Aims
The impact of CrossFit (high energy and intensity exercise) on SUI has not been well described. This study evaluates the incidence of SUI in physically active women, and examines specific exercises that can increase SUI.
Methods
A cross‐sectional study was conducted in women from four CrossFit centers and one aerobic center for comparison. Participants were surveyed regarding baseline demographics, activity levels, severity, and frequency of leakage during CrossFit exercises as well as preventative strategies against SUI. Participants were stratified based on age, body mass index, types of exercises, parity, delivery, and compared using Mann Whitney‐U and Chi square.
Results
This study had 105 CrossFit (mean = 36.9 years) and 44 aerobic (mean = 29.0 years) participants. Fifty women reported SUI during exercises, while none of the aerobic women reported SUI during exercise. The top three CrossFit exercises associated to SUI were double‐unders (47.7%), jumping rope (41.3%), and box jumps (28.4%). CrossFit women with a history of parity had significantly more episodes of SUI with box jumps, jumping rope, double‐unders, thrusters, squats without weights, squats with weights, and trampoline jumping (P < 0.001). The top preventative strategies were emptying the bladder before workouts, wearing dark pants, and performing Kegel exercises during workout. Vaginal delivery (OR 4.94) and total incontinence symptom severity index (OR 1.45) were both significant predictors of SUI during exercise (P < 0.05).
Conclusion
There is a significantly higher risk of SUI during CrossFit exercises associated with previous pregnancy and vaginal delivery but also in nulliparous women. In general, women participating in CrossFit have been applying preventative measures for protection of SUI during exercises.
This study was based upon a dissection of the pelvic fasciae and associated structures of one hundred and three adult pelves as well as those of three full term fetuses. The perineal fasciae and their neural and vascular relationships were studied in a n additional 55 specimens.The uterovaginal fascia, as stated by others, is a well-defined structure. One is usually able, on the basis of a fascial cleft, to distinguish readily between the fascial sheath of rectum proper and the deeper layer of subperitoneal fascia, called by some the presacral fascia. The latter is described, including the relationship of the pelvic autonomics thereto. The relationship of the vesical branches of the pelvic plexus and of the venous plexuses to the terminal ureter are also described.We were able to confirm the presence of a superficial and a deep perineal fascia; the latter forms the inferior boundary of the superficial perineal space proper, as described by others. The relationship of particular nerves (and vessels) to the fascial planes of the perineum follows a definite pattern even when variation from the normal is present.
To evaluate the effect of different surgical procedures on bowel function in women with pelvic organ prolapse (POP).METHODS: Adult women enrolled in a prospective POP database between 2008 and 2014 were reviewed. Baseline (BL) data and outcomes at one year after enrollment (1yr) were collected including the Colorectal-Anal Distress Inventory-8 (CRADI). Patients were grouped by having surgery (SGY) within the first year or no surgery (N-SGY) and compared. Sub-analyses of the SGY group were then performed by surgical approach (vaginal (Va) or abdominal (Ab)), with or without concurrent hysterectomy (HYS vs N-HYS), placement of mesh (mesh vs N-mesh), and concurrent posterior repair (POS vs N-POS). Data were analyzed with descriptive statistics, Chi-square tests, Fisher's exact tests, paired t-tests, and Wilcoxon rank sum tests.RESULTS: Of 274 prolapse patients, there were 230 in the SGY group and 44 in the N-SGY group. No significant differences in age, race or marital status was found between the SGY and N-SGY groups. 24.8% (57/230) of total surgery patients underwent a concurrent posterior repair (POS); all were done vaginally. For the SGY vs. N-SGY groups, CRADI scores were similar at BL and at 1yr, with intragroup comparisons showing a significant decrease in CRADI for SGY but not N-SGY (p < 0.0001 and p ¼ 1.00).When comparing the Va vs. Ab approach and mesh vs. N-mesh, there were no differences in BL nor 1yr CRADI scores. When comparing HYS to N-HYS, BL CRADI was significantly lower for HYS but there was no difference at 1yr. (see Table ) 40.1% (57/142) of the vaginal group had a concurrent rectocele repair (POS). When comparing POS to N-POS, BL CRADI was higher but CRADI at 1yr was not different.All surgical treatment groups had statistically significant CRADI improvement within group, from BL to 1yr, including those without posterior repair.CONCLUSIONS: Women who underwent surgical repair for prolapse had significantly improved CRADI scores regardless of abdominal or vaginal approach, with or without concurrent posterior repair, hysterectomy or mesh use.
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