Introduction Women’s baseline knowledge of pelvic floor exercises (PFEs) and pelvic floor disorders (PFDs) is not well established, as is their knowledge regarding PFE and participation in such exercise. The aim of our study was to assess baseline PFD and PFE knowledge and to determine if knowledge in any way influenced participation in PFEs. Methods This was an institutional review board–approved, cross-sectional survey administered to women 18 years or older. We included all women who completed the survey, of which 3733 met the criteria. A survey-based questionnaire was used to query lower urinary tract symptoms, PFD, knowledge, and frequency of participation in PFEs. Results Of those who responded, the mean incontinence knowledge score was 9.2 ± 2.6, whereas the mean score for pelvic organ prolapse (POP) knowledge was 6.8 ± 3.6. Of the respondents, 92.5% reported being familiar with Kegel exercises. The majority of respondents reported that they did not participate in PFEs (57.4%). Those with POP were more likely to do daily PFEs than those without POP, 34.8% versus 16.4% (P < 0.001). Stress urinary incontinence did not influence frequency of performing PFEs. Conclusions Our study demonstrated that while baseline knowledge of POP and incontinence knowledge were high in this patient population, the majority of participants did not participate in PFE. Participants with POP were more likely to partake in daily PFE. A gap exists between knowledge and willingness to participate in PFE. Bridging this gap may be significantly impactful for women’s health.

Aims The aim of this study is to identify factors associated with urinary incontinence (UI) in a community sample of young nulligravid women. Methods This was a secondary analysis from a cross‐sectional survey‐based study of cisgender women aged 18 to 25 years recruited through a national registry of research volunteers. Participants completed validated questionnaires assessing toileting behaviors, lower urinary tract symptoms (LUTS), and bowel symptoms. Women were excluded from analysis if currently pregnant, any prior pregnancy, cystectomy, or any neurologic disease including spinal cord injury, stroke, or multiple sclerosis. Analyses determined the prevalence of symptoms and evaluated candidate risk factors for UI. Results Final analyses included 964 women (mean age, 22.6 ± 2.0). Monthly UI was identified in 295 (30.6%) subjects, with mixed UI being the most common (56.9%; n = 168). Seventy‐two women (7.4%) reported fecal incontinence (FI) and 24 (3.5%) women reported both UI and FI. After multivariable regression modeling, UI was associated with an intermittent urine stream and the delayed voiding toileting behavior subscale. Conclusions UI in this cohort of young nulliparous women was highly prevalent and warrants further study as to the cause. Therapeutic guidelines to prevent UI and LUTS may need to be adjusted by targeting populations earlier than traditionally considered.

No abstract

No abstract

No abstract

Evaluation (VALUE) study suggested that routine urodynamics (URD) are not beneficial for pre-operative evaluation of uncomplicated, stress-predominant incontinence (SUI). Accordingly, professional organizations have advocated against routine pre-operative URD (pre-URD) in "index" SUI patients. We assessed URD rates in patients undergoing slings through analysis of patient claims data with focus on use following the VALUE study.METHODS: We identified female patients in the Virginia All Payers Claims Database with diagnosis of SUI from May 2011-December 2016 using appropriate ICD codes. CPT codes were used to select the subset undergoing URD and/or slings. Pre-URD was defined as URD within six months of sling placement. Non-index patients were defined as those with concurrent diagnosis of overactive bladder, urge incontinence, or neurogenic bladder, and were excluded from analysis. We analyzed longitudinal rate of URD in patients undergoing sling placement and fitted an interventional ARIMA model with a step function after the time of the VALUE study publication. To evaluate changes in proportion of slings with pre-URD, we fitted a beta regression model using a logit link.RESULTS: A total of 44,347 patients with a SUI diagnosis were identified over the study period, with a mean of 7391 patients/year. Of index patients with a SUI diagnosis, 5,944 underwent sling procedures. The mean number of slings and URD per year was 1236 and 3488, respectively. A decrease in the annual number of slings, both with and without pre-UDS, was seen beginning in mid-2012 (Figure 1). In addition, interventional ARIMA models confirmed significant decreases in in number of slings with (p[0.02) and without (p<0.001) pre-URD. The proportion of slings with pre-URD demonstrated a small decrease over the study years (68%, 2011; 58%, 2016), with an estimated decrease in pre-operative URD by 0.85%/month (p<0.001).CONCLUSIONS: Our study demonstrates a decrease in the number of slings both with and without pre-URD in uncomplicated patients following publication of the VALUE study in May 2012. Notably, there was a small but significant decrease in the proportion of slings with pre-URD among index patients. Further research is needed to examine trends of pre-URD and underlying influences.

No abstract