An update on the current and future demand for care of pelvic floor disorders in the United States

Kirby, Anna C.; Luber, Karl M.; Menefee, Shawn A.

doi:10.1016/j.ajog.2013.09.011

Cited by 76 publications

(47 citation statements)

References 8 publications

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“…These dysfunctions have a significant impact on women's quality of life, and the costs of care are a concern to governmental institutions5 , 6. A recent study projected that the need to care for women with pelvic floor dysfunctions will increase by 35% between 2010 and 2030 in the United States if population growth continues7.…”

Section: Introductionmentioning

confidence: 99%

Relationship among vaginal palpation, vaginal squeeze pressure, electromyographic and ultrasonographic variables of female pelvic floor muscles

Pereira¹,

Hirakawa²,

Oliveira³

et al. 2014

Braz. J. Phys. Ther.

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Background: The proper evaluation of the pelvic floor muscles (PFM) is essential for choosing the correct treatment. Currently, there is no gold standard for the assessment of female PFM function. Objective: To determine the correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the female PFM. Method: This cross-sectional study evaluated 80 women between 18 and 35 years of age who were nulliparous and had no pelvic floor dysfunction. PFM function was assessed based on digital palpation, vaginal squeeze pressure, electromyographic activity, bilateral diameter of the bulbocavernosus muscles and the amount of bladder neck movement during voluntary PFM contraction using transperineal bi-dimensional ultrasound. The Pearson correlation was used for statistical analysis (p<0.05). Results: There was a strong positive correlation between PFM function and PFM contraction pressure (0.90). In addition, there was a moderate positive correlation between these two variables and PFM electromyographic activity (0.59 and 0.63, respectively) and movement of the bladder neck in relation to the pubic symphysis (0.51 and 0.60, respectively). Conclusions: This study showed that there was a correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the PFM in nulliparous women. The strong correlation between digital palpation and PFM contraction pressure indicated that perineometry could easily be replaced by PFM digital palpation in the absence of equipment.

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Section: Introductionmentioning

confidence: 99%

Relationship among vaginal palpation, vaginal squeeze pressure, electromyographic and ultrasonographic variables of female pelvic floor muscles

Pereira¹,

Hirakawa²,

Oliveira³

et al. 2014

Braz. J. Phys. Ther.

View full text Add to dashboard Cite

show abstract

“…The identification of such thresholds and the resultant 5-category model could facilitate the identification of clinically-significant urinary symptoms for epidemiologic studies. This model can also be used for ascertaining, communicating and planning a woman’s future clinical service demand, particularly of interest as we know that clinical service demand for pelvic floor disorders continues to rise at an unprecedented rate 11 .…”

Section: Discussionmentioning

confidence: 99%

“…The identification of such a threshold could be useful in epidemiologic research (to define clinically-significant urinary symptoms), in public health (to anticipate the demand for incontinence treatment across a population), and in clinical trials (to define treatment success). This is a significant and recognized need; in 2010, it is estimated that 1.2 million new patient visits for pelvic floor disorders took place in the US and 1.6 million are predicted by 2030 11 .…”

Section: Introductionmentioning

confidence: 99%

Care-Seeking for Stress Incontinence and Overactive Bladder Among Parous Women in the First Two Decades After Delivery

Fitzgerald¹,

Pierce

Nugent

et al. 2016

Female Pelvic Med Reconstr Surg

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OBJECTIVE To establish the extent to which care-seeking for urinary incontinence is a function of symptom bother; and to identify bother-score thresholds that predict care-seeking in the first two decades after delivery. METHODS In this longitudinal cohort, women were assessed annually for symptom bother related to stress urinary incontinence (SUI) and overactive bladder (OAB), as well as for recent episodes of care-seeking for urinary symptoms. Because the goal was to model care-seeking as a function of the woman’s characteristics at her prior visit, women who completed ≥two consecutive visits were included. The population was randomly divided into “training” (model development) and “testing” (model validation) sets. The predictive model was developed in the training set. For SUI and OAB bother scores, we identified thresholds to define statistically distinct probabilities of care-seeking. A multivariable model was created, including SUI and OAB bother categories as well as characteristics associated with care seeking at the P<0.05 level. The resultant prediction model was then applied to the “testing set”; predicted and observed care-seeking frequencies were compared. RESULTS Care-seeking was strongly associated with SUI and OAB bother. We defined three categories for OAB score and four categories for SUI score. The resulting twelve risk categories were then collapsed into five distinct risk-groups. These groups accurately predicted care-seeking in the testing set (area under the receiver-operating curve 0.760 (95% confidence interval 0.713, 0.807). Inclusion of other risk factors did not improve the model. CONCLUSIONS Symptom bother is a strong determinant of care-seeking in the first two decades after delivery. These results define five ordinal categories that predict seeking-care for urinary symptoms in a community population.

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“…Unfortunately, a thorough set of records concerning UI is not available in Brazil. However, based on data gathered in the censuses carried out in the country and on different studies about UI prevalence, it is possible to infer that a substantial increase in the number of incontinent elderly women may occur, as reported by Kirby et al 14 , whose results point to an increase of 72% in the previous forecast for 2030 in terms of the demand for care concerning pelvic floor dysfunctions in North American women aged over 30 years. Thus, quantifying this increasing demand for care related to UI and pelvic floor dysfunction is important for public health planning and for training professionals in this area, particularly those in Primary Care, the "entrance door" to the Brazilian Health System.…”

mentioning

confidence: 85%

Urinary incontinence in elderly women from Porto Alegre: its prevalence and relation to pelvic floor muscle function

et al. 2014

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| The purpose of this cross-sectional study was to assess the prevalence of self-reported urinary loss in elderly women living in the city of Porto Alegre (Rio Grande do Sul, Brazil), as well as to determine the relation between urinary incontinence (UI) and pelvic floor muscle function (PFMF). It included 270 elderly women (aged from 60 to 92 years) from a population sample, who reported the presence (n=155; 69.1±7.8 years) or absence (n=115; 67.7±7.9 years) of urine loss. Those who reported UI were asked about how long they had been experiencing urinary leakage, the amount of urine lost (drops, jets or complete micturition) and situations in which they lost urine. Out of the total number of individuals, 178 agreed to undergo the assessment of PFMF by means of a perineometry and a bidigital test. The prevalence of elderly women who reported UI (57.4%) was significantly higher, and the most common isolated situation of urine loss was being unable to get to the toilet in time (26.1%), and this occurred mainly in drops (52.3%). The UI lasted for a median of three years. The elderly women with UI had significantly lower PFMF than those without it, regardless of the type of measurement used (perineometry or bidigital test). Therefore, we conclude that, in this sample, UI had a high prevalence and was associated with decreased PFMF. Bearing these findings in mind and taking into account the data available in the literature about the impact of UI on health and quality of life, as well as the low cost of its assessment and treatment, we suggest that the management and care of this dysfunction should be carried out at the Primary Health Care level.Keywords | Pelvic Diaphragm; Physical Therapy Specialty; Aged; Women's Health.RESUMO | O objetivo deste estudo foi avaliar a prevalên-cia do relato de perda urinária em idosas residentes no município de Porto Alegre (RS-Brasil), bem como determinar a relação entre incontinência urinária (IU) e a função muscular do assoalho pélvico (FMAP). Participaram 270 idosas (60 a 92 anos) provenientes de uma amostra populacional, que relataram (n=155; 69,1±7,8 anos) ou não (n=115; 67,7±7,9 anos) perda urinária. As idosas que referiram IU foram questionadas quanto a: duração da perda urinária, quantidade de urina perdida (gotas, jato ou completa) e situações em que perdiam urina. Desse total, 178 aceitaram ser submetidas a uma avaliação da FMAP por meio da perineometria e do teste bidigital. A prevalência de idosas com relato de IU (57,4%) foi significativamente mais elevada, sendo que a situação isolada de perda miccional mais

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An update on the current and future demand for care of pelvic floor disorders in the United States

Cited by 76 publications

References 8 publications

Relationship among vaginal palpation, vaginal squeeze pressure, electromyographic and ultrasonographic variables of female pelvic floor muscles

Relationship among vaginal palpation, vaginal squeeze pressure, electromyographic and ultrasonographic variables of female pelvic floor muscles

Care-Seeking for Stress Incontinence and Overactive Bladder Among Parous Women in the First Two Decades After Delivery

Urinary incontinence in elderly women from Porto Alegre: its prevalence and relation to pelvic floor muscle function

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