Antepartum pelvic floor muscle training (PFMT) plus perineal massage vs. postpartum PFMT alone: analysis of pelvic floor disorders, Quality of Life and sexual function.

BACKGROUND: The aim of this study was to analyze how antepartum pelvic floor muscle training (PFMT) plus perineal massage associated with postpartum PFMT have a significant impact on pelvic floor health during pregnancy and after delivery. METHODS: One thousand two hundred thirty-three women were enrolled from January 2019 to December 2021. They were divided into two groups: 786 women underwent postpartum PFMT only, 447 women experienced both prepartum perineal massage and PFMT and postpartum PFMT. The primary endpoint was to evaluate prepartum perineal massage and PFMT's impact on delivery. The second endpoint was the evaluation of Quality of Life and sexual function at 3- and 12-months follow-up after delivery. RESULTS: Women who underwent prepartum PFMT experienced significantly lower percentage of episiotomy, high-grade obstetric tear or instrumental delivery and higher percentage of intact perineum. Furthermore, prepartum PFMT appeared to improve sexual function at 3 months follow-up, and it was associated with an earlier first sexual intercourse after childbirth. The incidence of stress urinary incontinence was significantly higher in women who experienced PFMT only in postpartum, both at 3- and 12-months follow-up, while the other examined clinical parameters did not show a significant difference. CONCLUSIONS: Prepartum PFMT has a role in preventing obstetric traumas and on improving Sexual Function and Quality of Live in the immediate postpartum. Moreover, prepartum PFMT in association with postpartum PFMT reduces the incidence of stress urinary incontinence in a higher percentage than postpartum PFMT only.

Italian multicenter mid-term analysis of laparoscopic lateral suspension in women with pelvic organ prolapse: clinical, sexual and Quality of Life assessment after surgical intervention.

BACKGROUND: The aim of this study was to evaluate effectiveness and safety of laparoscopic lateral suspension in women affected by high grade uterine prolapse associated to anterior defect. The secondary endpoint is to evaluate mid-term impact on Quality of Life and sexual function. METHODS: A multicenter retrospective study on women undergoing laparoscopic lateral suspension for uterine prolapse ≥III stage was performed. We included 174 women, but due to exclusion criteria, 134 patients were enrolled for this study. Preoperative evaluation consisted of an urogynecological interview, clinical exam, 3-day voiding diary and urodynamic testing; the prolapse Quality of Life Questionnaire was used to quantify the impact of prolapse symptoms on Quality of Life and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form, the Female Sexual Function Index and the Female Sexual Distress Scale were administered to evaluate sexual function before surgical intervention and at median follow-up of 3.8 years. RESULTS: We included 134 women with uterine prolapse ≥III stage. All patients underwent laparoscopic lateral suspension, 8 also posterior colporrhaphy and 5 also transobturator tape insertion. POP-Q classification score for anterior and apical compartment showed a significant average decrease. The surveys administered to patients showed an improvement in Quality of Life, an increase in the number of monthly intercourses and a significant improvement in sexual life after surgery. CONCLUSIONS: Laparoscopic lateral suspension for pelvic organ prolapse correction is a safe and effective technique for uterine and anterior associated defect. Quality of Life and sexual function significantly improved after surgery.

Menstrual cycle alterations in reproductive age women after anti COVID-19 vaccination. A survey in 419 Italian women and quality of life and sexual function evaluation.

BACKGROUND: Pharmacovigilance agencies did not collect data regarding menstrual changes after COVID-19 vaccination even if many women experienced it. Our aim was to evaluate whether COVID-19 vaccination is associated with secondary changes in menstrual cycle and to assess both quality of life (QoL) and sexual function (SF). METHODS: This study is a retrospective analysis referred to our Department from January 2021 to December 2021. The study cohort responded to same questionnaires before the second dose of vaccination (referring to previous 3 months) and 3 months after that (referring to three menstrual cycles after full-dose vaccination). The surveys administered were FSFI, FSDS, SF-36, MEDI-Q and the VAS-scale for dysmenorrhea. RESULTS: Four-hundred-nineteen vaccinated women were included in the study. The survey did not show a significant change in menstrual cycle length before and after COVID-19 vaccine (5.88±3.67 vs. 4.97±2.89, P=0.21); the interval between periods was significantly higher after a full-cycle vaccination (28.32±7.34 vs. 32.38±7.45, P<0.02); 32 patients (7.6%) developed amenorrhea after the second dose; VAS Scale did not change significantly (median range 3 (3-5) vs. 4 (3-6), P=0.20). MEDI-Q did not show significant variations before and after the vaccination (43.21±11.65 vs. 40.28±9.88, P=0.35). QoL and SF did not change significantly (FSFI median 27 [24-29] vs. 28 [25-30], P=0.12, FSDS median 9 [5-11] vs. 8 [4-12], P=0.22), SF-36 median 81 [70-85] vs. 82 [72-86], P=0.43). CONCLUSIONS: COVID-19 vaccination is associated with a significant change in intervals between menstrual cycles without other alterations in menstrual characteristics, in QoL or SF.