Effect of depression and anxiety on the success of pelvic floor muscle training for pelvic floor dysfunction

Abstract

The objective of this study was to determine the impact of the psychiatric symptoms of anxiety and depression, as assessed by validated questionnaires on the success of pelvic floor muscle training (PFMT). A prospective observational study was carried out by the Uro-gynaecological Physiotherapy Department at the Singleton Hospital, Swansea. A total of 108 consecutive women with pelvic floor dysfunction were referred for physiotherapy and admitted to the 6-month physiotherapy programme. They underwent subjective and objective assessments of their pelvic floor and psychological health at the beginning and end of the programme. A strong correlation was noted between the severity of anxiety and depression symptoms and the severity of their pelvic floor dysfunction. Following physiotherapy, apart from sexual function, all domains of pelvic floor dysfunction showed significant improvement. Based on the severity of their anxiety/depression symptoms, the patients were stratified into three groups. The group of patients that benefitted most had either no or only mild anxiety/depression. This study raises the question of whether a targeted approach should be undertaken for managing patients who, in addition to their pelvic floor dysfunction, demonstrate psychiatric symptoms.

Efficacy and Predictors for Biofeedback Therapeutic Outcome in Patients with Dyssynergic Defecation

“…The emotional centers in the brain can affect motility and sensation in the gut, acting mainly via the hypothalamic-hypophyseal axis and brain-gut axis. Studies have shown that depression increases pelvic floor muscle tension and reduces rectal sensitivity [45,46]. Mild depression can be relieved to some extent by psychological counseling and by explanation of the symptoms.…”

Does pelvic floor muscle training augment the effect of surgery in women with pelvic organ prolapse? A systematic review of randomized controlled trials

“…Pelvic organ prolapse (POP) is a common medical problem in women and is classified as anterior, posterior vaginal wall prolapse, uterus (cervix) or apical vaginal prolapse, and/or enterocele; these forms are often coexistent. Women with POP usually experience one or more discomforts involving a feeling of pelvic heaviness, fullness or low back pain, or voiding and/or defecation dysfunction; these symptoms greatly affect quality of life and can even result in social, psychological, and sexual problems . Estimates of prevalence of POP in the general population range from 2.9% to 50% due to the lack of a standard definition, differences in the demographic characteristics of the surveyed population, and imperfect records .…”

“…Women with POP usually experience one or more discomforts involving a feeling of pelvic heaviness, fullness or low back pain, or voiding and/or defecation dysfunction; these symptoms greatly affect quality of life and can even result in social, psychological, and sexual problems. 1 Estimates of prevalence of POP in the general population range from 2.9% to 50% due to the lack of a standard definition, differences in the demographic characteristics of the surveyed population, and imperfect records. [2][3][4] Approximately, 300,000 surgeries for prolapse are performed annually in the United States 5 ; however, over the next 30 years, the demand for services to care for female pelvic floor disorders is expected to increase at twice that of the same population.…”

A Review of Hypnotherapy for Overactive Bladder

“…Although physical and psychological factors both produce drug non-persistence, physical dysfunction is not its primary predictor (Dumoulin et al, 2010;Hay-Smith & Dumoulin, 2006), contrasting with psychological variables (e.g., depression, anxiety) that play key roles (Goode et al, 2008;Khan et al, 2013;Osborne et al, 2016). Although development of β3-adrenoceptor agonists, that have fewer side effects, helps overcome the problems associated with older antimuscarinic drugs (Thiagamoorthy et al, 2016), such an Hypnotherapy for OAB -4 approach does not address the psychological factors that can determine therapy nonadherence (DiMatteo et al, 2000).…”