A Contextual Model of Pelvic Floor Muscle Defects in Female Stress Urinary Incontinence

Madill, Stéphanie J.; McLean, Linda

doi:10.1196/annals.1389.035

Cited by 15 publications

(7 citation statements)

References 138 publications

(265 reference statements)

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“…Women with more severe SUI symptoms may have more defects or more extensive defects including tissue damage, nerve damage, and/or reduced vascularization of their urethra and/or pelvic floor, making a complete cure more difficult to attain through conservative approaches. PFMT interventions may provide some compensation for these defects [27], but may be insufficient when the defects are more severe. Bladder neck height reflects the support of the bladder and trigone, and as demonstrated by the ROC curve, bladder neck height in a quiet standing position holds most of the predictive ability of this model.…”

Section: Discussionmentioning

confidence: 99%

A model identifying characteristics predictive of successful pelvic floor muscle training outcomes among women with stress urinary incontinence

et al. 2020

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Introduction and hypothesis The aim of this study was to prospectively identify aspects of baseline demographic, clinical, and pelvic morphology of women with stress urinary incontinence (SUI) that are predictive of cure with physiotherapist-supervised pelvic floor muscle training (PFMT). Methods Women ≥18 years old with SUI were recruited from urogynecology and pelvic health physiotherapy clinics. Participants completed a 3-day bladder diary, the International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI-SF), a standardized pad test, manual assessment of pelvic floor muscle (PFM) strength and tone, and transperineal ultrasound (TPUS) assessment of their urogenital structures at rest while in a supine position and standing, and during contraction, straining, and coughing. Participants attended six physiotherapy sessions over 12 weeks and performed a home PFMT program. The assessment was repeated after the intervention; cure was defined as a dry (≤2 g) pad test. Results Seventy-seven women aged 50 (±10) years completed the protocol; 38 (49%) were deemed cured. Based on univariate testing, four predictors were entered into a binary logistic regression model: ICIQ-UI-SF, PFM tone, bladder neck (BN) height in a quiet standing position, and BN height during a cough in a standing position. The model was significant (p < 0.001), accurately classifying outcome in 74% of participants. The model, validated through bootstrapping, performed moderately, with the area under the receiver operating characteristic curve = 0.80 (95% CI: 0.69–0.90; p = 0.00), and with 70% sensitivity and 75% specificity. Conclusions Women with better bladder support in a standing position and less severe symptoms were most likely to be cured with PFMT. Clinical trial registration #NCT01602107.

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Section: Discussionmentioning

confidence: 99%

A model identifying characteristics predictive of successful pelvic floor muscle training outcomes among women with stress urinary incontinence

et al. 2020

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“…As primíparas submetidas à cesariana ficaram protegidas do desenvolvimento do SU após quatro meses do pós-parto, se comparadas às que foram submetidas ao parto vaginal 25 , embora não haja evidências conclusivas de que a cesariana diminui o risco do surgimento de disfunções miccionais quando precedida de trabalho de parto 26 .…”

Section: Discussionunclassified

[Id 32401] Sintomas Urinários Em Primíparas De Parto Normal E Cesárea

Siqueira¹,

Souto²,

Rodrigues³

et al. 2019

RBCS

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Objetivo: correlacionar os sintomas urinários em primíparas de parto normal e cesárea. Métodos: foi realizado um estudo observacional analítico do tipo transversal realizado com 98 primíparas, sendo 57 (58,16%) de parto cesárea e 41 (41,84%) de parto normal, com idade de 18 a 35 anos, realizado no Centro de Saúde Escola do Marco na cidade de Belém - PA. Os dados foram coletados através de questionários referentes aos sintomas urinários. A análise estatística foi feita com aplicação do Teste Exato de Fisher com índice de significância de 5% pelo programa Spss 20 e com o estudo de prevalência. Resultados: Esse estudo mostrou que as primíparas de parto normal têm maior chance de apresentar algum sintoma urinário em relação às que tiveram parto cesárea, sendo os sintomas mais frequentes a noctúria, com 22,81% nas primíparas de parto cesárea e a urge-incontinência, com 31,71% nas primíparas de parto normal. Conclusão: dessa maneira, conclui-se que ao analisar à amostra individualmente, as primíparas de parto normal teriam maior chance de apresentarem algum sintoma urinário, porém, ao relacionar esses sintomas com a paridade, os resultados apresentados foram insignificantes, ou seja, independente da via de parto, essas primíparas podem apresentar algum sintoma urinário.

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“…The defects leading to stress urinary incontinence can be summarized into 4 categories: (1) increased tonic stress on the pelvic floor fascia due to pelvic floor muscle tears; (2) fascial tearing due to pelvic floor muscle denervation; (3) fascial weakness resulting from tears; and (4) inefficient pelvic floor muscle contraction due to altered motor control. 7 Treatment for SUI should start with physical therapy to strengthen the pelvic floor muscles. 8,9 Pelvic floor muscle training should begin before women develop SUI.…”

Section: Conditions Associated With Pfmdmentioning

confidence: 99%

Pelvic Floor Muscle Dysfunction

Finamore¹,

Goldstein²,

Whitmore³

2008

Journal of Pelvic Medicine and Surgery

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Pelvic floor muscle dysfunction is a problem that affects women of all ages. The disorder can present as chronic pelvic pain, dyspareunia, rectal pain, chronic constipation, lower back pain, and a wide array of other complaints. As a result of the various presenting symptoms, patients with pelvic floor muscle dysfunction are seen by a variety of health care workers, including obstetrician-gynecologists, urogynecologists, urologists, colorectal surgeons, orthopedic surgeons, physical therapists, chiropractors, pain management specialists, psychotherapists, and others. The purpose of this review is to discuss the etiology, symptomatology, associated conditions, diagnostic tools, and treatment options for this condition.The supportive function of the female pelvic floor is generally achieved by a combination of multiple components working together in a highly coordinated, specialized fashion. This intricate unit is made up of bones, ligaments, muscles, connective tissue, visceral organs, nerves, and vessels. These components are involved in a wide variety of functions that range from simple acts, such as sitting, standing, and walking to more complicated ones, such as child birth, micturition, and defecation. The dynamic capacity of the pelvic floor can be traumatized by a number of events and this can lead to pelvic floor dysfunction. It is important to review the anatomy and function of the pelvic floor, and recognize potential causes for damage and options for treatment when there is dysfunction. ANATOMY BonesThe bony pelvis provides the scaffolding to which the supportive tissues attach. The bones of the pelvis include the pubic bone, the ilium, and the ischium. Ligaments, muscles, fascia, and tendons attach to various parts of the pelvic bones including the ischial spines, rami and tuberosities, the iliac spines, the pubic rami, the sacrum, and the coccyx. The femur is attached to the pelvis via the obturator internus and the piriformis muscles. MusclesThe deep striated muscles of the pelvic floor are made up of the levator ani group that includes the puborectalis, pubococcygeus, and ileococcygeus. The coccygeus, piriformis, and obturator internus muscles also contribute to the pelvic floor. There are smooth muscles that are part of the sphincter mechanism for the urethra and rectum that also contribute to the pelvic floor. 1 Finally, there are superficial muscles such as the bulbospongiosus, ischiocavernosus, and the deep and superficial transverse perinei muscles. 2 These superficial muscles unite at the perineal body, an important component of the pelvic floor.

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A Contextual Model of Pelvic Floor Muscle Defects in Female Stress Urinary Incontinence

Cited by 15 publications

References 138 publications

A model identifying characteristics predictive of successful pelvic floor muscle training outcomes among women with stress urinary incontinence

A model identifying characteristics predictive of successful pelvic floor muscle training outcomes among women with stress urinary incontinence

[Id 32401] Sintomas Urinários Em Primíparas De Parto Normal E Cesárea

Pelvic Floor Muscle Dysfunction

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