Menopause is associated with impaired responsiveness of involuntary pelvic floor muscle contractions to sudden intra‐abdominal pressure rise in women with pelvic floor symptoms: A retrospective study

Huang, Wen Chen; Yang, Jenn Ming

doi:10.1002/nau.23433

Cited by 9 publications

(16 citation statements)

References 27 publications

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“…Aging and menopause have been linked to continuous loss of PFM mass and reduced contraction strength and velocity, as with other skeletal muscles. More specifically, menopause is associated with increased LH diameters and impaired PFM contractions in response to sudden rises in intra‐abdominal pressure 25,26 . Therefore, one would expect that older women would present minor if any long‐term effects of PFM training.…”

Section: Discussionmentioning

confidence: 99%

Pelvic floor morphometrical and functional changes immediately after pelvic floor muscle training and at 1‐year follow‐up, in older incontinent women

Cacciari

Morin

Mayrand

et al. 2020

Neurourology and Urodynamics

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Aims: To compare the effects of group-based and individual physiotherapy for stress or mixed urinary incontinence (UI) on pelvic floor morphometry, pelvic floor muscle (PFM) function, and related self-efficacy, immediately after treatment and at 1 year. Methods: This is a planned secondary analysis of the group rehabilitation or individual physiotherapy study, an assessor-blinded, randomized, noninferiority trial. Eligible participants included 362 community-dwelling older women with symptoms of stress/mixed UI. After learning how to contract PFMs, participants completed 12 weeks of PFM training, either individually (one-on-one) or as part of a group (eight women). Pelvic floor transperineal ultrasound volumes (morphometry), PFM intravaginal dynamometric data (function), and self-efficacy in performing PFM exercises were acquired at baseline, posttreatment, and at 1 year. Results: Groups were comparable at all time points. Immediately posttreatment, both groups demonstrated significant changes in pelvic floor morphometry during coughs, and in PFM function during contractions and coughs. Participants also reported improved self-efficacy in performing PFM exercises. Results were sustained at 1 year. When participants coughed, pelvic floor structures were better supported (reflected by less caudal movement of the puborectalis sling and a smaller opening of the levator hiatus) in a pattern consistent with the "knack" strategy. Furthermore, both interventions resulted in stronger, faster, more coordinated, and more endurant PFMs. Conclusion: In older women with stress or mixed UI, both individual and group-based PFM training resulted in comparable improvements in overall PFM function, pelvic floor morphometry during coughs, and related selfefficacy in performing PFM exercises, which were sustained at 1 year.

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Section: Discussionmentioning

confidence: 99%

Pelvic floor morphometrical and functional changes immediately after pelvic floor muscle training and at 1‐year follow‐up, in older incontinent women

Cacciari

Morin

Mayrand

et al. 2020

Neurourology and Urodynamics

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“…The resting, coughing, and squeezing 4D ultrasound volumes were stored on digital video discs. Post-processing analysis was performed using the QLAB 6.0 (Philips Medical Systems) software programs [8,9] later by another investigator (JMY) blinded to the clinical information.…”

Section: Methodsmentioning

confidence: 99%

“…In the midsagittal plane, the genitohiatal size was evaluated in the polar coordinate system [23] via the distance between the anorectal reflection and the lower border of the symphysis pubis (genitohiatal dimension, GHd), and the genitohiatal location was evaluated via the angle between the anorectal reflection-sym-physeal line and the midline of the pubic symphysis (genitohiatal angle, GHa) [9]. Additionally in the axial plane, the genitohiatal area (GHAR) was assessed to estimate the genitohiatal area at the plane of minimal hiatal dimensions [9]. The GHAR was defined as the area surrounded by the most medial part of the pubovisceral muscle, inferior pubic ramus, and symphysis pubis (▶ Fig.…”

Section: Methodsmentioning

confidence: 99%

“…The presence of involuntary PFM function was determined by a stable bladder neck location, genitohiatal size, or genitohiatal location during coughing, which were respectively defined as no caudal bladder neck displacement (indicated by no BNd decrease or no BNa increase), no genitohiatal enlargement (indicated by no increase in GHd and GHAR), or no caudal genitohiatal displacement (indicated by no GHa increase) from resting to coughing on ultrasound (▶ Fig. 3b, ▶ Video 1) [8,9,24]. Capable voluntary PFM contraction was defined as cranioventral movement of the bladder neck or genital hiatus during squeezing on ultrasound (▶ Fig.…”

Section: Methodsmentioning

confidence: 99%

“…A PFM contraction results in cranioventral movement of pelvic and peritoneal structures as well as closure of the urethra, vagina, and anorectum [8][9][10]. Both involuntary and voluntary PFM contractions are required to support the pelvic floor during increased intraabdominal pressure [10].…”

Section: Zusammenfassung Ziel Die Forschung üBer Den Einsatz Von Ultraschall Zurmentioning

confidence: 99%

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Four-Dimensional Introital Ultrasound in Assessing Perioperative Pelvic Floor Muscle Functions of Women with Cystoceles

2020

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Purpose Research on the use of ultrasound to explore the pelvic floor in women is rarely done with introital ultrasound. This study aimed to investigate the performance of four-dimensional (4D) introital ultrasound in the perioperative assessment of pelvic floor muscle (PFM) function in women with cystocele. Materials and Methods The reliability and agreement of ultrasound measurements were determined by intraclass correlation coefficients (ICC) with 95 % confidence interval and Bland-Altman analysis in 20 women. The validity of ultrasound parameters was assessed by correlating squeezing ultrasound measurements with the modified Oxford scale (MOS) in 317 women. 4D introital ultrasound data of 241 women with (n = 29) and without (n = 212) postoperative cystocele at the 12-month postoperative assessment were retrospectively analyzed. Levator avulsion was diagnosed using tomographic ultrasound imaging. Involuntary and voluntary PFM functions were explored by dynamic changes in the bladder neck and genital hiatus, respectively, upon coughing and squeezing on 4D introital ultrasound. Results The ICC for the reliability of all tested ultrasound parameters was good to very good. The changes and change ratios of most ultrasound measurements from resting to squeezing were fairly correlated with MOS. Women with postoperative cystocele demonstrated more rates of complete levator avulsion [41.3 % vs. 4.7 %, P < 0.001, odds ratio (OR) 14.26, 95 % confidence interval (CI) 4.88–42.42] and fewer rates of capable voluntary PFM contraction (65.5 % vs. 92.5 %, P < 0.001, OR 0.16, 95 % CI 0.06–0.43) than those without postoperative cystocele postoperatively. Conclusion 4D introital ultrasound is feasible to assess perioperative PFM function in women with cystocele.

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Evidence-Based Women’s Health Physical Therapy Across the Lifespan

Badillo¹

2020

Curr Phys Med Rehabil Rep

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Menopause is associated with impaired responsiveness of involuntary pelvic floor muscle contractions to sudden intra‐abdominal pressure rise in women with pelvic floor symptoms: A retrospective study

Abstract: For women with pelvic floor symptoms, menopause is associated with impaired responsiveness of involuntary PFM contractions to sudden intra-abdominal pressure rise but not with voluntary PFM contractions.

Cited by 9 publications

References 27 publications

Pelvic floor morphometrical and functional changes immediately after pelvic floor muscle training and at 1‐year follow‐up, in older incontinent women

Pelvic floor morphometrical and functional changes immediately after pelvic floor muscle training and at 1‐year follow‐up, in older incontinent women

Four-Dimensional Introital Ultrasound in Assessing Perioperative Pelvic Floor Muscle Functions of Women with Cystoceles

Evidence-Based Women’s Health Physical Therapy Across the Lifespan

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