This preliminary study suggests that pelvic floor muscle training, with and without biofeedback, is associated with increased muscle strength, myoelectric activity, precontraction of pelvic floor muscles, and improved quality of life in postmenopausal women with stress urinary incontinence.

Background: Pelvic floor muscles (PFM) and rectus abdominis muscles (RAM) of pregnant diabetic rats exhibit atrophy, co-localization of fast and slow fibers and an increased collagen type I/III ratio. However, the role of similar PFM or RAM hyperglycemic-related myopathy in women with gestational diabetes mellitus (GDM) remains poorly investigated. This study aims to assess the frequency of pelvic floor muscle disorders and pregnancy-specific urinary incontinence (PS-UI) 12 months after the Cesarean (C) section in women with GDM. Specifically, differences in PFM/ RAM hyperglycemic myopathy will be evaluated. Methods: The Diamater is an ongoing cohort study of four groups of 59 pregnant women each from the Perinatal Diabetes Research Centre (PDRC), Botucatu Medical School (FMB)-UNESP (São Paulo State University), Brazil. Diagnosis of GDM and PS-UI will be made at 24-26 weeks, with a follow-up at 34-38 weeks of gestation. Inclusion in the study will occur at the time of C-section, and patients will be followed at 24-48 h, 6 weeks and 6 and 12 months postpartum. Study groups will be classified as (1) GDM plus PS-UI; (2) GDM without PS-UI; (3) Non-GDM plus PS-UI; and (4) Non-GDM without PS-UI. We will analyze relationships between GDM, PS-UI and hyperglycemic myopathy at 12 months after C-section. The mediator variables to be evaluated include digital palpation, vaginal squeeze pressure, 3D pelvic floor ultrasound, and 3D RAM ultrasound. RAM samples obtained during C-section will be analyzed for ex-vivo contractility, morphological, molecular and OMICS profiles to further characterize the hyperglycemic myopathy. Additional variables to be evaluated include maternal age, socioeconomic status, educational level, ethnicity, body mass index, weight gain during pregnancy, quality of glycemic control and insulin therapy. Discussion: To our knowledge, this will be the first study to provide data on the prevalence of PS-UI and RAM and PFM physical and biomolecular muscle profiles after C-section in mothers with GDM. The longitudinal design allows for the assessment of cause-effect relationships between GDM, PS-UI, and PFMs and RAMs myopathy. The findings may reveal previously undetermined consequences of GDM.

The aim of this narrative review was to determine effects of whole body vibration exercises (WBVE) on the pelvic floor muscle (PFM) of healthy and unhealthy individuals. Searches were performed in the databases PubMed, Scopus, Science Direct and PEDRo. The level of evidence and methodological quality of the selected papers were determined. It was included six studies with a total of 189 participants (95.76% women) with ages ranging from 18 to 68 years. It was reported that WBVE: (I) improves the PFMs strength and quality of life (QOL) in individuals with urinary incontinence; (II) does not cause (PFM) fatigue in nulliparous continent women; (III) leads to higher (PFM) activation in subjects with weakened (PFM) and achieves higher pelvic floor (PF) activation than maximum voluntary contraction alone; (IV) in an individual with postprostatectomy stress urinary incontinence (SUI), over a period of 6 weeks after starting treatment, the patient regained continence (usage of 1 safety pad) and (V) has a significant effect on the electromyographic response and additionality and the rating of perceived exertion (RPE) significantly increased with increased frequency of the mechanical vibration. Relevant findings are presented and demonstrated that the WBVE might be highly relevant to the management of clinical disorders of the (PFM).Nevertheless, this intervention must be more understood and known to be used in the management of individuals with impairment of the (PFM) and there is the necessity of more research in this area.

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Objetivo: Verificar a literatura acerca das disfunções do assoalho pélvico promovidas pela radioterapia após o tratamento de carcinoma de colo uterino. Métodos: Revisão integrativa da literatura, na qual foi feita uma verificação de bibliografias publicadas nas bases de dados Pubmed, Scielo, Portal Capes, Lilacs, Cochrane, PEDro e Medline, no período de 2010 a 2021. As palavras-chave utilizadas foram “disfunções”, “assoalho pélvico”, “radioterapia” e “neoplasias do colo do útero” e suas correlatas na língua inglesa e espanhola. Resultados: No final da análise, sete estudos foram incluídos por se adequarem aos critérios da pesquisa, em que foi verificado que as disfunções pélvicas mais relatadas na literatura após a radioterapia para tratamento de câncer de colo de útero são a dispareunia e a incontinência urinária. Considerações finais: Foi possível inferir que esse tipo de intervenção traz inúmeros impactos para o assoalho pélvico, com destaque para a incontinência urinária e a dispareunia. Sugere- a inserção de forma mais ampla de atividades de recuperação através da fisioterapia para as alterações decorrentes desse tipo de tratamento, visando a melhora da funcionalidade dos músculos do assoalho pélvico e redução das alterações pélvicas, que trazem complicações no bem-estar físico e psicológico dessa população.