Questionnaires to evaluate pelvic floor dysfunction in the postpartum period: a systematic review

Abstract

BackgroundPelvic floor dysfunctions (PFDs) affect the female population, and the postpartum period can be related to the onset or aggravation of the disease. Early identification of the symptoms and the impact on quality of life can be achieved through assessment instruments.ObjectiveThe purpose of this systematic review is to evaluate questionnaires used to assess PFD in the postpartum period.MethodsA systematic review study was conducted, following Preferred Reporting Items for the Systematic Reviews and Meta-Analyses (PRISMA) criteria, using the databases: PubMed, Biblioteca Virtual de Saúde (BVS), Web of Science, and Scopus, and the keywords PFD or pelvic floor disorders, postpartum or puerperium, and questionnaire. Articles published up till May 2018 were included, searching for articles using validated questionnaires for the evaluation of PFDs in postpartum women. The articles included were evaluated according to a checklist, and the validation studies and translated versions of the questionnaires were identified.ResultsThe search of the databases resulted in 359 papers, and 33 were selected to compose this systematic review, using nine validated questionnaires to assess PFDs in the postpartum period: International Consultation on Incontinence Questionnaire – Vaginal Symptoms (ICIQ-VS), Pelvic Floor Distress Inventory 20 (PFDI-20), Pelvic Floor Impact Questionnaire (PFIQ-7), PFDI-46, Pelvic Floor Impact Questionnaire (PFIQ-31), Pelvic Floor Bother Questionnaire (PFBQ), Female Pelvic Floor Questionnaire, electronic Personal Assessment Questionnaire – Pelvic Floor, and PFD questionnaire specific for pregnancy and postpartum. The most frequently reported questionnaires included PFDI-20, PFIQ-7, and ICIQ-VS and are recommended by ICI. In addition, the review identified a specific questionnaire, recently developed, to access PFD during pregnancy and postpartum.ConclusionThe questionnaires used to evaluate PFD during postpartum period are developed for general population or urology/gynecology patients with incontinence and reinforce the paucity of highly recommended questionnaires designed for postpartum, in order to improve early and specific approach for this period of life.

A Comparative Study on the Effects of High-Intensity Focused Electromagnetic Technology and Electrostimulation for the Treatment of Pelvic Floor Muscles and Urinary Incontinence in Parous Women: Analysis of Posttreatment Data

“…This serves as a powerful tool for the practitioners when used in combination with some objective evaluation (magnetic resonance, ultrasound imaging, or electromyography). 21 , 22 Especially, the 3-dimensional (3D) transperineal ultrasonography of the pelvic floor has become widely used due to its ability to promptly assess essential parameters of pelvic floor integrity. 23 , 24 …”

Urogynecology in obstetrics: impact of pregnancy and delivery on pelvic floor disorders, a prospective longitudinal observational pilot study

“…To avoid using several different validated questionnaires to cover the questions of interest, we decided to use two individualized none-validated questionnaires in contrast to other authors [ 48 ]. In addition, Zuchelo et al [ 52 ] postulated that validated questionnaires are developed for women with incontinence and are not suitable for the postpartum period. They recommended new designed questionnaires to improve early and specific approach for this period of life.…”

Translation, cultural adaptation, and validation and reliability of assessment of pelvic floor disorders and their risk factors during pregnancy and postpartum questionnaire in Turkish population

“…Pelvic floor dysfunction after birth is usually accepted as a "normal" situation that patients do not discuss with their healthcare professionals. So, it is underestimated and not well evaluated unless adressing the symptoms [14].…”