Influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions

Murad-Regadas, Sthela Maria; Regadas, Francisco Sérgio Pinheiro; Rodrigues, Lusmar Veras; Furtado, D. C.; Gondim, A. C.; Dealcanfreitas, Iris Daiana

doi:10.1590/s0004-28032011000400009

Cited by 12 publications

(9 citation statements)

References 31 publications

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“…The presence of rectal intussusception was more common in older women in this study, supporting the results of the previous study [8]. Hawskin., et al [27] assessed 147 patients with OD who underwent defecography and showed that the patients with rectal intussusception were significantly older than those without rectal intussusception.…”

Section: Discussionsupporting

confidence: 92%

“…However, the relation between age, vaginal delivery, and posterior pelvic floor disorders involving obstructed defecation syndrome (ODS) is a matter of controversy [3][4][5]. The influence of aging or vaginal delivery on such disorders has been described in the previous studies [3,6,7], but others have failed to identify the associations between childbirth and such disorders [4,8].…”

Section: Introductionmentioning

confidence: 99%

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Effect of Pelvic Floor Descent on Posterior Pelvic Floor Disorders in Women with Obstructed Defecation Syndrome

Tsunoda¹,

Takahashi²,

Kusanagi³

2020

Act Sci wom hea

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Background:The relation between age, parity, and posterior pelvic floor disorders involving obstructed defecation syndrome (ODS) is a matter of controversy. This study aimed to determine the effect of pelvic floor descent (PFD) on the prevalence of posterior pelvic floor disorders in women with ODS.Methods: Data for women with ODS, collected in a prospective pelvic floor database, and were assessed retrospectively. Data on demographic variables and defecography were analyzed. PFD during defecation was estimated by the degree of the anorectal junction in relation to the inferior margin of the ischial tuberosity.Results: Of 334 women with ODS, the most frequently detected defecographic abnormalities were rectal intussusception (58%) and rectocele (45%). Regression analysis showed that the presence of rectocele and enterocele was more common in women with increased PFD. A higher incidence of rectocele and enterocele was found in women with excessive PFD (≧ 30 mm) than those without excessive PFD [58% (68/118) vs. 37% (77/209), P < 0.0001; 23% (27/118) vs. 14% (29/209), P = 0.038, respectively]. Increasing size of rectocele was significantly associated with increasing PFD. There were no significant differences in the prevalence of various posterior pelvic floor disorders between nulliparous and parous women. Conclusions:The prevalence of both rectocele and enterocele increased significantly with increasing PFD in women with ODS, but the incidence of rectal intussusception showed no such relationship.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Effect of Pelvic Floor Descent on Posterior Pelvic Floor Disorders in Women with Obstructed Defecation Syndrome

Tsunoda¹,

Takahashi²,

Kusanagi³

2020

Act Sci wom hea

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“…We found a limited number of in vivo research publications about the changing of vaginal tissue elasticity with the age. 29 , 30 , 31 In general, our findings fit with previous observations of vaginal tissue properties with age. Previously, we found that in the midposterior region of the vagina, the average values of the Young modulus decreased with age from 13.1 ± 7.8 to 6.1 ± 3.0 kPa; in apical posterior compartments, the average value of the Young modulus was 13.2 ± 3.1 kPa for a 28- to 35-year-old group and 3.0 ± 1.5 kPa for a 76- to 90-year-old group.…”

Section: Discussionsupporting

confidence: 92%

Quantitative Assessment and Interpretation of Vaginal Conditions

et al. 2017

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IntroductionFew means exist to provide quantitative and reproducible assessment of vaginal conditions from biomechanical and functional standpoints.AimTo develop a new approach for quantitative biomechanical characterization of the vagina.MethodsVaginal tactile imaging (VTI) allows biomechanical assessment of soft tissue and function along the entire length of the anterior, posterior, and lateral vaginal walls. This can be done at rest, with applied vaginal deformation, and with pelvic muscle contraction.ResultsData were analyzed for 42 subjects with normal pelvic floor support from an observational case-controlled clinical study. The average age was 52 years (range = 26–90 years). We introduced 8 VTI parameters to characterize vaginal conditions: (i) maximum resistance force to insertion (newtons), (ii) insertion work (millijoules), (iii) maximum stress-to-strain ratio (elasticity; kilopascals per millimeter), (iv) maximum pressure at rest (kilopascals), (v) anterior-posterior force at rest (newtons), (vi) left-right force at rest (newtons), (vii) maximum pressure at muscle contraction (kilopascals), and (viii) muscle contraction force (newtons). We observed low to moderate correlation of these parameters with subject age and no correlation with subject weight. 6 of 8 parameters demonstrated a P value less than .05 for 2 subject subsamples divided by age (≤52 vs >52 years), which means 6 VTI parameters change with age.ConclusionsVTI allows biomechanical and functional characterization of the vaginal conditions that can be used for (i) understanding “normal” vaginal conditions, (ii) quantification of the deviation from normality, (iii) personalized treatment (radiofrequency, laser, or plastic surgery), and (iv) assessment of the applied treatment outcome.Egorov V, Murphy M, Lucente V, et al. Quantitative Assessment and Interpretation of Vaginal Conditions. Sex Med 2018;6:39–48.

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“…The results of our study are compatible with a report from Brazil. Murad-Regadas and collogues showed no correlation between the delivery mode and parity with the prevalence of rectocele, intussusceptions and anismus in females with ODS ( 14 ).…”

Section: Discussionmentioning

confidence: 87%

Obstructed Defecation Syndrome After Delivery Trauma

Mehrvarz¹,

Towliat²,

Mohebbi³

et al. 2015

Trauma Mon

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Background:Obstructed defecation syndrome (ODS) occurs in about 7% of adults; it seems that the etiology of pelvic floor disorders is multifactorial. Pregnancy and childbirth damage to the pelvic nerve and muscles are proposed causes for this condition. The precise role of vaginal delivery (VD) is not clearly defined, although in recent studies association of pelvic floor disorder with Operative vaginal delivery and episiotomy has been proposed.Objectives:In this prospective study, we assessed the outcome of stapled transanal rectal resection (STARR) in females with one of the two modes of delivery (VD or caesarean section (C/S).Patients and Methods:We used Longo’s ODS score for the assessment of the severity of pelvic floor malfunction. Stapled Trans Anal Rectal Resection (STARR) procedure was performed using two circular staplers. Follow-up was done 12 months after the discharge. To assess the role of episiotomy in patient with VD, we divided them into two subgroups; females who had VD with episiotomy (Vd + epi) and females who had VD alone. Data were analyzed using SPSS version 20 software. P values less than 0.05 were considered statistically significant.Results:In 30 consecutive females undergoing STARR for the treatment of ODS, who enrolled in this prospective study, 19 (63.3%) had Vaginal Delivery VD and 11 (36.7%) had Cesarean Section (C/S). The ODS score before the surgery was higher in females who had C/S, although there was no significant difference between VD and C/S groups in terms of the percentage of the ODS score improvement after the STARR surgery.Conclusions:Higher ODS score in females who had C/S showed that C/S could not protect the pelvic organ from pregnancy and delivery trauma. It seems that episiotomy has a protective effect during VD; it can reduce the severity of trauma in pelvic organs during childbearing.

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Influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions

Cited by 12 publications

References 31 publications

Effect of Pelvic Floor Descent on Posterior Pelvic Floor Disorders in Women with Obstructed Defecation Syndrome

Effect of Pelvic Floor Descent on Posterior Pelvic Floor Disorders in Women with Obstructed Defecation Syndrome

Quantitative Assessment and Interpretation of Vaginal Conditions

Obstructed Defecation Syndrome After Delivery Trauma

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