Knowledge of pelvic floor problems: a study of third trimester, primiparous women.

INTRODUCTION AND HYPOTHESIS: Pelvic floor problems in women (urinary incontinence, faecal incontinence, uterovaginal prolapse) are common, and have an adverse effect on quality of life. We hypothesized that there is low knowledge of these problems amongst primiparous women in their third trimester of pregnancy. METHODS: We conducted a cross-sectional study in antenatal clinics of three hospitals in London, UK, from 2011 to 2013. Primiparous women aged ≥18 years and in the third trimester of pregnancy answered questions on pelvic floor problems. Knowledge scores were calculated based on the proportion of questions answered correctly. RESULTS: A total of 249 women completed the question set. The average knowledge score across all domains was low at 45 %. Scores were lowest for the less common problems of faecal incontinence (35 %) and prolapse (36 %). The score for urinary incontinence was higher at 63 %, but low when questions explored more detailed levels of knowledge (41 %). Knowledge scores were positively associated with both education to tertiary level and the use of books as the information source on pregnancy and delivery. Only 35 % of women cited antenatal classes as a source. CONCLUSIONS: Knowledge of pelvic floor problems is low amongst third-trimester, primiparous women in this London-based population. Adequate knowledge of these problems is important for women to be able to make informed choices about their antenatal care and to seek help if problems arise. The data suggest scope for health-care professionals to raise these issues early during pregnancy, and to help women access accurate sources of information.

Mixed urinary incontinence: continuing to confound?

PURPOSE OF REVIEW: Mixed incontinence remains a complex clinical problem for urogynaecologists and generalists alike, as research for new treatments and interventions tend to focus on single-symptom groups. Those with mixed symptoms form a diverse group, which is difficult to study precisely. Recent studies, however, have aimed to classify the subgroups within this heterogeneous group so that the response to treatment can be determined with greater accuracy. This review aims to evaluate these advances and place the research in a clinical context. RECENT FINDINGS: The main developments have occurred with the acknowledgement of the large number of patients with these symptoms, the assessment of patients and attempts to classify symptom predominant types. Responses following pharmacological and surgical treatment have also improved. SUMMARY: There is greater awareness of the prevalence of mixed urinary incontinence, which has a large impact on the quality of life of women, irrespective of their desire to seek medical help. Tools are available to identify different subgroups within the sphere of mixed urinary incontinence, and, once accurately assessed, patients can expect good outcomes from treatment. Further collaboration between units will lead to more consistent information being published.