A review of the impact of pregnancy and childbirth on pelvic floor function as assessed by objective measurement techniques

Geelen, Hans van; Ostergard, Donald R.; Sand, Peter K.

doi:10.1007/s00192-017-3540-z

Cited by 71 publications

(62 citation statements)

References 91 publications

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“…As the PFM is the key muscular structure in the pelvis, mechanical support provided by the PFM is the main factor that maintains the correct positions and functions of organs in the pelvic area [43][44][45] . Pregnancy, MVD and age are important factors that damage the PFM 5,7,46 . In skeletal muscle, CACNA1H is the major subunit for Tchannels (Fig.…”

Section: Discussionmentioning

confidence: 99%

CACNA1H downregulation induces skeletal muscle atrophy involving endoplasmic reticulum stress activation and autophagy flux blockade

Hao

et al. 2020

Cell Death Dis

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Multiple vaginal delivery (MVD) is an important factor for pelvic floor muscle (PFM) function decline and pelvic floor dysfunction (PFD). PFD is common in middle-aged and elderly women, but its pathogenesis is not clear. In this study, we found that the expression of CACNA1H was lower in the PFM of old mice after MVD compared with old or adult mice. In in-vitro studies, we found that treatment with the T-type Ca 2+ channel (T-channel) inhibitor NNC-55 or downregulation of the CACNA1H gene by siRNA intervention promoted myotube atrophy and apoptosis. Mechanistically, we revealed that NNC-55 increased the expression of GRP78 and DDIT3 in myotubes, indicating endoplasmic reticulum stress (ERS) activation, and that the IRE1 and PERK pathways might be involved in this effect. NNC-55 induced the formation of autophagosomes but inhibited autophagy flux. Moreover, rapamycin, an autophagy activator, did not rescue myotube atrophy or apoptosis induced by NNC-55, and the autophagy inhibitors 3-MA and HCQ accelerated this damage. Further studies showed that the ERS inhibitors 4-PBA and TUDAC relieved NNC-55-induced damage and autophagy flux blockade. Finally, we found multisite muscle atrophy and decreased muscle function in Cacna1h −/− (TH-null) mice, as well as increased autophagy inhibition and apoptotic signals in the PFM of old WT mice after MVD and TH-null mice. Taken together, our results suggest that MVD-associated PFD is partially attributed to CACNA1H downregulation-induced PFM atrophy and that ERS is a potential therapeutic target for this disease.

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Section: Discussionmentioning

confidence: 99%

CACNA1H downregulation induces skeletal muscle atrophy involving endoplasmic reticulum stress activation and autophagy flux blockade

Hao

et al. 2020

Cell Death Dis

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“…[17][18][19][20] Also corroborating with the literature, we demonstrated that number of pregnancies and vaginal delivery are variables associated with POP. 13,21,22 In their metanalysis, MacLennan et al 23 estimated that vaginal delivery confers a seven-fold increase in POP risk. We found a 13-fold increased chance of POP development in women that had at least one vaginal delivery, being the main independent risk factor for POP.…”

Section: Discussionmentioning

confidence: 99%

Collagen I and collagen III polymorphisms in women with pelvic organ prolapse

Batista

Bortolini

Silva

et al. 2020

Neurourology and Urodynamics

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Aims Verify the presence of the single nucleotide polymorphisms rs1800012 of the collagen I (COL1A1) and rs1800255 of the collagen III (COL3A1) genes and their association with pelvic organ prolapse (POP) in Brazilian women and to determine risk factors for POP. Methods We assessed 826 postmenopausal women divided into POP (stages III and IV) and control groups (stages 0 and I) by examination and peripheral blood sample collection. DNA sequences of interest were analyzed by real‐time reverse‐transcriptase polymerase chain reaction. We used logistic regression analyses, recessive and codominance models of inheritance, and P < .05 for significance. Results Six‐hundred and thirty‐four postmenopausal women were included: 348 (54.8%) POP cases and 286 (45.1%) controls. The frequencies of GG, GA, and AA genotypes for COL1A1 were 69.12%, 20.24%, and 10.59% in POP group and 71.79%, 20%, and 8.21% in controls; GG, GT, and TT for COL3A1 were 37.54%, 59.53%, and 2.93% in POP group and 36.24%, 60.14%, and 3.62% in controls. There were no genotypic or allelic association with POP phenotype that link both SNPs rs1800012 and rs1800255 to increased risk of POP. Vaginal delivery (odds ratio [OR] = 13; 95% confidence interval [CI] [4.00‐47.08]), POP family history (OR = 3.1; 95% CI [1.49‐6.50]), diabetes mellitus (OR = 2.3; 95% CI [1.08‐5.21]), number of pregnancies (OR = 1.2; 95% CI [1.05‐1.36]), and age (OR = 1.1; 95% CI [1.09‐1.19]), were variables of increased risk for POP (P < .05 for all). Conclusion Our study suggests lack of association between DNA polymorphisms rs1800012 of COL1A1 and rs1800255 of COL3A1 with advanced POP. Vaginal delivery, POP family history, diabetes mellitus, number of pregnancies, and age are risk factors for POP.

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“…More than one method has been adopted to obtain a comprehensive understanding of PFM function [22][23] . However, it is difficult to evaluate PFM function and there is no gold standard for such evaluation [24] .…”

Section: Discussionmentioning

confidence: 99%

A non-randomized chlinical trial The effect of pelvic floor exercises at home and electrical stimulation plus biofeedback in hospital in management of stress urinary incontinence of primiparas in short-term postpartum period

Tang¹,

Zhao²,

Sun³

et al. 2019

Preprint

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Background To investigate the effect of pelvic floor exercises at home and electrical stimulation plus biofeedback in hospital in management of stress urinary incontinence (SUI) primiparas in short-term postpartum period. Methods A total of 150 SUI primiparas at postpartum 6-8 weeks were interviewed. According to participants’ willingness and necessary coordination, the subjects were divided into 2 groups including the treatment group (n=69) and the control group (n=81). The treatment group received at-home pelvic floor muscle training(PFMT) every day and in-hospital electrical stimulation plus biofeedback therapy twice a week for consecutive 5 weeks (from 6-8 postpartum weeks to 11-13 postpartum weeks). The control group was not given pelvic floor exercise at home or in hospital. The PFM strength in the two groups was measured by specially trained personnel using digital palpation (Modified Oxford scale:0-5 grade) and surface electromyography(sEMG) in 6-8 postpartum weeks and in 11-13 postpartum weeks. For statistical analysis, t -test,Chi-square analysis and Wilcoxon test were carried out. Results The recovery rate of SUI in the treatment group was 63.8% (44/69), which was higher than that in the control group (12.3%,10/81) ( p <0.05). In the treatment group, the PFM strength was higher after PFMT than that before PFMT no matter measured by digital palpation or by sEMG ( p <0.05); but in the control group, it had no change at postpartum 6-8 weeks and at postpartum about 12 weeks ( p >0.05). Conclusion: The combination treatment of at-home PFM training and in-hospital electrical stimulation plus biofeedback PFM therapy is an effective method to manage SUI and improve PFM strength in short-time postpartum.

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A review of the impact of pregnancy and childbirth on pelvic floor function as assessed by objective measurement techniques

Cited by 71 publications

References 91 publications

CACNA1H downregulation induces skeletal muscle atrophy involving endoplasmic reticulum stress activation and autophagy flux blockade

CACNA1H downregulation induces skeletal muscle atrophy involving endoplasmic reticulum stress activation and autophagy flux blockade

Collagen I and collagen III polymorphisms in women with pelvic organ prolapse

A non-randomized chlinical trial The effect of pelvic floor exercises at home and electrical stimulation plus biofeedback in hospital in management of stress urinary incontinence of primiparas in short-term postpartum period

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