Pelvic floor myofascial pain in patients with symptoms of urinary tract infection

Abstract

Objective To correlate lower urinary tract symptoms typically associated with a urinary tract infection (UTI) with physical examination findings of pelvic floor myofascial pain (PFMP). Methods This retrospective review included all new patients presenting to a urogynecology clinic between August 2 and December 19, 2016. Patients completed validated questionnaires, had a catheterized urine specimen, and underwent pelvic examination. Associations between demographics, symptoms, urine culture, and PFMP were analyzed. Results We included 250 patients with urinary frequency (n=160, 64.0%), urgency (n=155, 62.0%), urgency incontinence (n=140, 56.0%), pelvic pain (n=43, 17.2%), and dysuria (n=25, 10.0%). PFMP was detected in 125 (50.0%) patients and culture‐proven UTI in 15 (6.0%) patients. Demographics associated with PFMP were lower prolapse stage (P<0.001), age younger than 50 years (P<0.001), lower parity (P=0.028), and non‐white ethnicity (P=0.003). Symptoms associated with PFMP were dysuria (adjusted odds ratio 4.13, 95% confidence interval 1.08–15.78), urgency/frequency (2.72, 1.47–5.04), and patient‐reported pelvic pain (2.57, 1.08–6.12). These symptoms were independent predictors in multivariable logistic regression analysis. Conclusions Most patients had symptoms associated with UTI; however, culture‐confirmed diagnosis was infrequent and PFMT was diagnosed in half of participants. Clinicians treating women with these symptoms are advised to examine the pelvic floor muscles.

Stress Urinary Incontinence Among Young Nulliparous Female Athletes

“…A recent study found stronger pelvic muscles in athletes with UI than without UI [20]. It may be due to solid pelvic muscles that fail to relax fully and increase stress leading to increased urinary frequency and eventually UI [30]. In the past, jumping was thought to have the highest prevalence for UI since it is a significant factor for PFM weakening [1].…”

The Case for Comorbid Myofascial Pain—A Qualitative Review

“…Pelvic pain and dysuria are commonly associated with MPS [ 94 ]. In a retrospective study of 250 women presenting with symptoms of urinary tract infection, 50% were found to have pelvic MPS, but only 6% had positive urine cultures [ 95 ]. This observation suggests that irritative urinary symptoms may be associated with MPS and that, in some cases, pelvic MPS can accompany urinary tract infections.…”

Diagnosis and treatment of chronic pelvic pain syndrome

“…Также пациенты могут сообщать о диспареунии, нарушениях мочеиспускания, запорах, боли в вульве, влагалище, прямой кишке, ягодицах или бедрах. При этом данные симптомы не зависят от локализации триггерной точки [18]. Большинство пациентов с МФБС мышц промежности описывают боль как самопроизвольно исчезающую, длящуюся от 30 с до нескольких часов.…”