Pelvic prolapse and urinary incontinence in nulliparous college women in relation to paratrooper training

OBJECTIVE To determine, in a case-control study, whether pelvic organ prolapse (POP) is associated with overall lifetime physical activity (combined leisure, outdoor, household, occupational), and lifetime leisure, lifetime strenuous, and teen years strenuous activity. STUDY DESIGN 191 POP cases (defined as maximal vaginal descent ≥1 cm below the hymen) and 191 age and recruitment-site matched controls (defined as maximal vaginal descent ≤1 cm above the hymen) between 39–65 years with no or mild urinary incontinence, were recruited chiefly from primary care clinics. Participants completed Lifetime Physical Activity (LPAQ) and Occupation (OQ) Questionnaires, recalling activities during 4 age epochs. We performed separate logistic regression models for physical activity measures. RESULTS Compared to controls, POP cases had greater BMI and parity. Median overall lifetime activity, expressed in MET-hours/week, did not differ significantly between cases and controls. In adjusted analyses, we observed no associations between odds of POP and overall lifetime physical activity, lifetime leisure activity, or lifetime strenuous activity. There was a marginally significant nonlinear relationship between teen strenuous activity and POP with an increase in the log-odds of POP for women reporting ≥ 21 hours/week of strenuous activity (p=0.046). CONCLUSION Lifetime physical activity does not increase the odds of anatomic POP in middle-aged women not seeking care for POP. Strenuous activity during teenage years may confer higher odds of POP. This relationship and the potential role of physical activity and POP incidence should be evaluated prospectively.

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“…42,44,9 In three other studies, heavy work was associated with POP based on the POP-Q system, as was military paratrooper training. 28,43,45 …”

Section: Discussionmentioning

confidence: 99%

Lifetime physical activity and pelvic organ prolapse in middle-aged women

Nygaard

Shaw

Bardsley

et al. 2014

American Journal of Obstetrics and Gynecology

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“…21,22 Based on this association, it could be hypothesised that vigorous physical activity may also be a risk factor. However, although two studies reported no association between current exercise or the self-report of past strenuous exercise and POP, 16,19 details of relevant data, such as the type of activity, frequency, duration and intensity, were not described.…”

Section: Discussionmentioning

confidence: 99%

“…Based on the recently published integrated life span model, 6 it can be assumed that the development of POP includes predisposing factors (growth and development, genetic factors, connective tissue weakness, joint mobility), [7][8][9][10][11][12] inciting factors (childbirth, pelvic surgery) [12][13][14][15][16][17][18] and intervening factors (age-related changes, obesity, constipation, heavy occupational work, vigorous physical activity). 12,[14][15][16][17][18][19][20][21][22][23][24] Unfortunately, only a minority of these risk factors can easily be prevented.…”

Section: Introductionmentioning

confidence: 99%

Pelvic floor function is independently associated with pelvic organ prolapse

Brækken

Majida

Engh

et al. 2009

BJOG

111

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Objective To investigate the risk factors for pelvic organ prolapse (POP), including physical activity, clinically measured joint mobility and pelvic floor muscle (PFM) function.Design One-to-one age-and parity-matched case-control study.Setting Akershus university hospital and one outpatient physiotherapy clinic in Norway.Population Forty-nine women with POP (POP quantification, stage ‡II) and 49 controls (stages 0 and I) were recruited from community gynaecologists and advertisements in newspapers.Methods Validated questionnaires, interview and clinical examination, including Beighton's scoring system (joint hypermobility) and vaginal pressure transducer measurements (PFM function), were used. Univariate and multivariate conditional logistic regression analyses for one-to-one matched case-control studies were used, and odds ratios with 95% CIs are reported.Main outcome measures Pelvic floor muscle function (strength, endurance and resting pressure), socioeconomic status, body mass index, heavy occupational work, physical activity, family history, obstetric factors and markers of connective tissue weakness (striae, varicose veins, bruising, diastasis recti abdominis, joint hypermobility).Results No significant differences were found between groups with regard to postmenopausal status, current smoking, current low-intensity exercise, type of birth (caesarean, forceps, vacuum), birth weight, presence of striae, diastasis recti abdominis and joint hypermobility. Body mass index (OR 5.0; 95% CI 1.1-23.0), socioeconomic status (OR 10.5; 95% CI 2.2-50.1), heavy occupational work (OR 9.6; 95% CI 1.3-70.3), anal sphincter lacerations (OR 4.5; 95% CI 1.0-20.0), PFM strength (OR 7.5; 95% CI 1.5-36.4) and endurance (OR 11.5; 95% CI 2.0-66.9) were independently related to POP.Conclusions Body mass index, socioeconomic status, heavy occupational work, anal sphincter lacerations and PFM function were independently associated with POP, whereas joint mobility and physical activity were not.Keywords Anal sphincter lacerations, body mass index, casecontrol, joint hypermobility, occupational work, pelvic floor muscle, pelvic organ prolapse, socioeconomic status, varicose veins.Please cite this paper as: Braekken I, Majida M, Ellström Engh M, Holme I, Bø K. Pelvic floor function is independently associated with pelvic organ prolapse.

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“…23,24 Women undergoing strenuous military activity such as heavy lifting or paratrooper training are more likely to have worsening of pelvic support. 25 The effect of these exposures over the long term as women transition to being veterans is unknown but could lead to increased rates of stress urinary incontinence and pelvic organ prolapse.…”

Section: Urogenital Healthmentioning

confidence: 99%

Reproductive Health Management for the Care of Women Veterans

Zephyrin

2016

Obstetrics & Gynecology

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There are more than 2 million women veterans living in the United States. Many women do not identify themselves as veterans. As women's health care providers, it is important to understand and recognize the potentially complex health and social needs of women veterans and the role of military service on their lives. The reproductive health needs of women veterans may be shaped by their military experiences and coexisting medical or mental health conditions. Military sexual trauma and combat exposure are common causes of posttraumatic stress disorder and can affect overall health and well-being. Screening for military service is important in all women, and inclusion of this as a key demographic variable in research and clinical encounters can further inform health care considerations. The following key topics are addressed: who are women veterans, health and social risk factors associated with a history of military service, reproductive health across the life course, military sexual trauma and reproductive health of women veterans, how to take a military history, and the essential role of women's health providers, including obstetrician-gynecologists, in enhancing health systems and providing high-quality care to veterans.

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Pelvic prolapse and urinary incontinence in nulliparous college women in relation to paratrooper training

Cited by 31 publications

References 10 publications

Lifetime physical activity and pelvic organ prolapse in middle-aged women

Lifetime physical activity and pelvic organ prolapse in middle-aged women

Pelvic floor function is independently associated with pelvic organ prolapse

Reproductive Health Management for the Care of Women Veterans

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