reviewers. Meta-analyses were performed to determine the effects of pelvic floor muscle training in telerehabilitation. Results: Five randomized controlled trials and three single cohort clinical trials were included in this review. Four studies were evaluated as good quality, and four as fair. Pelvic floor telerehabilitation was well tolerated and demonstrated good patient compliance and satisfaction. Pooled analysis indicated significant effects of pelvic floor telerehabilitation on the severity of urinary incontinence with a large effect size, pelvic floor muscle strength with a large effect size, and quality of life with a medium effect size. Conclusion: This systematic review demonstrates that pelvic floor muscle training in telerehabilitation is a feasible and effective approach and highlights its efficacy in patients with urinary incontinence. This review supports the application of pelvic floor muscle training in telerehabilitation and informs further clinical and research endeavors to incorporate digital health technologies in managing pelvic floor dysfunction. [ABSTRACT FROM AUTHOR]

Background: Sports and physical activity are known risk factors for pelvic floor dysfunction (PFD). The aim of this study is to examine the impact of amateur running on PFD, quality of life (QoL), and sexual function. Methods: Amateur runners were contacted through social media. Their PFD, sexual function, and QoL were evaluated by self-reporting validated questionnaires (PFDI-20, PISQ-12, IIQ-7). They were divided by degree of effort into two categories, 'High effort' and 'Moderate effort'. The differences between the two groups were examined by a Mann–Whitney U Test, T-Test, and Chi-square test. Results: 180 women were included. A high incidence of PFD was found among 'High effort' runners in comparison to 'Moderate effort' runners. In addition, women who scored above the median in the PFDI-20 showed significantly greater impairment in QoL and sexual function. Interestingly, the 'High effort' group reported experiencing higher intensity orgasms compared with women in the 'Moderate effort' group. A correlation was also found between the weekly running distance and the intensity of orgasm experienced (P value = 0.004). Conclusion: 'High effort' runners present a higher incidence of PFD in comparison to 'Moderate effort' runners. Professional pelvic floor muscle training counselling should be considered even for amateur runners. Future interventional physical therapy studies should be carried out in order to investigate preventative strategies. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the association of minimal levator ani hiatus area with age in female adults without pelvic floor dysfunction. Methods: 532 female subjects aged 18 ~ 90 years without pelvic floor dysfunction, divided into four groups (Group A, 18 ~ 29 years old; Group B, 30 ~ 39 years old; Group C, 40 ~ 49 years old; Group D, ≥ 50 years old) based on age, underwent traditional pelvic two-dimensional (2D) T2-weighted imaging (T2WI) axial to the body (AxB) for measuring the minimal levator ani hiatus area. 39 female volunteers were re-recruited to undergo both traditional pelvic 2D T2WI AxB and three-dimensional (3D) T2WI. An axial plane parallel to the direction of the puborectalis muscle (AxPRM) was acquired based on 3D T2WI. The difference of levator ani hiatus area measured on AxB and AxPRM images in 39 female volunteers was compared by one-sample t test, to verify if minimal levator ani hiatus area can be acquired on the traditional pelvic 2D T2WI AxB images. Spearman analysis evaluated the association of minimal levator ani hiatus area with age and the rank-sum test analyzed the area differences among four age groups. Results: Female age was positively correlated with minimal levator ani hiatus area (r = 0.23; p < 0.001). The minimal levator ani hiatus areas of 532 subjects were: 15.17 ± 1.77 cm2 in Group A, 15.52 ± 2.21 cm2 in Group B, 16.03 ± 2.16 cm2 in Group C, and 16.40 ± 2.10 cm2 in Group D. ANOVA showed significant statistical differences among four age groups (F = 7.519, p < 0.0001). Significant differences in minimal levator ani hiatus areas were found between Group A and Group C (p = 0.0491), Group A and Group D (p = 0.0007), and Group B and Group D (p < 0.001). There was no statistical difference in minimal levator ani hiatus areas measured on AxB and AxPRM images in 39 female volunteers (p = 0.1000). There were no statistical difference in minimal levator ani hiatus areas between nulliparous and multiparous group for each age group (all p > 0.05). Conclusions: Based on a large sample, this study summarized the minimum levator ani hiatus area of female adults without pelvic floor dysfunction in different age groups. We found significant differences among different age groups. In addition, a positive correlation was found between age and the minimum levator ani hiatus area. These findings can provide reference criteria for diagnosing pelvic organ prolapse in female adults of different age groups. [ABSTRACT FROM AUTHOR]

The II Symposium of the Academic League of Women's Health and Pelvic Floor Physiotherapy at the Federal University of Uberlândia took place in March 2024 and had the participation of 90 registered attendees. The event offered workshops, lectures, and roundtable discussions on physiotherapy in the area of women's health and pelvic floor, as well as the presentation of 25 academic papers. One of the studies investigated the presence of urinary incontinence in women who practice Beach Tennis and identified associated characteristics. Other studies addressed topics such as pelvic floor disorders during pregnancy, genital prolapse in Brazilian runners, and the effects of hypopressive exercises in postpartum women with diastasis recti. Additionally, the role of physical exercise in the prevention of preeclampsia and other cardiovascular diseases in the postpartum period was discussed, as well as the relationship between cycling practice and sexual dysfunction in women. The use of EPI-NO and perineal massage in the prevention of perineal trauma during normal delivery, as well as sleep problems in women with obstructive sleep apnea, even with a high level of physical activity, were also addressed. [Extracted from the article]

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The impact of frailty, a state of vulnerability to insult with reduced likelihood of full recovery, resulting in suboptimal clinical outcomes following medical intervention has been recognized for some years. Pelvic floor dysfunction is common in frail older women and, as greater proportions of women survive into late life, the number requiring treatment is likely to increase. This article discusses the assessment of frailty, its impact on management of women with PFD and presents what is known about the management of PFD in frail older women from conservative to surgical therapies. [ABSTRACT FROM AUTHOR]

Pelvic floor dysfunctions, associated with alterations in respiratory mechanics and, consequently, quality of life, are the cause of the most frequent gynecological problems. Pelvic floor muscle training emerges as a first-line treatment, with new approaches such as hypopressive exercises. The aim of this study was to analyze the efficacy of an 8-week supervised training program of hypopressive exercises on the pelvic floor and its impact on improving the ventilatory mechanics and quality of life in women. Analysis of the spirometric parameters showed a significant main Group × Time effect for three parameters: the ratio of FEV1/FVC (p = 0.030), the forced expiratory flow at 75% of the expired vital capacity (p < 0.001), and the forced expiratory flow over the middle half of the forced vital capacity (p = 0.005). No statistical significance was found regarding the SF-12 questionnaire components; only differences were found over time in the physical role (p = 0.023), bodily pain (p = 0.001), and vitality (p < 0.010) domains and in the physical component summary score (p = 0.010). After an 8-week intervention of hypopressive exercises, an improvement in the ventilatory and pulmonary capacities can be observed. [ABSTRACT FROM AUTHOR]

Background: Pelvic floor myofascial pain is one of the pelvic floor dysfunction diseases disturbing women after delivery. There is a lack of objective standardization for the diagnosis of pelvic floor myofascial pain due to the various symptoms and the dependence on the palpating evaluation. Ultrasound imaging has the advantages of safety, simplicity, economy and high resolution, which makes it an ideal tool for the assistant diagnosis of pelvic floor myofascial pain and evaluation after treatment. Methods: This is a retrospective case-control study including women accepting evaluation of pelvic floor function at 6 weeks to 1 year postpartum. They were divided into pelvic floor myofascial pain group and normal control group. A BCL 10–5 biplane transducer was applied to observed their puborectalis. The length, minimum width, area, deficiency, deficiency length, deficiency width, deficiency area, rate of deficiency area, local thickening,angle between the tendinous arch of levator ani muscle and puborectalis of corresponding puborectalis in different groups were observed and measured. Results: A total of 220 postpartum women participated in the study, with 77 in the pelvic floor myofascial pain group and 143 in the normal control group. The Intraclass correlation coefficient value was over 0.750, and Kappa ranged from 0.600 to 0.800. puborectalis deficiency (adjusted odds ratio = 11.625, 95% confidence interval = 4.557–29.658) and focal thickening (adjusted odds ratio = 16.891, 95% confidence interval = 1.819–156.805) were significantly associated with higher odds of having postpartum pelvic floor myofascial pain. Grayscale or the angle between the arch tendineus levator ani and puborectalis measurements on the pain side tended to be smaller than on the non-pain side in patients with unilateral puborectalis or iliococcygeus pain (P < 0.05). Conclusions: This study demonstrated that transvaginal ultrasound was a potentially efficient technique for evaluating postpartum pelvic floor myofascial pain due to its ability to assess various sonographic characteristics of the levator ani muscles. [ABSTRACT FROM AUTHOR]

Introduction: Stress is characterized as a challenging occurrence that triggers a physiological and/or behavioral allostatic response, alongside the demands typically encountered throughout the natural course of life. A sustained state of stress gives rise to secondary effects, including insomnia and neck pain. Also, the risk of musculoskeletal problems in the cervical and lumbar spine can be increased due to a sustained state of stress. The present study main objective is to study the association between orofacial and pelvic floor muscles in women in Spain. Methodology: An observational, cross-sectional, retrospective analytical study was designed and carried out in the laboratories of the European University of Madrid. Sixty-five participants were recruited with a mean age of 29.9 ± 7.69. Measurements were taken by myotonometry on natural oscillation frequency (Hz), dynamic stiffness (N/m), elasticity (N/m2), mechanical stress relaxation time (ms) and creep, for the following muscles: right and left masseter, right and left temporalis and central fibrous nucleus of the perineum (CFPF). On the other hand, the subjects completed the following questionnaires: perceived stress scale (PSS-14), anxiety scale (STAI), self-reported bruxism questionnaire (CBA), Fonseca Anamnestic Index and the Pittsburgh Sleep Quality Scale (PSQI). Results: Significant correlations were found in several parameters between the right temporalis and CFPF (p<0.05). Highlighting the correlation between TMDs and lubrication r = -0.254 (p = 0.041) and bruxism with pain in sexual intercourse r = 0.261 (p = 0.036). Conclusion: The results support the proposed hypothesis. To the author's knowledge, this is the first study which relates both locations, and it is suggested to continue with the research and expand the knowledge of it. [ABSTRACT FROM AUTHOR]

Background: Severe perineal lacerations (SPLs), common worldwide, are associated with short- and long-term complications: pelvic floor disorders, fecal incontinence, fistula, and profound psychological impacts. Limited research suggests that experiencing SPL may influence future reproductive intentions, but research on outcomes is lacking. Methods: We analyzed the effect of experiencing SPL during a first delivery among a large cohort of Swedish births between 1992 and 2013. We used linear and multinomial logistic regression to estimate the associations between SPL and four reproductive outcomes: subsequent total birth number, probability of a second birth, interpregnancy interval (IPI), and subsequent scheduled cesarean birth. Results: Among 947,035 singleton live-born first-births, we found that experiencing SPL was associated with slightly fewer overall births in fully adjusted models (a decrease of −0.020 births; 95% confidence interval [CI]: −0.028 to −0.012), but no difference in the probability of a second birth (risk ratio [RR]: 1.00; 95% CI: 0.99 to 1.00) or IPI. Scheduled cesarean was increased in births after SPL (adjusted RR: 4.57; 95% CI: 4.42 to 4.73). A secondary comparison of SPL to severe postpartum hemorrhage suggests that some of these observed differences may be related to experiencing any severe outcome, and some specifically to perineum disruption. Conclusion: This study provides a deeper understanding of the long-term impacts of SPL, which may be useful in informing best clinical practices for supporting women who have experienced SPL. [ABSTRACT FROM AUTHOR]

Background: Pelvic floor dysfunction encompasses conditions like urinary and fecal incontinence, pelvic organ prolapse, and pelvic pain, significantly affecting women's quality of life. Despite its prevalence, few studies have adopted a qualitative approach to understanding women's perceptions and emotions regarding these issues. This study aims to delve into how women with pelvic floor disorders perceive their condition and its impact on their daily lives. Methods: We analyzed qualitative data from interviews with 160 women suffering from pelvic floor dysfunctions. Using inductive qualitative content analysis, we systematically examined the data to identify variations, differences, and similarities. Results: The analysis revealed four primary themes in the women's narratives: "Physical Impacts", "Emotional and Psychological Impacts", "Social and Relational Impacts", and "Sexual Health Impacts", along with 12 subthemes. The findings predominantly highlight how pelvic floor dysfunctions detrimentally affect women's quality of life and emotional well-being, instilling fear and insecurity in daily activities, compounded by sleep disturbances and sexual dysfunction. Conclusions: Women living with pelvic floor dysfunction face multifaceted challenges that adversely affect various aspects of their lives, diminishing their overall quality of life. This includes notable impacts on sleep, physical, and sexual activities. However, not all affected women report these issues, often due to fear of stigma, choosing instead to conceal their struggles in an effort to maintain an appearance of normalcy. [ABSTRACT FROM AUTHOR]

Introduction: Pelvic floor disorders are one of the most common morbidities in women, which have negative consequences on women's daily life. Since the total prevalence‬ of‬ this‬ disorder‬ among‬ Iranian′s‬ women‬ has‬ not‬ been‬ reported‬ by‬ appropriate tools, this study was conducted with aim to determine the prevalence of pelvic floor disorder and its risk factors. Methods: This cross-sectional study was conducted in 2021-2022 on 400 nonpregnant women of reproductive age referring to Tabriz health centers. Data related to pelvic floor disorders were collected through the Australian Pelvic Floor Questionnaire and the Sociodemographic and Obstetric Characteristics Questionnaire. Data were analyzed using SPSS software (version 26) and Chi-square test and multivariate logistic regression. P<0.05 was considered significant. Results: In this study, 264 participants (66.0%) had pelvic floor disorder. Also, 191 participants (47.8%) had urinary incontinence, 235 (58.8%) had fecal incontinence, 52 (13.0%) had pelvic organ prolapse, and 271 (67.8%) had sexual dysfunction. The odds of pelvic floor disorder was lower in women with primary education (odds ratio (OR): 0.46; 95% confidence interval (95% CI): 0.24 to 0.86; P=0.016) and women who exercised (OR: 0.55; 95% CI: 0.35 to 0.86; P=0.009). History of vaginal delivery (OR: 2.37; 95% CI: 1.41 to 3.96; P=0.001) and having constipation (OR: 3.37; 95% CI: 1.62 to 7.00; P<0.001) significantly increased the odds of pelvic floor disorders. Conclusion: Pelvic floor disorders were common among participated women. The results of the study highlight specific risk factors in the management and prevention of pelvic floor disorders. Therefore, screening and preventive measures are suggested by health workers considering its risk factors. [ABSTRACT FROM AUTHOR]

Background: Pelvic floor disorders are often complex due to symptoms ranging from vague low back pain to major faecal incontinence and urinary incontinence. It is important to perform a dynamic study because certain abnormalities can be identified only during the straining or defaecation phase; for example, rectal prolapse or intussusception. Methods: This observational and descriptive study conducted over 18 months had included 50 patients (34 females). Cystocele was graded as mild, moderate and severe based on descent of urinary bladder below the pubococcygeal line (PCL). All of them underwent dynamic magnetic resonance imaging (MRI) of the pelvic floor. Uterine and vaginal vault prolapse was graded as mild, moderate and severe based on uterus, cervix and vaginal vault prolapse below the PCL line. Results: Their mean age was 52.4 (range 11-86) years. Cystocele was present in 59% of females and 19% of males. Urethral hypermobility seen in 6% females and 9% males. Conclusions: Dynamic MRI can be used as an important investigation before surgery to plan an appropriate surgical procedure based on grading of the pelvic organ prolapsed and involved compartment. [ABSTRACT FROM AUTHOR]

Background: Worldwide, there are regional and demographic differences in the prevalence of pelvic floor complications (PFCs) during childbirth. Pelvic floor complications have been found to occur more frequently in some studies than others, despite some studies reporting a low incidence. This systematic review and meta-analysis sought to identify which types of PFCs were seen to occur most frequently in the studies chosen, as well as to provide an updated and thorough summary of the incidence and risk factors associated with various types of PFCs during childbirth. Methods: Search terms derived from free text words and medical topic headings (MeSH) were used to comb through a number of significant web databases. The first stage in the study selection strategy involved a search using keywords related to "pelvic floor," "childbirth," "complications," and "risk factors," which originally produced 759 papers. Results: 10 studies relevant to our objectives were ultimately selected for the investigation. In majority of the studies, urinary incontinence (UIT) and anal incontinence (AIT) were found to be the most commonly occurring PFCs, with stress urinary incontinence (SUT), overactive bladder syndrome (OAB), pelvic organ prolapse (POP) being incidental in decreasing order. The meta-analysis also reported the effects of UIT to be of significant impact in the studies in which it occurred. Although one study did report the occurrence of certain depressive symptoms following childbirth, the inference obtained was not very significant. Conclusion: The findings highlight the need for further research on the prevention and management of pelvic floor complications during childbirth, particularly in relation to UIT and AIT. Clinicians should be aware of the high prevalence of these conditions and their associated risk factors (especially psychosocial and psychological health) to provide appropriate care for affected women. [ABSTRACT FROM AUTHOR]

Objective The objective of this study was to evaluate whether early postpartum exercise is associated with changes in pelvic symptom severity, pelvic floor muscle strength, and diastasis recti abdominis (DRA) from 3 to 12 months postpartum. Methods In this prospective cohort study, 504 participants with and without pelvic symptoms (pelvic girdle pain, stress urinary incontinence, vaginal heaviness) were followed. At 3, 6, 9, and 12 months postpartum, we assessed pelvic symptoms, exercise behavior (by questionnaires), pelvic floor muscle strength (by vaginal palpation), and DRA (by caliper measurement). Based on the 3-months questionnaire, participants were categorized as nonexercisers (n  = 105), minimal low-impact exercisers (n  = 249), regular low-impact exercisers (n  = 117), and high-impact exercisers (n  = 32). Between-group differences and within-group changes from 3 to 12 months were calculated using Chi-square tests, Kruskal–Wallis tests, and Friedman analysis of variance. Results At 3 months, no differences in symptom prevalence were seen between the groups. Nonexercisers reported higher pelvic girdle pain severity and had weaker pelvic floor muscles. The within-group analysis showed that pelvic girdle pain severity did not change in nonexercisers or high-impact exercisers, but decreased in minimal and regular low-impact exercisers. Stress urinary incontinence increased in nonexercisers from 3 to 12 months, while it remained unchanged in regular low-impact and high-impact exercisers, and decreased in minimal low-impact exercisers. Across all groups, vaginal heaviness and DRA decreased, and pelvic floor strength increased from 3 to 12 months. Conclusion The study indicates that early low-impact exercising is associated with reduced pelvic girdle pain severity during the first postpartum year. Minimal low-impact exercisers also showed a slight reduction in stress urinary incontinence. Conversely, nonexercisers reported an increase in stress urinary incontinence between 3 and 12 months postpartum. Impact Physical therapists should encourage women to start with low-impact exercise early after pregnancy. Lay Summary This study highlights the positive effects of starting gentle, low-impact exercise early after childbirth to reduce pelvic girdle pain and urinary incontinence. [ABSTRACT FROM AUTHOR]

Objective: To identify differences in the muscle mechanical properties of the pelvic floor (PF) and lumbar paravertebral (LP) muscles between young nulliparous and uni/multiparous women. Secondarily, specific behaviors, depending on the presence or absence or urinary incontinence (UI), were also researched. Design: Case–control study. Setting: Higher education institution. Participants: One hundred young women participated, divided into two groups depending on whether they had vaginal birth (nulliparous or uni/multiparous). Each group included women with and without UI. Main measures: A muscle mechanical properties (tone, stiffness, decrement—inverse of elasticity—, and viscoelastic properties: relaxation and creep) assessment of the PF and LP muscles were performed with a hand-held tonometer. Results: Tone and stiffness of both sides of the PF presented group by UI interaction (p < 0.05), with uni/multiparous women with UI showing higher tone and stiffness compared to multiparous women without UI. In LP muscles, uni/multiparous women showed greater tone and stiffness on the right and left sides [−2.57 Hz (95% confidence interval −4.42,−0.72) and −79.74 N/m (−143.52,−15.97); −2.20 Hz (−3.82,−0.58) and −81.30 N/m (−140.66-,21.95), respectively], as well as a decrease in viscoelastic properties compared to nulliparous women [relaxation: 2.88 ms (0.31,5.44); creep: 0.15 (0.01,0.30); relaxation: 2.69 ms (0.13,5.25); creep: 0.14 (0,0.28), respectively]. Conclusions: Vaginal birth and UI have a differential influence on the muscle mechanical properties of the PF and LP muscles. The determination of muscle mechanical properties by externally applied hand-held tonometry improves the knowledge of the lumbopelvic status, with applicability in clinical and research fields. [ABSTRACT FROM AUTHOR]

Introduction and Hypothesis: The main risk factor for pelvic floor disorders is vaginal delivery, which may cause levator ani muscle (LAM) injury and denervation. LAM includes pubovisceral muscle (PVM, pubococcygeus), puborectalis muscle (PRM), and iliococcygeus muscle. We hypothesize that primiparous women with low pelvic floor muscle contraction have a reduced PVM cross-sectional area (CSA) compared to nulliparous women. Methods (Sample Size and Statistical Approaches): This single-centre prospective observational study compared healthy nulliparous (n = 40) to primiparous (n = 40) women after vaginal delivery without LAM avulsion and Oxford score ≤ 3. Demographics, questionnaires (ICIQ-UI-SF, OAB-Q-SF, PISQ-12), POP-Q, Oxford score, ultrasound measurements (minimal anteroposterior and lateral diameters, hiatal area, PRM thickness, levator-urethra gap) and magnetic resonance imaging (MRI)—PVM CSA were evaluated. Normality was tested, and an appropriate test was used to compare the groups. Power calculation suggested 40 participants per group. Results: The primiparous group was older, had a higher BMI, and their hiatal area on ultrasound at contraction was larger compared to the nulliparous group. The CSA of the left-sided PVM (1.15 ± 0.50 cm2) was larger compared to the right side (1.03 ± 0.50 cm2), p = 0.02 in nulliparous women. The PVM CSA of primiparous women with low Oxford score was reduced compared to nulliparous (0.87 ± 0.30 versus 1.09 ± 0.50 cm2, p = 0.006). The intra-rater reliability for PVM CSA had an ICC of 0.90 and inter-rater ICC of 0.77. Conclusions: Primiparous women after vaginal delivery with low pelvic floor contraction force had reduced PVM CSA on MRI images compared to nulliparous women. [ABSTRACT FROM AUTHOR]

To determine the effectiveness of multimodal physiotherapy in an interdisciplinary setting for the treatment of women with persistent pelvic pain (PPP) who have concomitant pelvic floor tension myalgia (PFTM). Prospective cohort study with 2-year follow-up at an interdisciplinary tertiary referral centre for PPP and endometriosis. Thirty-four women with PPP of gynaecological origin >6 months duration and PFTM on examination underwent individualised physiotherapy. Outcome measures were pain, measured by Visual Analogue Scale (VAS) on a scale of 0–100, quality of life assessed by AQoL-6D score range 0.0–1.0 and sexual function measured by the Female Sexual Function Index (FSFI). Participants attended a median of 4 physiotherapy sessions (range 1–11) with the median treatment duration 7 weeks (range: 1–16 weeks). Results at 3 months demonstrated a significant decrease in VAS scores for dysmenorrhoea (72.5 vs. 52, p=.015), low back pain (55 vs. 47.5, p=.004), dyschezia (45 vs. 30.5, p=.031), abdominal pain (52 vs. 36.5, p=.049) and non-menstrual pain (53 vs. 41, p=.018) with a non-significant decrease in dyspareunia (57 vs. 50, p=.365). At 2 years, improvements in dysmenorrhoea persisted (72.5 vs. 60, p=.002) and dyspareunia was significantly improved (57 vs. 36, p=.033). For the 11/24 (46%) women who had no medical or surgical co-intervention throughout the study duration, quality of life score was improved at 2 years compared with baseline (0.72 vs. 0.84, p=.002). Physiotherapy may improve certain pain outcomes in the short and long term. It offers an additional treatment option for women with PPP. [ABSTRACT FROM AUTHOR]