Prolapse, pain, and pelvic floor muscle dysfunction

Bradley, Catherine S.

doi:10.1016/j.ajog.2019.07.038

Cited by 5 publications

(6 citation statements)

References 13 publications

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“…Pelvic "pressure" and "heaviness or dullness" were reported more frequently in the PFMD group, but these differences were not significant. In a subset (n = 54) who were sexually active, pain during sexual activity also did not differ by PFMD status (median [IQR] 3.5 [2][3][4] PFMD vs 4 [3][4][5] no PFMD, P = 0.16). Clinical findings were also different in those with PFMD.…”

Section: Resultsmentioning

confidence: 93%

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Pelvic Pain and Pelvic Floor Muscle Dysfunction in Women Seeking Treatment for Prolapse

Gore

Kenne

Kowalski

et al. 2023

UROGC

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Importance Pelvic floor muscle dysfunction (PFMD) can cause pelvic pain, but its associations with pelvic organ prolapse (POP) and POP treatment outcomes are poorly understood.Objectives The objectives of this study were to determine (1) if pelvic pain is associated with PFMD in women seeking POP treatment and (2) if baseline PFMD in women seeking management of POP is associated with improvement in pelvic pain at 12 months. Study Design This was an ambispective cohort study of women enrolled at one site of the Pelvic Floor Disorders Registry. Pelvic floor muscle dysfunction was identified if tenderness was reported on a standardized pelvic floor muscle examination at baseline. Outcomes included a pelvic pain questionnaire (score 0-70, assessed pain in the past 24 hours in 7 pelvic locations) and the Global Health-10 overall average pain rating (0-10). Results One hundred forty-four women planning surgery (118) or pessary (26) were included. Twenty (13.9%) had baseline PFMD. Women with PFMD versus no PFMD had greater baseline Pelvic Pain scores (median [IQR], 9.7 [4-23] vs 2.5 [0-7], P < 0.001) and overall average pain (4 [3-6] vs 1 [0-3], P < 0.001). In 107 women with 12-month treatment outcomes, those with PFMD at baseline had greater improvement in pelvic pain compared with those without PFMD (change score −6.5 [−15.2 to 0] vs 0 [−3 to 0] respectively, P = 0.03). Overall pain improved after treatment in the no PFMD group but not in the PFMD group. Conclusions Patients with baseline PFMD vs none undergoing treatment for prolapse had higher baseline pelvic pain and greater improvement in pelvic pain at 12 months.

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Section: Resultsmentioning

confidence: 93%

“…Pelvic floor muscle dysfunction is a cause of pelvic pain, is understudied, and its associations with prolapse and prolapse treatment outcomes are poorly understood. Taken together, these studies suggest PFMD may play an important role in the management of patients with POP 3 …”

mentioning

confidence: 69%

Pelvic Pain and Pelvic Floor Muscle Dysfunction in Women Seeking Treatment for Prolapse

Gore

Kenne

Kowalski

et al. 2023

UROGC

Self Cite

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“…Dyspareunia: Recurrent genital pain that occurs just before, during or after intercourse. [6] dIagnostIc evaluatIon [7] 2. Physical examination: Physical examination to evaluate the ability to control pelvic floor muscles.…”

Section: Types Of Pelvic Floor Dysfunctionmentioning

confidence: 99%

Pelvic Floor Dysfunction and Management: Comprehensive Review

Manimegalai¹

2020

IJNMI

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The post-natal period refers to the 6 weeks period after childbirth. In this period, the pelvic organs revert back approximately to the pre-pregnant state both anatomically and physiologically are known as involution of pelvic structures. Women can experience problems during the post-natal period such as tiredness, perineal pain, breast problems, backache, hemorrhoids, constipation, depression, anemia, headache, and pelvic floor dysfunction. At present, pelvic floor dysfunction is becoming a major problem during post-natal period. Pelvic floor dysfunction is a condition where pelvic floor muscles lose its control and relax completely following childbirth which alters the normal bladder and bowel functions during the post-natal period. The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus, and associated connective tissue which span the area underneath the pelvis. The functions of the pelvic floor are providing support of abdominopelvic viscera (bladder, intestines, uterus, etc.) through their tonic contraction, maintaining resistance to increases in intra-pelvic/abdominal pressure during activities such as coughing or lifting heavy objects and the muscle fibers have a sphincter action on the rectum and urethra. They relax to allow urination and defecation. [1] defInItIon of PelvIc floor dysfunctIon Pelvic floor dysfunction is the inability to control the muscles of the pelvic floor. [2] causes of PelvIc floor dysfunctIon durIng PuerPerIum Multiparity, it is one of the main causes of pelvic floor disorders. A woman's risk tends to increase the more times she

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“…Pelvic organ prolapse (POP) is a prevalent condition that increases with age and affects about half of women worldwide 1 . Women diagnosed with POP are generally not in pain, but do suffer from pain‐related symptoms including pelvic pressure and experience a decreased quality of life 2,3 . Nearly 1 in 10 women with POP undergo surgical treatment with a lifetime risk of surgery for POP in the United States of 11% by the eighth decade of life 4 .…”

Section: Introductionmentioning

confidence: 99%

“…1 Women diagnosed with POP are generally not in pain, but do suffer from pain-related symptoms including pelvic pressure and experience a decreased quality of life. 2,3 Nearly 1 in 10 women with POP undergo surgical treatment with a lifetime risk of surgery for POP in the United States of 11% by the eighth decade of life. 4 The surgical management options for POP include colporrhaphy or colpopexy (vaginal or sacrocolpopexy).…”

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confidence: 99%

Opioid prescribing and risks among commercially insured women undergoing pelvic organ prolapse repair

Gressler

dosReis

Chughtai

2021

Pharmacoepidemiology and Drug

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Purpose: Opioid use after surgical repair for pelvic organ prolapse (POP) is intended for short-term post-operative pain. This study compared the incidence of opioid prescribing in women undergoing POP transabdominal repair with mesh and transvaginal native tissue repair.Methods: A retrospective cohort of women undergoing POP transabdominal repair with mesh or transvaginal native tissue repair, was derived from a 10% random sample of enrollees from 2007 to 2015 within the IQVIA PharMetrics ® Plus Database.Primary outcomes were any prescription of opioids and cumulative days of opioids prescribed in the 14-180 days following surgical intervention. Inverse probability of treatment weights controlled for observed baseline confounders. Any opioid prescription was estimated using logistic regression and generalized linear regression for cumulative days of opioids prescribed. Results:The cohort of 49 052 women who underwent POP surgical repair included 46 813 women with transvaginal native tissue repair and 2239 women with transabdominal repair with mesh. Women with a transabdominal repair with mesh had a 1.19 (95%CI: 1.09-1.31) significantly higher odds of receiving an opioid prescription than women with transvaginal native tissue repair. Post-operatively, over 29% of women received opioid prescriptions. Mean cumulative days of post-surgical opioid prescribing was 32.2 (SD = 43.1), and was not statistically different between groups.Thirteen percent of women were prescribed opioids for 90 days or more.Conclusions: Women undergoing POP with transabdominal mesh are more likely to receive prescriptions for opioids after surgery compared to transvaginal native tissue repair. Treatment plans that address pain while mitigating the risks associated with prolonged opioid prescribing should be employed.bias analysis, long-term opioid use, native-tissue repair, pelvic organ prolapse, pharmacoepidemiology, post-operative opioid prescribing, transabdominal mesh | INTRODUCTIONPelvic organ prolapse (POP) is a prevalent condition that increases with age and affects about half of women worldwide. 1 Women diagnosed with POP are generally not in pain, but do suffer from pain-related symptoms including pelvic pressure and experience a decreased quality of life. 2,3 Nearly 1 in 10 women with POP undergo surgical treatment with a lifetime risk of surgery for POP in the United States of 11% by the eighth decade of life. 4 The surgical management options for POP include colporrhaphy or colpopexy (vaginal or sacrocolpopexy).

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Prolapse, pain, and pelvic floor muscle dysfunction

Cited by 5 publications

References 13 publications

Pelvic Pain and Pelvic Floor Muscle Dysfunction in Women Seeking Treatment for Prolapse

Pelvic Pain and Pelvic Floor Muscle Dysfunction in Women Seeking Treatment for Prolapse

Pelvic Floor Dysfunction and Management: Comprehensive Review

Opioid prescribing and risks among commercially insured women undergoing pelvic organ prolapse repair

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