The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic health care

Swift, Steven

doi:10.1067/mob.2000.107583

Cited by 472 publications

(284 citation statements)

References 21 publications

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“…In the US approximately half of all women over the age of 50 years have been reported to complain of symptomatic prolapse. [1][2][3][4][5] The burden of disease is found to be even larger in less affluent societies, where childbearing starts earlier, parity is higher, and access to all health care including gynaecological surgery is limited. [6][7][8][9] In spite of the magnitude of the problem worldwide, the knowledge of the aetiology and natural history of POP remains incomplete.…”

Section: Introductionmentioning

confidence: 99%

Change in pelvic organ support during pregnancy and the first year postpartum: a longitudinal study

Reimers

Stær-Jensen

Siafarikas

et al. 2015

BJOG

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Summary Objective To describe changes in pelvic organ support from mid pregnancy until 1 year postpartum among nulliparous pregnant women, and to examine whether delivery route affects changes in pelvic organ support.Design Prospective cohort study. Setting Akershus University Hospital in Norway.Population A cohort of 300 nulliparous pregnant women included at mid-pregnancy.Methods Pelvic organ support assessed at 21 and 37 weeks of gestation, and again at 6 weeks, 6 months, and 12 months postpartum, by the use of the Pelvic Organ Prolapse Quantification (POP-Q) system. Linear mixed model was used to assess longitudinal change in pelvic organ support.Main outcome measures Prevalence of anatomic POP. Change in POP-Q variables over time and between delivery groups.Results The prevalence of anatomic POP ranged from 0 to 10%. Vaginal POP-Q points made a cranial shift from mid to late pregnancy, a caudal shift following delivery, and again a cranial shift after 6 weeks postpartum. Postpartum change was present following both vaginal and caesarean deliveries, but was more pronounced following vaginal delivery. The perineal body and genital hiatus became longer from mid to late pregnancy, and shortened after 6 weeks postpartum. At 12 months postpartum all POP-Q points, except cervix, had recovered to baseline in the vaginal delivery group.Conclusions The prevalence of anatomic POP was low in this cohort. There was change in pelvic organ support both during pregnancy and following vaginal as well as caesarean delivery. The short-term ability to recover was good after the first pregnancy and delivery.Keywords Delivery, pelvic organ support, POP, postpartum, pregnancy, primipara.Tweetable Abstract Pelvic organ support changes during pregnancy. A contribution to the risk of POP?

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Section: Introductionmentioning

confidence: 99%

Change in pelvic organ support during pregnancy and the first year postpartum: a longitudinal study

Reimers

Stær-Jensen

Siafarikas

et al. 2015

BJOG

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“…1 Loss in PFM function may cause defecation dysfunction, sexual dysfunction, pelvic organ prolapse or involuntary loss of urine (urinary incontinence, UI) or stool and gas (anal incontinence, Source of study: Østfold Hospital Trust and St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. AI).…”

Section: Introductionmentioning

confidence: 99%

Do pelvic floor muscle exercises reduce postpartum anal incontinence? A randomised controlled trial

Johannessen

Wibe

Stordahl

et al. 2016

BJOG

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Objective To evaluate the effect of pelvic floor muscle exercises (PFME) for postpartum anal incontinence (AI).Design A parallel two-armed randomised controlled trial stratified on obstetrical anal sphincter injury with primary sphincter repair and hospital affinity.Setting Ano-rectal specialist out-patient clinics at two hospitals in Norway.Population One hundred and nine postpartum women with AI at baseline. MethodsThe intervention group received 6 months of individual physiotherapy-led PFME and the control group written information on PFME. Changes in St. Mark's scores and predictors of post-intervention AI were assessed by independent samples t-tests and multiple linear regression analyses, respectively. The study was not blind.Main outcome measures The primary outcome measure was change in AI symptoms on the St. Mark's score from baseline to post-intervention. Secondary outcome measures were manometry measures of anal sphincter length and strength, endoanal ultrasound (EAUS) defect score and voluntary pelvic floor muscle contraction.Results There was a significant difference in the reduction of St. Mark's scores from baseline to post-intervention in favour of the PFME group (À2.1 versus À0.8 points, P = 0.040). No differences in secondary outcome measures were found between groups. Baseline St. Mark's, PFME group affinity and EAUS defect score predicted post-intervention St. Mark's score in the imputed intention-to-treat analyses. The analysis on unimputed data showed that women performing weekly PFME improved their AI scores more than women in the control group did.Conclusions Our results indicate that individually adapted PFME reduces postpartum AI symptoms.

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“…They were much younger (mean age of 31 years) than those women studied in most studies based on POP-Q staging system 7,17 . Only a single study carried out in 40 villages in Gambia, Africa, included women at similar age (mean 32.6 years old).…”

Section: Chart 1: Pop-q Staging Distribution In 377 Women Evaluated Imentioning

confidence: 99%

“…Among all risk factors for POP, parity is the single one relevant not only in developed but also in developing countries 7,17,1 . Yet, some authors have described squatting delivery position as causing less injury to PFMs, and squatting is also the preferred position for urination and evacuation in Asian and African countries 25,26 .…”

Section: Chart 1: Pop-q Staging Distribution In 377 Women Evaluated Imentioning

confidence: 99%

Learning with the Amerindians: the evaluation of pelvic floor disorders among indigenous women who live in the Xingu Indian Park,Brazil

et al. 2008

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Summary: Objective: to evaluate the pelvic floor muscles and the incidence of pelvic organ prolapse among indigenous women who lives in Xingu Indian Park, Mato Grosso, Brazil. Methods: observational study with 377 indigenous women, mean age 31±15 years, mean gravity 5±4, mean parity 4±3 and mean body mass index 23,3±4 Kg/m 2 . The Pelvic Organ Prolapse Quantification (POP-Q) was the system used to quantification the staging of pelvic support and the pelvic floor muscle strength was assessed by a perineometer. Logistic regression was used to determine odds ratios and 95% CI for factors that were associated with prolapse. Results: The overall distribution of POP-Q stage system was the following: 15,6% stage 0, 19,4% stage I, 63,9% stage II and 0,8% stage III. Parity (OR=9.40, 95% CI 2.81-31,42) and age (OR=1,03, 95% IC 1,01-1,05) were the most important risk factors for pelvic organ prolapse. The high resting pressure was considered as a protector factor (OR=0,96, 95% IC 0,98). Conclusions: Like non indigenous community, age and the parity were the most important risk factors to the genital prolapse; however the pelvic floor muscles strength were intact, maybe due to the indigenous lifestyle.

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The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic health care

Cited by 472 publications

References 21 publications

Change in pelvic organ support during pregnancy and the first year postpartum: a longitudinal study

Change in pelvic organ support during pregnancy and the first year postpartum: a longitudinal study

Do pelvic floor muscle exercises reduce postpartum anal incontinence? A randomised controlled trial

Learning with the Amerindians: the evaluation of pelvic floor disorders among indigenous women who live in the Xingu Indian Park,Brazil

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