Prevalence and associated factors of symptomatic pelvic floor disorders among women living in Debre Tabor Town, Northwest Amhara, Ethiopia.

BACKGROUND: Pelvic floor disorders are a group of disorders affecting the pelvic floor that include clinically definable conditions such as pelvic organ prolapse, urinary incontinence and fecal incontinence. These conditions silently affect millions of women worldwide and related problems are not well disclosed by women due to associated social stigma or lack of access to services in developing countries. Thus, the magnitude and related burden of these conditions vary, and little is known about them. This study was conducted to assess the magnitude and associated factors of symptomatic pelvic floor disorders in Debre Tabor town, Northwest, Ethiopia, from May 30-July 30, 2020. METHOD: A community-based cross-sectional study was conducted on child bearing women (> 15 years) who resided in Debre Tabor Town from May 30-July 30, 2020. The participants were selected through multistage systematic random sampling. The data were collected via a structured questionnaire through face-to-face interviews, entered into Epi-info-7.2, and subsequently analyzed using SPSS version 20. The prevalence of pelvic floor disorders was presented along with the 95% CI. RESULTS: A total of 402 women participated in this study, 59 (14.7%; 95% CI; 11.4, 18.2) of whom reported one or more types of pelvic floor disorders. The most prevalently reported pelvic floor disorders were pelvic organ prolapse (13.9%; 95% CI: 10.9, 17.4), urinary incontinence (10.9%; 95% CI: 7.4, 9.2) and fecal incontinence (7.7%; 95% CI: 5.2, 10.2). Additionally, aging, multiparity and having early marriage (< 18 yrs.) were identified as potential risk factors associated with pelvic floor disorders. CONCLUSIONS: The prevalence of symptomatic pelvic floor disorders in the current study was high. Thus, early detection, preventive and treatment strategies should be considered. In addition, it is better to educate the community and women on the association of early marriage and multiparty with PFDs.

Pelvic floor muscle strength and dysfunctions in women with pes planus: A case-control study.

BACKGROUND/AIM: Distal extremity misalignment may give rise to pelvic floor dysfunctions (PFDs). This study aimed to compare pelvic floor muscle strength (PFMS) and dysfunctions in women with and without pes planus. MATERIALS AND METHODS: Women with (pes planus group, n = 30) and without pes planus (control group, n = 30) were included. The presence of PFDs questioned. Pes planus with the Feiss Line Test, PFMS with the Modified Oxford Scale, and the severity of PFDs with the Pelvic Floor Distress Inventory-20 (PFDI-20), including three subscales (Pelvic Organ Distress Inventory-6 (POPDI-6) for pelvic organ prolapse, Colorectal-Anal Distress Inventory-8 (CRADI-8) for colorecto-anal symptoms, and Urinary Distress Inventory-6 (UDI-6) for urinary symptoms, were assessed. RESULTS: It was seen that no difference was found between groups in terms of PFMS (p > 0.05). However, urinary incontinence and anal incontinence were higher in women with pes planus than in women without pes planus (p < 0.05). Only the PFDI-20, CRADI-8, and UDI-6 scores were higher in women with pes planus compared to controls (p < 0.05). There was no difference was found between groups in terms of POPDI-6 scores (p > 0.05). CONCLUSION: The PFMS did not change according to the presence of pes planus. However, the prevalence of PFDs and their severity were higher in women with pes planus in comparison to controls. Posture assessments of individuals with PFDs, especially examination of foot posture, and pelvic floor assessments of individuals with posture disorders should be considered.

Breaking barriers: Exploring female-specific health challenges affecting performance in an elite multisport training environment.

OBJECTIVES: Female-specific issues, such as breast injuries, pelvic floor dysfunctions, saddle sores, and menstrual symptoms, can significantly impact female athletes. This study examined the prevalence, perceived impact on performance, and role of the support staff in addressing and managing these issues in elite athletes based at a multisport training centre. DESIGN: Anonymous online questionnaire. METHODS: A total of 180 female athletes from various sport disciplines at the Dutch Olympic Training Centre were invited to participate in the study. An anonymous, 39-item questionnaire was developed and hosted on Qualtrics collecting data on respondents' characteristics, breast injuries, pelvic floor dysfunctions, saddle sores, menstrual symptoms, contraceptive use, and communication about these issues. RESULTS: A total of 105 valid responses were analysed. The findings revealed that athletes regularly experience breast injuries (15.2 %), urinary incontinence (29.5 %), other pelvic floor problems (21.0 %), saddle sores (65.7 %), and menstrual cycle-related symptoms, with negative performance effects. Communication with support staff remained limited, with only 23.8 % of athletes discussing any of these issues, often due to concerns about understanding, shame, or a lack of opportunity for easy communication. CONCLUSIONS: The findings underscore the crucial role of creating a supportive environment, promoting early intervention, and utilising multisport centres to comprehensively address these concerns, emphasising the need for open communication, education, and support to enhance female athletes' performance and well-being.

Pelvic floor symptoms according to the severity of second-degree perineal tears within 12 months post-partum: A longitudinal prospective cohort study.

INTRODUCTION: Second-degree perineal tears following vaginal birth are common and presumed to be of little clinical importance. However, the extent of damage to the perineal body varies widely, and there is reason to believe that larger second-degree tears may be associated with more pelvic floor symptoms, compared to lesser form. Therefore, the aim of this study was to assess differences in pelvic floor symptoms according to the severity of second-degree perineal tears up to 12 months post-partum, stratified by parity. MATERIAL AND METHODS: This was a prospective cohort study conducted at Akershus University Hospital, a tertiary referral hospital in Norway. The study sample consisted of 409 primiparas and 394 multiparas with vaginal births. Perineal tears were classified using the classification system recommended by the Royal College of Obstetricians and Gynecologists. Further, second-degree tears were subclassified as 2A, 2B, or 2C, depending on the percentage of damage to the perineal body. Episiotomies were analyzed as a separate group. Pelvic floor symptoms were assessed using the Karolinska Symptoms After Perineal Tear Inventory (KAPTAIN). A linear mixed model was estimated to assess the trend in pelvic floor symptom scores according to perineal tear category and stratified by parity. The primary and secondary outcome measures were the mean sum scores of the KAPTAIN-Inventory, measured in pregnancy (at 18 weeks of gestation), at 3- and 12 months post-partum, and the reported impact of genital discomfort on quality of life measured in pregnancy and at 12 months post-partum. RESULTS: There were no significant differences in pelvic floor symptom scores over time, or at any timepoint, between no tear, first-degree tear, or second-degree tear subcategories, for primi-, and multiparas. Pelvic floor symptoms increased from pregnancy to 3 months post-partum and remained higher at 12 months post-partum compared to pregnancy in all perineal tear categories. Compared to primiparas, multiparas reported a significantly higher impact of genital discomfort on quality of life in pregnancy and at 12 months post-partum. CONCLUSIONS: There were no statistically significant differences in pelvic floor symptoms according to the severity of second-degree perineal tears.

Epidemiology of Pelvic Floor Dysfunction in the Tacna Region of Peru, 2023.

INTRODUCTION AND HYPOTHESIS: Urinary incontinence (UI) is highly prevalent in the general population, with numerous studies conducted in Europe and North America. However, there is a scarcity of data regarding its prevalence and sociodemographic factors in the southern region of Peru. There is an association between sociodemographic factors-such as age, educational level, body mass index, number of pregnancies, parity, mode of delivery, weight of the newborn-along with lifestyle factors such as physical effort, coffee and tobacco consumption with pelvic floor dysfunction (PFD). We anticipate that this association will negatively impact women's quality of life. METHODS: This was a quantitative study, with a non-experimental, descriptive, cross-sectional correlational design. A sample consisting of 468 women between 30 and 64 years old. A previously tested survey was applied to explore prevalence, symptoms, associated factors, and quality of life. RESULTS: The prevalence of PFD was 73.9%. UI was the most common. There is a significant association with overweight, obesity, parity, route of delivery, and physical effort. Even though a large percentage of participants presented with PFD, they reported that their quality of life was not affected (65.9% urinary discomfort, 96.5% colorectal-anal discomfort and 92.2% pelvic organ prolapse discomfort) and only in the case of urinary discomfort did they state that the impact was mild (28.6%) and moderate (5.5%). CONCLUSIONS: Pelvic floor dysfunction in women is very common and it is strongly associated with overweight, obesity, parity, route of delivery, and physical exertion. The impact on quality of life was mild and moderate for those who had urinary discomfort.

Symptomatology and knowledge regarding pelvic floor dysfunctions and influence of gender stereotypes in female athletes.

Pelvic floor dysfunctions (PFD) are highly prevalent among females who do athletics, a sport requiring jumping, strength, and running. Although educational approaches are useful options, the educational need for this particular population remains unknown. The objective of the present study was to describe the level of knowledge regarding PFD and its relationship with symptomatology and gender stereotypes in female athletes in Spain. A total of 255 female athletes completed an anonymous online survey to explore their knowledge regarding urinary incontinence (UI), pelvic organ prolapse (POP), anal incontinence (AI), and sexual dysfunction (SexD), as well as their PFD symptoms and gender stereotyped beliefs related to sport. Educational level and sports characteristics (training volume, experience, and athletic modality) were also explored. Participants demonstrated a low level of knowledge in terms of POP (52.5%), AI (64.0%), and SexD (40%), but not for UI (70.8%). The proportion of PFD complaints was 63.5% for dyspareunia, 51.8% for urine leakage, 42.4% for pelvic pain, 17.3% for AI, and 9.0% for POP, with no associations with knowledge (p > 0.05). Lower knowledge about UI and SexD was related to greater gender stereotypes (p < 0.05) and rejection of professional healthcare (p = 0.010). As a conclusion, the level of knowledge about PFD was low in female athletes who train and compete in athletics in Spain, mainly with regard to sexual dysfunction. Although 63.5% of athletes had dyspareunia and 51.8% urinary leakages, symptomatology was not associated with level of knowledge. However, a lower level of knowledge was associated with more stereotyped beliefs and rejection of professional healthcare for PFD. These findings confirm the need to design appropriate educational interventions to disseminate information on all the types of PFD, particularly sexual contents. The potential influence of gender stereotypes makes it appropriate to include the gender perspective in these interventions.

Pelvic Floor Dysfunction in Transgender Men on Gender-affirming Hormone Therapy: A Descriptive Cross-sectional Study.

INTRODUCTION AND HYPOTHESIS: The objective of this research is to explore the effects of hormone therapy using testosterone on pelvic floor dysfunction (PFD) in transgender men. We hypothesize that PFD might be prevalent among transgender men undergoing hormone therapy. Therefore, this study was aimed at verifying the frequency of these dysfunctions. METHODS: A cross-sectional study was conducted between September 2022 and March 2023 using an online questionnaire, which included transgender men over 18 years old who underwent gender-affirming hormone therapy. Volunteers with neurological disease, previous urogynecology surgery, active urinary tract infection, and individuals without access to the internet were excluded. The questionnaire employed validated tools to assess urinary symptoms, such as urinary incontinence (UI), as well as sexual dysfunction, anorectal symptoms, and constipation. The data were analyzed descriptively and presented as frequencies and prevalence ratios with their respective confidence intervals (95% CI), mean, and standard deviation. RESULTS: A total of 68 transgender men were included. Most participants had storage symptoms (69.1%), sexual dysfunction (52.9%), anorectal symptoms (45.6%), and flatal incontinence (39.7%). Participants with UI symptoms reported moderate severity of the condition. CONCLUSIONS: Transgender men on hormone therapy have a high incidence of PFD (94.1%) and experience a greater occurrence of urinary symptoms (86.7%).

Systematic Review and Meta-analysis of the Prevalence of Levator Ani Avulsion with Obstetric Anal Sphincter Injury and its Effects on Pelvic Floor Dysfunction.

INTRODUCTION AND HYPOTHESIS: The objective was to evaluate the prevalence of levator ani avulsion (LAA) among primiparous women with obstetric anal sphincter injury (OASI) and how this association could affect future pelvic floor dysfunction. METHODS: Three electronic databases (MEDLINE/PubMed/EMBASE) were searched in December 2018 and again in October 2022. Nine full-text articles were included in the analysis. The exclusion criteria were language other than English, studies not based on primiparous women only, conference abstracts, and evaluation without ultrasound or MRI. RESULTS: The overall prevalence of LAA was 24% (95% CI: 18-30%). Those with OASI, were at a higher risk of LAA, OR 3.49 (95% CI: 1.46 to 8.35). In women with LAA + OASI versus OASI alone, Three of Five studies showed worsened AI symptoms. Three of Five studies assessing urinary incontinence (UI) reported no significant difference in UI, whereas two reported increased UI. All studies that looked at pelvic organ prolapse reported a higher incidence of symptomatic prolapse and reduced pelvic floor muscle strength in women with LAA + OASI compared with those without LAA. CONCLUSION: Levator ani avulsion is prevalent following vaginal birth and is strongly associated with OASI. Incidence of AI does not increase in women with LAA and OASI, but they had greater symptom bother. OASI with LAA appears to increase the incidence of pelvic floor weakness and pelvic organ prolapse. There is no consensus agreement on the effect of LAA + OASI on UI.

Pelvic Floor Physical Therapy Attendance Among High-Risk Postpartum Patients.

IMPORTANCE: Limited data describe attendance to pelvic floor physical therapy (PFPT) in a postpartum patient population. OBJECTIVES: The objective was describe attendance to PFPT in a cohort of postpartum women at high-risk of pelvic floor concerns. We secondarily compared attendance between patients with and without evaluation in a postpartum pelvic floor healing clinic (PPFHC). STUDY DESIGN: This was a retrospective cohort study of 2 convenience samples from an academic hospital. The PPFHC cohort comprised all postpartum vaginal delivery patients evaluated in the PPFHC from July 2021 to July 2022. The historical pre-PPFHC cohort comprised patients with third/fourth-degree obstetrical lacerations from December 2019 to January 2021. We abstracted attendance to PFPT, number of visits, Pelvic Floor Distress Inventory-20 (PFDI-20) scores, Pelvic Floor Impact Questionnaire (PFIQ) scores, and discharge status. RESULTS: Our cohort contained 464 patients, 195 (42.0%) from pre-PPFHC and 269 (58.0%) from PPFHC. Among all patients 302 (65.1%) were referred to PFPT and 170 (56.3%) attended at least 1 visit, 82 (48.2%) were discharged from PFPT with goals met, and the median number of visits was 6 (3-10). The majority of patients (97.0%, n = 261) seen in the PPFHC were referred to PFPT, compared with 22.0% (n = 41) of pre-PPFHC patients (P < 0.01). More patients in the pre-PPFHC cohort attended PFPT than in those the PPFHC cohort (75.6% vs 53.5%, P ≤ 0.01). Most patients exhibited improved PFDI and PFIQ scores after PFPT (n = 88, 80.0%, and n = 89, 81.7% respectively). CONCLUSIONS: Patients attending postpartum PFPT demonstrated high therapy completion rates. A dedicated PPFHC had more referrals, however, lower PFPT attendance rates, when compared with a historical cohort.

Pelvic Floor Disorders Among Minority Women: Differences in Prevalence, Severity and Health-Related Social Needs.

OBJECTIVE: To characterize prevalence and severity of pelvic floor disorders (PFDs) in various health care settings and to examine unmet health-related social needs (HRSN) among minority women. MATERIALS AND METHODS: Minority women with PFDs were recruited from our academic urogynecology clinic, a general urology clinic at our institution's safety net hospital, and a community outreach mobile clinic. Questions from the Urinary Distress Index-6, Pelvic Organ Prolapse Distress Inventory-6, and Female Genitourinary Pain Index were used to identify patients with stress urinary incontinence, overactive bladder (OAB), and chronic pelvic pain syndrome (CPPS). RESULTS: Sixty-one (46.6%) women identified as Hispanic, 53 (40.4%) as Black, and 17 (12.9%) as Other. Overall, self-reported PFDs included stress urinary incontinence in 45%, OAB in 74.8%, and CPPS in 24.4% of women. Hispanic women were more likely to report OAB symptoms, compared to Black women (odds ratio (OR) 3.4 [1.2-10.2], P = .03) or Other women (OR = 5.1 [1.3-20.4], P = .02). Participants held a median of 5 unmet HRSN. Minority women facing issues with family and community support, transportation, and utilities were more likely to report CPPS symptoms, compared to those without psychosocial issues (support OR: 4.8 [1.7-13.7], P = .002; transportation OR: 2.0 [1.0-8.2], P = .05; utility OR: 7.0 [1.9-28.1], P = .005). CONCLUSION: Minority women with PFDs may have several unmet HRSNs which impact their ability to receive appropriate medical care. Our findings may assist in the development of effective strategies to improve health care outcomes for women dealing with PFDs.

Pelvic floor dysfunction after intervention, compared with expectant management, in prolonged second stage of labour: A population-based questionnaire and cohort study.

OBJECTIVE: To investigate the effect of vacuum extraction (VE) or caesarean section (CS), compared with expectant management, on pelvic floor dysfunction (PFD) 1-2 years postpartum in primiparous women with a prolonged second stage of labour. DESIGN: A population-based questionnaire and cohort study. SETTING: Stockholm, Sweden. POPULATION: A cohort of 1302 primiparous women with a second stage duration of ≥3 h, delivering from December 2017 to November 2018. METHODS: The 1-year follow-up questionnaire from the Swedish National Perineal Laceration Register was distributed 12-24 months postpartum. Exposure was VE or CS at 3-4 h or 4-5 h, compared with expectant management. MAIN OUTCOME MEASURES: Pelvic floor dysfunction was defined as at least weekly symptoms of urinary incontinence, pelvic organ prolapse or a Wexner score of ≥4. The risk of PFD was calculated using Poisson regression with robust variance estimation, presented as crude and adjusted relative risks (RRs and aRRs) with 95% confidence intervals (95% CIs). The implication of obstetric anal sphincter injury (OASI) on pelvic floor disorders was investigated through mediation analysis. RESULTS: In total, 35.1% of women reported PFD. Compared with expectant management, the risk of PFD was increased after VE at 3-4 h (aRR 1.33, 95% CI 1.06-1.65) and 4-5 h (aRR 1.34, 95% CI 1.05-1.70), but remained unchanged after CS. The increased risk after VE was not mediated by OASI. CONCLUSIONS: Pelvic floor dysfunction was common in primiparous women after a prolonged second stage, and the risk of PFD increased after VE but was unaffected by CS, compared with expectant management. If a spontaneous vaginal delivery eventually occurred, allowing an extended duration of labour did not increase the risk of PFD.

Pelvic floor disorders among amateur runners.

BACKGROUND: Sports and physical activity are known risk factors for pelvic floor dysfunction (PFD). The aim of this study is to examine the impact of amateur running on PFD, quality of life (QoL), and sexual function. METHODS: Amateur runners were contacted through social media. Their PFD, sexual function, and QoL were evaluated by self-reporting validated questionnaires (PFDI-20, PISQ-12, IIQ-7). They were divided by degree of effort into two categories, 'High effort' and 'Moderate effort'. The differences between the two groups were examined by a Mann-Whitney U Test, T-Test, and Chi-square test. RESULTS: 180 women were included. A high incidence of PFD was found among 'High effort' runners in comparison to 'Moderate effort' runners. In addition, women who scored above the median in the PFDI-20 showed significantly greater impairment in QoL and sexual function. Interestingly, the 'High effort' group reported experiencing higher intensity orgasms compared with women in the 'Moderate effort' group. A correlation was also found between the weekly running distance and the intensity of orgasm experienced (P value = 0.004). CONCLUSION: 'High effort' runners present a higher incidence of PFD in comparison to 'Moderate effort' runners. Professional pelvic floor muscle training counselling should be considered even for amateur runners. Future interventional physical therapy studies should be carried out in order to investigate preventative strategies.

The causal effect of reproductive factors on pelvic floor dysfunction: a Mendelian randomization study.

BACKGROUND: Pelvic floor dysfunction (PFD) is an extremely widespread urogynecologic disorder, the prevalence of which increases with aging. PFD has severely affected women's quality of life and has been called a social cancer. While previous studies have identified risk factors such as vaginal delivery and obesity for PFD, other reproductive factors, including age at menarche (AAMA), have been largely overlooked. Therefore, we used a Mendelian randomization (MR) study for the first time to investigate the potential causal relationship between reproductive factors and PFD. METHODS: We obtained summary statistics from genome-wide association studies (GWAS) for female genital prolapse (FGP), stress urinary incontinence (SUI), and five reproductive factors. Two-sample Mendelian randomization analysis (TSMR) was performed to explore the causal associations between these factors. The causal effects of reproductive factors on FGP and SUI were primarily estimated using the standard inverse variance weighting (IVW) method, with additional complementary and sensitivity analyses conducted using multiple approaches. A multivariate Mendelian randomization (MVMR) study was also conducted to adjust for pleiotropic effects and possible sources of selection bias and to identify independent exposure factors. RESULTS: Our findings revealed that advanced age at first sexual intercourse (AFS) and age at first birth (AFB) exhibited negative causal effects on both FGP and SUI. AAMA showed negative causal effects solely on FGP, while age at last live birth (ALB) and age at menopause (AAMO) did not demonstrate any causal effect on either FGP or SUI. And the MVMR results showed that AFB and AFS had independent negative causal effects on FGP and SUI, respectively. CONCLUSIONS: This study, for the first time, investigates the causal relationship between reproductive factors and PFD. The results suggested a causal relationship between some reproductive factors, such as AFB and AFS, and PFD, but there were significant differences between FGPand SUI. Therefore, future studies should explore the underlying mechanisms and develop preventive measures for reproductive factors to reduce the disease burden of PFD.

Pelvic Floor Disorders in Black Women: Prevalence, Clinical Care, and a Strategic Agenda to Prioritize Care.

Pelvic floor disorders are a group of common conditions affecting women of all racial and ethnic groups. These disorders are undertreated in all women, but this is especially magnified in Black people who have been historically marginalized in the United States. This article seeks to highlight the prevalence of pelvic floor disorders in Black women, evaluate the clinical care they receive, examine barriers they face to equitable care, and present a strategic agenda to prioritize the care of Black women with pelvic floor disorders.

Influence of pelvic floor disorders on sexuality in women.

OBJECTIVE: To determine the association between different pelvic floor disorders and the presence of sexual dysfunction in women. METHOD: An observational study of non-pregnant women was carried out in Spain in 2021 and 2022. To assess the presence of pelvic floor problems, the Pelvic Floor Distress Inventory (PFDI-20) was used, consisting of the subscales Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6; prolapse symptoms), Colorectal-Anal Distress Inventory (CRADI-8; colorectal symptoms), and Urinary Distress Inventory-6 (UDI-6; urinary symptoms). The validated tool, Female Sexual Function (FSF), was used to evaluate female sexual function. RESULTS: In total, 1008 women participated. Of these, 288 (28.6%) had some type of sexual dysfunction. Regarding symptoms, 52 (5.2%) stated that they do not reach orgasm and 172 (17.1%) said they had never or occasionally felt sexual desire in the last month. Women with sexual dysfunctions had higher mean scores on the POPDI-6, CRADI-8, and UDI-6 subscales than those who did not have sexual dysfunction (P ≤ 0.005). Risk factors identified included being postmenopausal, with an adjusted odds ratio (aOR) of 2.98 (95% confidence interval [CI] 2.12-4.18), and a greater impact of the symptoms of pelvic floor problems as assessed by the PFDI-20 scale, in such a way that for each point increase the probability of sexual dysfunction increases with an aOR of 1.008 (95% CI 1.005-1.011). CONCLUSION: Women with pelvic floor disorders and postmenopausal women present sexual dysfunction more frequently.

Association of Low Vitamin D Level with Pelvic Organ Prolapse in Post Menopausal Women: A Case Control Study.

Pelvic organ prolapse refers to protrusion of the pelvic organ into or out of the vaginal canal. One in four women in the USA suffer from some type of pelvic floor disorder including pelvic organ prolapse and frequency of pelvic organ prolapse is more with increasing age. In Bangladesh, 15.6% women suffered from pelvic organ prolapse and more than 11.0% of women require surgical correction of prolapse in their life times. According to few researches, there is an observed association between low vitamin D levels with pelvic organ prolapse but this finding is not unequivocal. This case control study has been conducted in the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from October 2018 to August 2020 to investigate the level of vitamin D in patients with and without pelvic organ prolapse to explore the association of low vitamin D with pelvic organ prolapse. A total 148 participants of 52 years or older attending the out or inpatient department were enrolled in the study. The study population was divided into two groups, a case group (n=74) consisting of patients with pelvic organ prolapse and a control group (n=74) comprising of women without pelvic organ prolapse. After taking informed written consent the serum vitamin D level of all participants was measured by CMIA technology with flexible assay protocols at Biochemistry and Molecular Biology department of the same institute. All necessary Data were collected on variables of interest by using the structured questionnaire pre-designed for interview, observation, clinical examination, and biochemical Data collection. Distributions were expressed by mean and standard deviation for continuous variables and by frequency and percentage for qualitative variables. Student's t-test and Chi square test were done to see the significance of differences between Group I and Group II. Odds ratio, correlation coefficient, and multivariate logistic regression analysis was done to assess the association of low vitamin D level with pelvic organ prolapse. Mean±SD level of Vitamin D in the case group was 13.96±5.18ng/ml and in the control group was 21.08±5.77ng/ml respectively. The difference was statistically significant (p<0.05). Moreover, the vitamin D levels were inversely proportionate with the severity of pelvic organ prolapse. OR (95% CI), of two groups showed risk of developing pelvic organ prolapse 5.63 times higher in women with decreased vitamin D level. Thus it can be concluded that women having low level of vitamin D have more chance of developing pelvic organ prolapse.

Pelvic floor dysfunction after colorectal cancer treatment is related to physical and psychological health and body image: A cross-sectional study.

PURPOSE: Pelvic floor dysfunction (PFD) often occurs in patients with colorectal cancer (CRC), which can affect their quality of life. However, the precise factors that related to PFD in CRC patients remain elusive. The main objective of this study was to identify the variables associated with PFD following CRC treatment and establish a foundation for the development of a tailored rehabilitation plan specific to this population. METHODS: The classification of 149 patients with CRC was conducted according to the type of medical treatment they underwent. PFD was evaluated using the Urogenital Distress Inventory 6 (UDI-6) and Colorectal-Anal Distress Inventory 8 (CRADI-8) questionnaires. The study employed the Short form 36 health survey (SF-36) and Body Image Scale (BIS) to evaluate physical and psychological health as well as body image disorders. The connection between PFD and independent variables was determined through logistic regression analyses. RESULTS: Of all patients, more than 50% reported experiencing dysfunction, with the highest proportion observed in the PRT (primary radiotherapy) group. The LRR/RR (robotic-assisted colorectal resection or laparoscopic colorectal resection) group revealed a significant association between high BMI (Body Mass Index) and alcohol consumption with PFD. Moreover, in the PRT group, PFD was correlated with poorer physical condition (OR = 0.94, 95% CI = [0.88-1.00]). CONCLUSIONS: PFD is a commonly complained-about issue among patients with CRC. Early intervention targeted towards these factors may aid in the alleviation of associated distress and contribute towards the individualization of CRC rehabilitation programs, consequently improving the quality of life for patients.

Effect of Surgically Induced Weight Loss on Pelvic Organ Prolapse: A Meta-analysis.

INTRODUCTION: Bariatric surgery alleviates certain aspects of pelvic floor disorder, but the effect on pelvic organ prolapse (POP) is unclear. To assess the effect of bariatric surgery on POP we conducted the present meta-analysis and firstly performed a subgroup analysis based on the duration of follow-up. METHODS: Four databases including PubMed, The Cochrane Library, Web of Science, and Embase were searched to identify relevant studies published before February 24, 2023. The main outcome was the prevalence and severity of POP symptoms before and after bariatric surgery. Then we assessed the heterogeneity, publication bias and performed subgroup analyses based on follow-up time, study quality and region. RESULTS: Eleven studies with a total of 696 participants met the inclusion criteria. The results showed that the prevalence of POP decreased after bariatric surgery (odds ratio[OR] = 2.29, 95% confidence interval[CI]: 1.05, 5.01; P = 0.04, I2 = 78%), with significant differences observed both at 3-6 months (OR = 2.24, 95% CI: 1.25, 4.01; P = 0.007, I2 = 59%) and 12 months (OR = 4.64, 95% CI: 2.83, 7.58; P < 0.0001, I2 = 0%) of follow-up compared with pre-surgery. Pelvic Organ Prolapse Distress Inventory scores 6-item also decreased after bariatric surgery (mean difference [MD] = 2.11, 95% CI: 0.32, 3.89; P = 0.02, I2 = 55%) with significant differences observed both at 3-6 months (MD = 3.72; 95% CI: [0.10, 7.34], P = 0.04, I2 = 70%) and ≥ 12 months (MD = 3.24; 95% CI: [0.56, 5.91], P = 0.02, I2 = 56%) of follow-up. CONCLUSION: Bariatric surgery alleviated POP symptoms in women with obesity both during short-term (3-6 months) and long-term (≥ 12 months) follow-up.

Pelvic floor dysfunction: prevalence and associated factors.

BACKGROUND: Pelvic floor dysfunction in women encompasses a wide range of clinical disorders: urinary incontinence, pelvic organ prolapse, fecal incontinence, and pelvic-perineal region pain syndrome. A literature review did not identify any articles addressing the prevalence of all pelvic floor dysfunctions. OBJECTIVE: Determine the prevalence of the group of pelvic floor disorders and the factors associated with the development of these disorders in women. MATERIAL AND METHODS: This observational study was conducted with women during 2021 and 2022 in Spain. Sociodemographic and employment data, previous medical history and health status, lifestyle and habits, obstetric history, and health problems were collected through a self-developed questionnaire. The Pelvic Floor Distress Inventory (PFDI-20) was used to assess the presence and impact of pelvic floor disorders. Pearson's Chi-Square, Odds Ratio (OR) and adjusted Odds Ratio (aOR) with their respective 95% confidence intervals (CI) were calculated. RESULTS: One thousand four hundred forty-six women participated. Urinary incontinence occurred in 55.8% (807) of the women, fecal incontinence in 10.4% (150), symptomatic uterine prolapse in 14.0% (203), and 18.7% (271) reported pain in the pelvic area. The following were identified as factors that increase the probability of urinary incontinence: menopausal status. For fecal incontinence: having had instrumental births. Factors for pelvic organ prolapse: number of vaginal births, one, two or more. Factors for pelvic pain: the existence of fetal macrosomia. CONCLUSIONS: The prevalence of pelvic floor dysfunction in women is high. Various sociodemographic factors such as age, having a gastrointestinal disease, having had vaginal births, and instrumental vaginal births are associated with a greater probability of having pelvic floor dysfunction. Health personnel must take these factors into account to prevent the appearance of these dysfunctions.