The relation of the pelvis and the perineal function in incontinent women: A neglected subject

Lemos, Amanda Queiroz; Brasil, Cristina; Alvares, Cecília Menezes; Passos, Jaqueline; Lordêlo, Patrícia; Sá, Kátia Nunes

doi:10.1002/nau.23772

Cited by 6 publications

(1 citation statement)

References 42 publications

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“…In the supine position, traction on the flexor muscles rotates the pelvis and the apex of the sacrum is displaced forward, so the pelvic‐perineal muscles are relaxed and the distance between the pubis and coccyx decreases. Recent studies underline the link between poor mobility of pelvic girdle joints and urinary incontinence 28 . Abnormalities in the curvature of the spine can also be linked to pelvic dysfunction 29 .…”

Section: Resultsmentioning

confidence: 99%

Assessing the patient undergoing pelvic rehabilitation for urinary incontinence: From theory to practice

Terzoni

Federica

Ferrara

et al. 2021

Int J of Uro Nursing

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Urinary incontinence is linked to pelvic floor dysfunction; the delicate balance between bones, muscles, tendons, and nerves is fundamental for continence and can be altered for numerous reasons, also linked to anatomical areas other than the pelvis. The assessment of the patient is at the basis of treatment choices; the literature reports the need to assess the patient's postural, respiratory, muscular and neurological components. To date, however, there are no studies that provide the nurse with a compendium of evidence in the form of a practical guide to assessment. To present literature evidence regarding the assessment of patients with urinary incontinence, undergoing pelvic conservative rehabilitation and to discuss the practical implications. This evaluation refers to the first contact with the patient and aims to understand how to set up the rehabilitation pathway and whether specific investigations or consultations are needed before starting rehabilitation. Narrative reviews of the literature on the PubMed, CINAHL, Cochrane Library, EMBASE, Scopus, Web of Science, PEDro database. We included studies published in the last 10 years, with no design restrictions, on the topic of assessment criteria for patients with urinary incontinence undergoing pelvic floor conservation rehabilitation, with regard to the role of the nurse. Thirty‐two references were retrieved including two systematic reviews. Assessment should focus on physical activity, bowel habits, spine and posture, nutrition and food habits, breathing and clinical history. Physical examination is aimed at (1) collecting data for establishing the correct rehabilitation programme and (2) excluding the need for evaluation/intervention by other healthcare professionals. Nurses play a key role in pelvic rehabilitation teams. Assessment and decision making about rehabilitation methods are complex tasks which require specialistic education. This paper summarizes the key points of both areas. Conservative rehabilitation of urinary incontinence requires a complex assessment in order to correctly set up the rehabilitation pathway. Aspects to be assessed include muscular, postural, respiratory, neurological and medical history. There are no works in the literature offering a compendium of the information to be considered. A complete overview of the evaluation phases and their characteristics including a practical description of the nursing assessment of the patient undergoing pelvic rehabilitation for urinary incontinence.

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Section: Resultsmentioning

confidence: 99%

Assessing the patient undergoing pelvic rehabilitation for urinary incontinence: From theory to practice

Terzoni

Federica

Ferrara

et al. 2021

Int J of Uro Nursing

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The pathophysiology of stress urinary incontinence: a systematic review and meta-analysis

et al. 2021

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Introduction and hypothesis To evaluate the evidence for pathologies underlying stress urinary incontinence (SUI) in women. Methods For the data sources, a structured search of the peer-reviewed literature (English language; 1960–April 2020) was conducted using predefined key terms in PubMed and Embase. Google Scholar was also searched. Peer-reviewed manuscripts that reported on anatomical, physiological or functional differences between females with signs and/or symptoms consistent with SUI and a concurrently recruited control group of continent females without any substantive urogynecological symptoms. Of 4629 publications screened, 84 met the inclusion criteria and were retained, among which 24 were included in meta-analyses. Results Selection bias was moderate to high; < 25% of studies controlled for major confounding variables for SUI (e.g., age, BMI and parity). There was a lack of standardization of methods among studies, and several measurement issues were identified. Results were synthesized qualitatively, and, where possible, random-effects meta-analyses were conducted. Deficits in urethral and bladder neck structure and support, neuromuscular and mechanical function of the striated urethral sphincter (SUS) and levator ani muscles all appear to be associated with SUI. Meta-analyses showed that observed bladder neck dilation and lower functional urethral length, bladder neck support and maximum urethral closure pressures are strong characteristic signs of SUI. Conclusion The pathology of SUI is multifactorial, with strong evidence pointing to bladder neck and urethral incompetence. While there is also evidence of impaired urethral support and levator ani function, standardized approaches to measurement are needed to generate higher levels of evidence.

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The relationship between low back pain, pelvic tilt, and lumbar lordosis with urinary incontinence using the DIERS formetric 4D motion imaging system

Ozudogru Celik,

Yalcin,

Keskin

et al. 2023

Int Urogynecol J

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The relation of the pelvis and the perineal function in incontinent women: A neglected subject

Abstract: In the present sample, incontinent women have a greater anterior slope of the pelvis, and the greater the degree of anterior slope, the greater the electrical activity of the PFM, during rest, and in orthostasis.

Cited by 6 publications

References 42 publications

Assessing the patient undergoing pelvic rehabilitation for urinary incontinence: From theory to practice

Assessing the patient undergoing pelvic rehabilitation for urinary incontinence: From theory to practice

The pathophysiology of stress urinary incontinence: a systematic review and meta-analysis

The relationship between low back pain, pelvic tilt, and lumbar lordosis with urinary incontinence using the DIERS formetric 4D motion imaging system

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