Overall the findings suggest some important differences in the characteristics of women with primary versus secondary PVD which may have management-related implications.

Background: Diastasis Recti Abdominis (DRA) can occur during pregnancy and postpartum. It is defined as an increase of the inter-recti distance (IRD) beyond normal values. The diagnosis of DRA is inconsistent within the literature and varies depending on measurement instrument and activity during measurement (rest versus active curl-up). DRA is characterized by the stretching of linea alba (LA) and contributes to a protrusion of the anterior abdominal wall due to increased laxity in the myofascial system that supports abdominal viscera. DRA has been postulated to affect lumbopelvic support and function due to laxity of the LA and altered angle of muscle insertion, but recent studies have not confirmed this. Risk factors for the development of DRA have been investigated in pregnancy to 12-months postpartum. Objective: Rehabilitation for DRA has been traditionally focused on reducing the IRD, but recent research has proposed that a sole focus on closing the DRA is suboptimal. Results: It is important alongside the rehabilitation of the abdominal wall that there is the consideration of the pelvic floor (PF). In healthy individuals, with the activation of the transversus abdominis, there is a sub-maximal co-contraction of the PF muscles. This co-contraction can be lost or altered in women with urinary incontinence. An increase in intra-abdominal pressure without simultaneous co-contraction of the PF may cause caudal displacement of the PF. Conclusion: The aim of this review is to bring the reader up to date on the evidence on DRA and to propose a rehabilitation framework for the whole abdominal wall in DRA with consideration of the impact on the PF.

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Introduction Pelvic floor surface electromyography (sEMG) is often used in the assessment and treatment of individuals with pelvic floor abnormalities to measure muscle tone and neural control of the pelvic floor muscles (PFM); however, little is known about the role of the PFM in sexual arousal. Aim The aim of this pilot study was to examine whether changes in deep and superficial PFM activity—assessed with sEMG—can be observed during the presentation of sexual stimuli. Methods Deep PFM sEMG activity was assessed with a vaginal probe. Superficial PFM activity was assessed with sEMG electrodes placed over the bulbocavernosus and perianal muscles. 15 sexually healthy women (mean age 27 years) watched a series of neutral, anxiety-evoking, and sexually explicit films. Continuous subjective sexual arousal was measured using a handheld arousometer. Main Outcome Measure Changes in microvolts were measured by sEMG sensors, from neutral to anxiety-evoking and neutral to sexually explicit films. Results There was an increase in intravaginal and perianal sEMG for both the erotic and anxiety films. Bulbocavernosus sEMG responses did not differ among the 3 films. Concordance between self-reported continuous sexual arousal for the erotic film and bulbocavernosus sEMG (r = 0.349) was not significantly different than concordance using intravaginal sEMG (r = 0.293) or perianal sEMG (r = 0.236). Clinical Implications Understanding more about which parts of the PFM respond specifically to sexual stimuli may have implications for measuring the effects of treatments aimed at improving sexual response in women. Strength & Limitations The results of this pilot study provide a preliminary understanding of which pelvic floor muscles respond to sexual stimuli. A limitation of this study was the small sample size. Conclusion Taken together, these findings suggest that intravaginal and perianal sEMG respond to erotic stimuli, whereas bulbocavernosal sEMG responses do not.

31 Background: Treatment for localized PC can adversely impact the quality of life for the patient (pts) and his partner. Addition of androgen deprivation therapy (ADT) to treat biochemical relapse or metastatic disease can result in further symptoms. We hypothesized that PC pts and partners would benefit from a clinical, educational, research-based approach to care that would focus on their specific needs. Methods: Funding from government agencies and philanthropic sources were used to establish a survivorship program in the urology clinic at the Vancouver Prostate Centre. A multi-disciplinary management team was formed to oversee the program. The Prostate Cancer Supportive Care (PCSC) Program is organized around 5 thematic modules 1) information about PC and primary treatment options (TX), 2) sexual health and intimacy (SH), 3) lifestyle changes in diet and exercise (DE), 4) managing the side effects of ADT, 5) incontinence and pelvic floor physiotherapy (PT). Group educational sessions (ED) are held 1-2 times monthly. Individual clinic appointments with SH and PT clinicians are also available. A program manager, clinic coordinator, and research assistant run PCSC on a day-to-day basis. Results: PCSC was initiated in January 2013. Urologists, nurses, pharmacists, and radiation oncologists referred patients to PCSC. Of 802 pts who enrolled (167 in 2013, 369 in 2014, and 266 in 2015 to date), to receive the quarterly newsletter, 626 (78%) chose to actively participate in at least one module (summarized in table). Feedback from couples, participating clinicians, and allied health personnel has been overwhelmingly positive. In addition, the PCSC population is proving to be a rich source of patients for research projects and training opportunities for young MDs. Conclusions: The results demonstrate that implementation of a disease specific survivorship program is feasible, well received and has other unanticipated benefits. Outcomes research and intervention protocols are in progress to address our hypothesis. [Table: see text]