The symptom of vaginal bulging in nulliparous women aged 25–64 years: a national cohort study

Gyhagen, Maria; Othman, Jwan Al-Mukhtar; Åkervall, Sigvard; Nilsson, Ida; Milsom, Ian

doi:10.1007/s00192-018-3684-5

Cited by 15 publications

(13 citation statements)

References 27 publications

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“…Although it is common knowledge among gynecologists that the relationship between the anatomical stage of POP and sPOP is unpredictable, it has been shown that symptoms increase markedly once the leading edge reaches 1 cm proximal to the introitus, including most patients with POPQ-stage ≥ 2 [ 27 ]. In 199 women with POPQ-stage 0 (parity not specified), Tegerstedt et al found that the “bulging” symptom was reported to occur “infrequently” in 6.0%, “sometimes” in 2.5%, and “often” in 0%, very similar to our results in almost 10,000 nulliparous women aged 25–64 years of age [ 16 , 18 , 21 ]. For women with POP-Q stage < 2, every third reported symptoms of “bulging,” of which 7% had POPQ-stage 0, i.e., were false positive [ 18 ].…”

Section: Strengths and Weaknessessupporting

confidence: 89%

“…This study is the fourth report of the Swedish Pregnancy Obesity and Pelvic Floor project in nulliparous women. Earlier studies addressed the age-dependent prevalence of UI, sPOP, and overactive bladder [ 14 – 16 ]. The questionnaire included questions about current height and weight, childhood NE, urinary incontinence (UI) or fecal incontinence (FI), genital prolapse, nocturia, urgency, and menstrual status (information about current pregnancy, hysterectomy, menopausal status, and hormone treatment).…”

Section: Methodsmentioning

confidence: 99%

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Childhood nocturnal enuresis—a marker for pelvic floor disorders and urinary tract symptoms in women?

Othman

Åkervall

Molin³

et al. 2020

Int Urogynecol J

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Introduction and hypothesis A systematic survey on the association between childhood nocturnal enuresis (CNE) and adult pelvic floor disorders (PFDs) has not been presented previously. The aim was to describe the prevalence of PFDs and lower urinary tract symptoms in nulliparous women, with or without a history of CNE, at the age of ≥ 5 years. Methods This national survey of urinary (UI) and fecal incontinence (FI) and symptoms of pelvic organ prolapse (sPOP) was a random sample of 20,000 nulliparous women aged 25–64 years conducted in 2014. Women ≥ 5 years of age having CNE were compared with those without the condition. Fisher’s exact test and logistic regression adjusted for BMI and age were used to analyze differences between groups. Results The response rate was 52% and 10.2% of adult women reporting CNE. One or more PFDs occurred in 38.3% of women with CNE compared to 23.8% in those without CNE ( p < 0.0001). Mixed UI had the strongest association with CNE, odds ratio (OR) 2.63 (95% CI 2.03–3.40). The rate of FI was 11.2% in the non-CNE group and 16.8% in those with CNE ( p < 0.0001) and sPOP 2.6% in the non-CNE and 4.8% in the CNE group ( p = 0.0004), respectively. The prevalence of lower urinary tract symptoms was consistently higher in women with a history of CNE: overactive bladder 32.6% versus 18.4% (OR 2.34 95% CI 2.03–3.40), daytime micturition ≥ 8/day 29.6% versus 24.0% ( p < 0.0001), and nocturia ≥ 2/night 12.4% versus 7.8% ( p < 0.0001) in the CNE group. Conclusion PFDs and lower urinary tract symptoms in nulliparous women were approximately doubled in women with a history of CNE and could therefore act as a strong confounding factor. Electronic supplementary material The online version of this article (10.1007/s00192-020-04345-x) contains supplementary material, which is available to authorized users.

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Section: Strengths and Weaknessessupporting

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Childhood nocturnal enuresis—a marker for pelvic floor disorders and urinary tract symptoms in women?

Othman

Åkervall

Molin³

et al. 2020

Int Urogynecol J

Self Cite

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“…LISA data can be used to compare responders and non-responders in questionnaire studies. In one study, postal questionnaire non-responders had lower education, lower income, and were more likely to have been born outside Sweden than responders [ 59 , 60 ]. Education and income can be used both as exposures and outcomes, but are most often used as covariates in statistical models [ 61 , 62 ].…”

Section: Contents Of Lisamentioning

confidence: 99%

The longitudinal integrated database for health insurance and labour market studies (LISA) and its use in medical research

et al. 2019

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Education, income, and occupation are factors known to affect health and disease. In this review we describe the Swedish Longitudinal Integrated Database for Health Insurance and Labour Market Studies (LISA, Longitudinell Integrationsdatabas för Sjukförsäkrings- och Arbetsmarknadsstudier). LISA covers the adult Swedish population aged ≥ 16 years registered on December 31 each year since 1990 (since 2010 individuals aged ≥ 15 years). The database was launched in response to rising levels of sick leave in the country. Participation in Swedish government-administered registers such as LISA is compulsory, and hence selection bias is minimized. The LISA database allows researchers to identify individuals who do not work because of injury, disease, or rehabilitation. It contains data on sick leave and disability pension based on calendar year. LISA also includes information on unemployment benefits, disposable income, social welfare payments, civil status, and migration. During 2000–2017, an average of 97,000 individuals immigrated to Sweden each year. This corresponds to about 1% of the Swedish population (10 million people in 2017). Data on occupation have a completeness of 95%. Income data consist primarily of income from employment, capital, and allowances, including parental allowance. In Sweden, work force participation is around 80% (2017: overall: 79.1%; men 80.3% and women 77.9%). Education data are available in > 98% of all individuals aged 25–64 years, with an estimated accuracy for highest attained level of education of 85%. Some information on civil status, income, education, and employment before 1990 can be obtained through the Population and Housing Census data (FoB, Folk- och bostadsräkningen).

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“…Противоречит указанной концепции также и то, что, несмотря на огромное число научных данных, достоверные морфологические маркеры синдрома так и не найдены, исследования, посвященные их поиску, достаточно спорны [41]. Но теория системной дисплазии соединительной ткани может объяснять раннее развитие пролапса у девочек, подростков и молодых нерожавших женщин [42].…”

Section: гинекологияunclassified

Current Paradoxes in Perineology

Toktar¹,

Aryutin²,

Volkova³

et al. 2019

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Цель обзора: систематизация контраверсионных аспектов современной перинеологии и пролаптологии. Основные положения. Современная перинеология существует в условиях накопившихся парадоксальных фактов, мнений и решений, среди которых дидактический, эпидемиологический, экономический, анатомический, герниологический, тактический, эволюционный, акушерский, морфологический и другие парадоксы. Существуют два уязвимых места множества исследований, посвященных выпадению тазовых органов у женщин, которые мешают преодолеть упомянутые парадоксы. Первое из них-это представление о тазовом дне как о статичной структуре. Известно, что мышцы тазового дна рефлекторно сокращаются в ответ на любое повышение внутрибрюшного давления аналогично батуту, т. е. никогда не находятся в покое. В то же время внимание исследователей приковано в основном к соединительной ткани тазовых фасций и связок, а основной ткани, обеспечивающей функцию тазового дна-мышечной,-посвящены лишь единичные публикации. Второе уязвимое место современных научных работ-рассмотрение пролапса лишь в одной точке его развития, и, к сожалению, эта точка-конечная. Тактика оперировать только выраженный пролапс, не искать пути хирургической профилактики запутала самих исследователей. Очевидно, что следует изучать морфологические, иммуногистохимические и другие ультраструктурные характеристики тканей на этапе продромальной несостоятельности тазового дна, при синдроме широкого влагалища без манифестации пролапса, сопоставляя полученные данные с результатами применения неинвазивных методов диагностики. Заключение. Получив представление о ранних формах, а не только о выраженном пролапсе с уже сформировавшимися декомпенсаторными необратимыми изменениями тканей и анатомических взаимоотношений, можно попытаться обоснованно объяснить патогенез тазовой десценции и разрешить накопившиеся парадоксы перинеологии. Ключевые слова: пролапс тазовых органов, несостоятельность тазового дна, тазовая дисфункция, перинеология, пролаптология.

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The symptom of vaginal bulging in nulliparous women aged 25–64 years: a national cohort study

Cited by 15 publications

References 27 publications

Childhood nocturnal enuresis—a marker for pelvic floor disorders and urinary tract symptoms in women?

Childhood nocturnal enuresis—a marker for pelvic floor disorders and urinary tract symptoms in women?

The longitudinal integrated database for health insurance and labour market studies (LISA) and its use in medical research

Current Paradoxes in Perineology

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