Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 392
Filtrar
1.
Br J Radiol ; 2024 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-39137140

RESUMO

OBJECTIVES: To investigate the correlation between three-dimensional ultrasonography parameters and pelvic floor dysfunction (PFD) and its application value in diagnosis and treatment. METHODS: 92 patients with PFD and 22 without who underwent three-dimensional ultrasonography were selected. Transperineal three-dimensional ultrasonography was performed by Voluson E8 color Doppler ultrasonography to analyze the anteroposterior diameter (LHAD), transverse diameter (LHLD), pelvic diaphragmatic hiatus area (LHA), and bladder neck mobility (BND) of the patients. Diagnostic sensitivity and specificity of ultrasound parameters in PFD were analyzed using ROC curves. Paired sample t test was used to analyze the improvement of PFMT in patients with PFD. RESULTS: Patients with PFD had significantly higher levels of △LHAD, △LHLD, △LHA and BND than controls (all P < 0.01). Binary logistic regression analysis showed that △LHA or BND levels were independent risk factors for the development of PFD. The ROC results showed that the area under the ROC curve with BND level was the highest (0.917). The diagnostic sensitivity of BND in PFD was 100.0% and the specificity was 70.7%. In Urinary incontinence (UI) patients, there was a significant positive correlation between the occurrence of UI and BND levels (all r > 0, P < 0.05). After PFMT treatment, the levels of △LHAD, △LHLD, △LHA and BND in patients with PFD were significantly decreased (all P < 0.001). CONCLUSION: The abnormal changes in the level of three-dimensional ultrasound parameters can be used as a sensitive indicator to evaluate PFD and a guiding parameter for PFMT treatment. ADVANCES IN KNOWLEDGE: The feasibility of operation and repetition by three-dimensional pelvic floor ultrasonography could provide a reliable imaging basis for clinical diagnosis and treatment of patients with PFD.

2.
World J Clin Cases ; 12(21): 4508-4517, 2024 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-39070827

RESUMO

BACKGROUND: Pelvic floor dysfunction (PFD) is related to muscle fiber tearing during childbirth, negatively impacting postpartum quality of life of parturient. Appropriate and effective intervention is necessary to promote PFD recovery. AIM: To analyze the use of hydrogen peroxide and silver ion disinfection for vaginal electrodes in conjunction with comprehensive rehabilitation therapy for postpartum women with PFD. METHODS: A total of 59 women with PFD who were admitted to the hospital from May 2019 to July 2022 were divided into two groups: Control group (n = 27) received comprehensive rehabilitation therapy and observation group (n = 32) received intervention with pelvic floor biostimulation feedback instrument in addition to comprehensive rehabilitation therapy. The vaginal electrodes were disinfected with hydrogen peroxide and silver ion before treatment. Intervention for both groups was started 6 weeks postpartum, and rehabilitation lasted for 3 months. Pelvic floor muscle voltage, pelvic floor muscle strength, vaginal muscle voltage, vaginal muscle tone, pelvic floor function, quality of life, and incidence of postpartum PFD were compared between the two groups. RESULTS: Before comprehensive rehabilitation treatment, basic data and pelvic floor function were not significantly different between the two groups. After treatment, the observation group showed significant improvements in the maximum voltage and average voltage of pelvic floor muscles, contraction time of type I and type II fibers, pelvic floor muscle strength, vaginal muscle tone, vaginal muscle voltage, and quality of life (GQOLI-74 reports), compared with the control group. The observation group had lower scores on the pelvic floor distress inventory (PFDI-20) and a lower incidence of postpartum PFD, indicating the effectiveness of the pelvic floor biostimulation feedback instrument in promoting the recovery of maternal pelvic floor function. CONCLUSION: The combination of the pelvic floor biostimulation feedback instrument and comprehensive rehabilitation nursing can improve pelvic floor muscle strength, promote the recovery of vaginal muscle tone, and improve pelvic floor function and quality of life. The use of hydrogen peroxide and silver ion disinfectant demonstrated favorable antibacterial efficacy and is worthy of clinical application.

3.
MedEdPORTAL ; 20: 11407, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38957526

RESUMO

Introduction: Pelvic fistulas affect a significant number of patients globally, with a relatively low prevalence in the United States. Virtual education offers an effective, scalable solution to bridge this educational gap and lead to a deeper understanding of more common conditions, such as urinary and fecal incontinence. Methods: We developed two virtual cases on rectovaginal and vesicovaginal/ureterovaginal fistulas to enhance medical students' exposure, knowledge, and confidence regarding assessment of pelvic fistulas. The cases could be completed in approximately 30 minutes, asynchronously, and at students' own pace. The cases were integrated into an OB/GYN clerkship. We conducted a survey among students receiving the cases to gather feedback on usability, acceptability, and educational value, which guided subsequent improvements. Results: Forty medical students, ranging from first to third year, participated in the urogynecology elective; 21 (53%) completed the survey. Ninety-one percent agreed or strongly agreed they were satisfied with the cases. All respondents found the format easy to use and appropriate for their level of learning. Most reported the cases improved their confidence in nonsurgical and surgical management options for pelvic fistulas. Discussion: Offering virtual and interactive patient cases on e-learning platforms represents an innovative approach to increasing clinical exposure to urogynecologic disorders. By providing medical students with the opportunity to interact with pelvic fistulas virtually, these cases can help bridge a gap in clinical education. Future exploration is valuable for examining knowledge deficiencies and developing cost-effective, self-paced, easily accessible educational resources to advance medical training and optimize patient care.


Assuntos
Ginecologia , Humanos , Feminino , Inquéritos e Questionários , Ginecologia/educação , Estudantes de Medicina/estatística & dados numéricos , Educação de Graduação em Medicina/métodos , Educação a Distância/métodos , Fístula Vesicovaginal/cirurgia , Adulto , Estados Unidos , Estágio Clínico/métodos , Urologia/educação , Competência Clínica
4.
Int Urogynecol J ; 2024 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-39060727

RESUMO

INTRODUCTION AND HYPOTHESIS: The objective was to evaluate the clinically beneficial effect of adding transvaginal monopolar non-ablative radiofrequency (RF) to pelvic floor muscle training (PFMT) on leakage severity, quality of life and urinary incontinence-related symptoms in women with stress urinary incontinence (SUI). METHODS: A double-blind randomised controlled trial was conducted, with a 6-week intervention and a 6-month follow-up. Participants were randomly assigned to the experimental group (PFMT plus RF; n = 18) or the control group (PFMT plus placebo; n = 20). The primary outcome was the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF). Secondary outcomes included the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7), self-efficacy, female sexual function, pelvic floor muscle dynamometry, 1-h pad test and number of SUI episodes per week. Inferential analyses of the data were performed using a two-factor analysis of variance. RESULTS: Both groups achieved a statistically significant improvement in ICIQ-SF over time. However, the differences observed in the experimental group exceeded the minimal clinically important differences by 4 points (MD = -9.4, 95% CI = -12.6 to -6.3), which was not observed in the control group (MD = -3.9, 95% CI = -6.9 to -1.0). This was maintained at the 6-month follow-up with a significant time*group interaction (p < 0.001, ηp2 = 0.150). There was no time*group interaction in the other variables (p > 0.05). Additionally, a significant difference in favour of the experimental group was observed in the 1-h pad test and episodes of SUI per week (p < 0.05). CONCLUSIONS: This study highlights the beneficial effects of adding transvaginal RF to PFMT on the severity and amount of leakage, as well as on the quality of life and urinary incontinence-related symptoms in women with moderate SUI. Future trials are needed to assess the effects of this intervention in women with severe SUI.

5.
Health Expect ; 27(4): e14152, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39010636

RESUMO

INTRODUCTION: Within 10 years of multiple sclerosis (MS) progression, nearly all women will have experienced symptoms associated with bladder, bowel and/or sexual health. Yet despite the impact these symptoms have on physical, psychological and social well-being, it remains an underserved area within the UK healthcare system. STUDY AIM: This research employs a participatory research approach framed within the principles of intersectional feminism to collaboratively investigate the lived experiences of pelvic floor dysfunction (PFD) and healthcare interactions among UK-based women with MS. SETTING AND PARTICIPANTS: Women residing in the United Kingdom with MS were invited to participate in online interviews facilitated by the primary author. ANALYSIS: A thematic framework analysis offering a structured yet adaptable approach to data collection and interpretation. RESULTS: One focus group involving four women with MS and seven individual, one-to-one interviews with women with MS provided insights into the challenges associated with navigating both MS and PFD. Four main themes included: Navigating MS and PFD; Cycles of Control; Mind, Mobility and Bladder Embodiment; Silenced Voices: The Impact of Taboos/Stigma/Dismissal on Preventing Access and Resistance through Collective Community. Six subthemes were also identified. Taken together, these themes cumulatively reflect PFD as an unmet healthcare need. CONCLUSION: Our findings underscore negative healthcare experiences, inadequate information provision and unmet needs related to PFD, emphasising the compounding effects of gender and disability biases. IMPACT: We hope that these insights can lay the groundwork for developing tailored therapeutic interventions and improved PFD healthcare for women with MS. Potential solutions include using existing MS support communities. PUBLIC CONTRIBUTIONS: Women with MS were actively involved in co-producing interview scripts for one-to-one interviews. The primary author shared study findings at an MS group event, engaging in discussions with over 30 individuals, including people with MS and their loved ones. MS advocates played a pivotal role in contextualising the study within the broader lived experience of MS.


Assuntos
Grupos Focais , Esclerose Múltipla , Pesquisa Qualitativa , Humanos , Feminino , Esclerose Múltipla/psicologia , Esclerose Múltipla/terapia , Pessoa de Meia-Idade , Reino Unido , Adulto , Distúrbios do Assoalho Pélvico/psicologia , Distúrbios do Assoalho Pélvico/terapia , Entrevistas como Assunto , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Estigma Social
6.
Eur J Med Res ; 29(1): 380, 2024 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-39039596

RESUMO

OBJECTIVES: To systematically evaluate the therapeutic effect of electrical stimulation combined with pelvic floor muscle exercise on female pelvic floor dysfunction (PFD). METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was applied. A computer-based retrieval was performed in the databases of PubMed, Web of Science, Embase, and Cochrane Library from database establishment to September 15, 2023, to identify randomized controlled trials on electrical stimulation combined with pelvic floor muscle function exercise on female PFD. Literature screening, data extraction, and quality evaluation were performed independently by two researchers, and meta-analysis was performed using the statistical software Stata15.0. RESULTS: 1. In total, 12 randomized controlled trials were included, involving 721 female patients. The overall quality of methodologies employed in the included studies was relatively high. 2. Meta-analysis results showed that electrical stimulation combined with pelvic floor muscle exercise could effectively mitigate the severity of female PFD (SMD = -1.01, 95% CI - 1.78, - 0.25, P < 0.05). 3. This combination treatment demonstrated a significant positive effect on the improvement of pelvic floor muscle strength in female patients (P < 0.05); however, it had no significant effect on the improvement in quality of life (P > 0.05). CONCLUSIONS: Compared with pelvic floor muscle exercise alone, electrical stimulation combined with pelvic floor muscle exercise could effectively mitigate the severity of female PFD. It had a notable positive impact on enhancing pelvic floor muscle strength in female patients, although it did not significantly improve quality of life. Future high-quality studies are warranted.


Assuntos
Terapia por Estimulação Elétrica , Terapia por Exercício , Distúrbios do Assoalho Pélvico , Diafragma da Pelve , Feminino , Humanos , Terapia por Estimulação Elétrica/métodos , Terapia por Exercício/métodos , Força Muscular/fisiologia , Diafragma da Pelve/fisiopatologia , Distúrbios do Assoalho Pélvico/terapia , Distúrbios do Assoalho Pélvico/fisiopatologia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 49(3): 482-490, 2024 Mar 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-38970523

RESUMO

Pelvic floor dysfunction (PFD) is a common clinical problem that can lead to bladder and bowel dysfunction such as urinary incontinence, urinary retention, fecal incontinence, pelvic organ prolapse, and sexual dysfunction. Pelvic floor rehabilitation aids are essential tools in the treatment of PFD. However, there is limited understanding of the efficacy and mechanisms of these aids, and there is a lack of standardized guidelines for selecting appropriate aids for different types of PFD. To assist patients in choosing suitable pelvic floor rehabilitation aids to their needs, it is necessary to summarize the existing types, mechanisms, and applications of these aids. Based on their mechanisms and target functions, pelvic floor rehabilitation aids can be mainly categorized into 3 main types. The first type includes aids that improve pelvic floor function, such as vaginal dumbbells, vaginal tampons, and vaginal dilators, which aim to strengthen pelvic floor muscles and enhance the contractility of the urethral, vaginal, and anal sphincters, thereby improving incontinence symptoms. The second type consists of aids that mechanically block the outlet, such as pessaries, urethral plugs, incontinence pads, incontinence pants, anal plugs, and vaginal bowel control systems, which directly or indirectly prevent incontinence leakage. The third type includes aids that assist in outlet drainage, such as catheters and anal excreta collection devices, which help patients effectively expel urine, feces, and other waste materials, preventing incontinence leakage. By summarizing the existing pelvic floor rehabilitation aids, personalized guidance can be provided to patients with PFD, helping them select the appropriate aids for their rehabilitation needs.


Assuntos
Distúrbios do Assoalho Pélvico , Diafragma da Pelve , Incontinência Urinária , Humanos , Feminino , Distúrbios do Assoalho Pélvico/reabilitação , Incontinência Urinária/reabilitação , Diafragma da Pelve/fisiopatologia , Incontinência Fecal/reabilitação , Incontinência Fecal/etiologia , Pessários
9.
Int J Sports Phys Ther ; 19(7): 868-876, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38966828

RESUMO

Background: Pelvic floor dysfunction (PFD) occurs when muscles of the pelvic floor become weakened, impaired, or experience tension leading to a variety of complications. Due to the reactive nature and high demands of many sports, athletes are at increased susceptibility and of particular interest concerning PFD. Hypothesis/Purpose: The purpose of this study was to explore the prevalence of PFD among college-aged athletes, assess how PFD impacted athletic performance, and identify contributing factors for increased likelihood of PFD in athletes. Study Design: Cross-Sectional Study. Methods: All fully active LVC NCAA Division 3 athletes were recruited for screening for PFD using the Cozean Pelvic Dysfunction Screening Protocol and were surveyed on their self-knowledge of PFD. Athletes who scored ≥ 3 on this tool completed an additional survey, created by the investigators, to identify the impact PFD had on their athletic performance and personal life and were then randomly assigned to one of three investigators to undergo a noninvasive coccygeal assessment to determine underactive, overactive, or normal pelvic floor muscle (PFM) activity. Results: Fifty-three Division III male and female athletes between the ages of 18-25 years old participated in the study. Statistically significant differences were found between Cozean scores and demographic factors of age (p \<0.001), gender (p \<0.05), self-knowledge of PFD (p \<0.001), and sport (p \<0.001) among all participants that contributed to the increased likelihood of PFD. Thirteen athletes scored ≥ 3 on the Cozean with the 92.3% experiencing under/over active PFM activity and the majority indicating that PFD significantly impacted their athletic performance and quality of life. Conclusion: The results indicate that older female NCAA Division III college athletes who participate in swimming and who possess self-knowledge of PFD are more likely to experience PFD. Additionally, these athletes are likely to encounter a significant impact on their athletic performance and quality of life. These results provide preliminary evidence on the need of PFD awareness and assessment among college athletes. Level of Evidence: Level 3b.

10.
Neurourol Urodyn ; 2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-38979823

RESUMO

INTRODUCTION: Today there is Level 1, recommendation A for pelvic floor muscle training (PFMT) to be effective in treatment of stress urinary incontinence (SUI) and pelvic organ prolapse (POP). However, the mechanisms of action are discussed. The aim of the present overview was to give an update of studies evaluating the effect of PFMT on pelvic floor morphology and associations between changes in PFM strength and symptoms of female SUI and POP. MATERIALS AND METHODS: This was a narrative review retrieving studies from systematic reviews of PFMT for SUI and POP. In addition, an open search on PubMed with the search terms PFMT and morphology was conducted. Both randomized controlled trials (RCTs) and pre-posttest design studies were included. PEDro rating scale (0-10) was used to assess risk of bias. RESULTS: Ten studies were found reporting on morphological changes after PFMT. The four RCTs had PEDro score between 5 and 8/10. The studies found significant higher bladder neck position and narrower levator hiatus dimensions, thicker external urethral sphincter, increased cross-sectional area of PFM, improvement in PFM tears and blood flow. Twenty studies analyzed associations between changes in different PFMT variables and SUI and POP. Eleven studies found a positive weak to moderate association and six studies reported no association. Studies comparing responders and nonresponders to PFMT found statistically significant better PFM variables in responders. CONCLUSION: PFMT can change pelvic floor muscle and external urethral sphincter anatomy. This contributes to the understanding on how PFMT can be effective in prevention and treatment of SUI and POP.

11.
Clinics (Sao Paulo) ; 79: 100428, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38972248

RESUMO

The use of stem cells capable of multilineage differentiation in treating Pelvic Floor Dysfunction (PFD) holds great promise since they are susceptible to entering connective tissue of various cell types and repairing damaged tissues. This research investigated the effect of microRNA-181a-5p (miR-181a-5p) on Bone Marrow Mesenchymal Stem Cells (BMSCs) in rats with PFD. BMSCs were transfected and analyzed for their fibroblast differentiation ability. miR-181a-5p, MFN1, and fibroblast-related genes were quantitatively analyzed. Whether MFN1 is a target gene of miR-181a-5p was predicted and confirmed. The efficacy of BMSCs in vivo rats with PFD was evaluated by measuring Leak Point Pressure (LPP), Conscious Cystometry (CMG), hematoxylin and eosin staining, and Masson staining. The present results discovered that miR-181a-5p was up-regulated and MFN1 was down-regulated during the differentiation of BMSCs into fibroblasts. Fibroblast differentiation of BMSCs was promoted after miR-181a-5p was induced or MFN1 was suppressed, but it was suppressed after miR-181a-5p was silenced. miR-181a-5p improved LPP and conscious CMG outcomes in PDF rats by targeting MFN1 expression, thereby accelerating fibroblast differentiation of BMSCs. In brief, miR-181a-5p induces fibroblast differentiation of BMSCs in PDF rats by MFN1, potentially targeting PDF therapeutics.


Assuntos
Diferenciação Celular , Fibroblastos , Células-Tronco Mesenquimais , MicroRNAs , Animais , Células-Tronco Mesenquimais/metabolismo , MicroRNAs/genética , MicroRNAs/metabolismo , Feminino , Ratos Sprague-Dawley , Distúrbios do Assoalho Pélvico/genética , Distúrbios do Assoalho Pélvico/terapia , Ratos , Regulação para Cima , Modelos Animais de Doenças , Regulação para Baixo , Células Cultivadas
12.
J Cell Mol Med ; 28(12): e18451, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38898783

RESUMO

Exosomes derived from bone marrow-derived mesenchymal stem cells (BMSCs) can alleviate the symptoms of pelvic floor dysfunction (PFD) in rats. However, the potential therapeutical effects of exosomes derived from BMSCs treated with tumour necrosis factor (TNF)-α on the symptoms of PFD in rats are unknown. Exosomes extracted from BMSCs treated with or without TNF-α were applied to treat PFD rats. Our findings revealed a significant elevation in interleukin (IL)-6 and TNF-α, and matrix metalloproteinase-2 (MMP2) levels in the vaginal wall tissues of patients with pelvic organ prolapse (POP) compared with the control group. Daily administration of exosomes derived from BMSCs, treated either with or without TNF-α (referred to as Exo and TNF-Exo), resulted in increased void volume and bladder void pressure, along with reduced peak bladder pressure and leak point pressure in PFD rats. Notably, TNF-Exo treatment demonstrated superior efficacy in restoring void volume, bladder void pressure and the mentioned parameters compared with Exo treatment. Importantly, TNF-Exo exhibited greater potency than Exo in restoring the levels of multiple proteins (Elastin, Collagen I, Collagen III, IL-6, TNF-α and MMP2) in the anterior vaginal walls of PFD rats. The application of exosomes derived from TNF-α-treated BMSCs holds promise as a novel therapeutic approach for treating PFD.


Assuntos
Exossomos , Metaloproteinase 2 da Matriz , Células-Tronco Mesenquimais , Prolapso de Órgão Pélvico , Fator de Necrose Tumoral alfa , Animais , Exossomos/metabolismo , Exossomos/transplante , Células-Tronco Mesenquimais/metabolismo , Feminino , Fator de Necrose Tumoral alfa/metabolismo , Ratos , Humanos , Prolapso de Órgão Pélvico/terapia , Prolapso de Órgão Pélvico/metabolismo , Metaloproteinase 2 da Matriz/metabolismo , Ratos Sprague-Dawley , Interleucina-6/metabolismo , Diafragma da Pelve , Modelos Animais de Doenças , Células da Medula Óssea/metabolismo , Vagina/patologia , Transplante de Células-Tronco Mesenquimais/métodos , Distúrbios do Assoalho Pélvico/terapia , Pessoa de Meia-Idade
13.
J Obstet Gynaecol Can ; 46(8): 102578, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38852809

RESUMO

OBJECTIVES: The Healthy Recovery after Childbirth Clinic (HRCC) in Nova Scotia provides postpartum care to patients who experience obstetric anal sphincter injuries (OASIS). The purpose of this study was to describe characteristics associated with HRCC attendance, characteristics associated with a trial of labour in a subsequent delivery, and OASIS recurrence by HRCC attendance status. METHODS: A retrospective cohort study using the Atlee Perinatal Database and clinical record review included primiparous individuals who sustained an OASIS at IWK Health in Halifax between 2013 and 2020. The χ2 and Fisher exact tests were performed to compare groups. RESULTS: Of the 1041 individuals included, 67% attended HRCC. Attendance increased from 58% in 2013-2015 to 77% in 2019-2020. Younger age (<25 years) and smoking were associated with lower HRCC attendance (P = 0.07 and <0.01, respectively). Other characteristics, including area-level income and driving distance to HRCC, were not associated with attendance (P > 0.05). Of the 439 individuals who had a subsequent delivery, 92% had a trial of labour. Individuals with fourth-degree injury were less likely to attempt a trial of labour than those with third-degree injury (73% vs. 94%, P < 0.01). Of those who delivered vaginally, OASIS recurrence was similar in those who did and did not attend the HRCC (7.5% vs. 6.5%, P = 0.84). CONCLUSIONS: HRCC attendance was high, but the disparity by age and smoking status suggests some barriers to access that should be explored. Although we found no difference in OASIS recurrence by HRCC attendance, more research with larger samples with adjustment for confounders is needed.

14.
J Bodyw Mov Ther ; 39: 38-42, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38876655

RESUMO

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.


Assuntos
Pé Chato , Força Muscular , Diafragma da Pelve , Incontinência Urinária , Humanos , Feminino , Força Muscular/fisiologia , Estudos de Casos e Controles , Diafragma da Pelve/fisiopatologia , Adulto , Pessoa de Meia-Idade , Incontinência Urinária/fisiopatologia , Incontinência Urinária/epidemiologia , Pé Chato/fisiopatologia , Incontinência Fecal/fisiopatologia , Incontinência Fecal/epidemiologia , Distúrbios do Assoalho Pélvico/fisiopatologia , Distúrbios do Assoalho Pélvico/epidemiologia
15.
Int J Mol Sci ; 25(11)2024 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-38891914

RESUMO

Pelvic floor dysfunction encompasses a group of disorders that negatively affect the quality of women's lives. These include pelvic organ prolapse (POP), urinary incontinence, and sexual dysfunction. The greatest risk factors for prolapse are increased parity and older age, with the largest group requiring surgical intervention being post-menopausal women over 65. Prolapse recurrence rates following surgery were reported to be as high as 30%. This may be attributed to ineffective healing in the elderly. Autologous stem cell transplantation during surgery may improve surgical results. In our previous studies, we showed that the transplantation of bone marrow-derived mesenchymal stem cells (MSCs) from young donor rats improved the healing of full-thickness vaginal surgical incision in the vaginal wall of old rats, demonstrated by both histological and functional analysis. In order to translate these results into the clinical reality of autologous MSC transplantation in elderly women, we sought to study whether stem cells derived from old donor animals would provide the same effect. In this study, we demonstrate that MSC transplantation attenuated the inflammatory response, increased angiogenesis, and exhibited a time-dependent impact on MMP9 localization. Most importantly, transplantation improved the restoration of the biomechanical properties of the vagina, resulting in stronger healed vaginal tissue. These results may pave the way for further translational studies focusing on the potential clinical autologous adjuvant transplantation of MSCs for POP repair for the improvement of surgical outcomes.


Assuntos
Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais , Vagina , Animais , Feminino , Vagina/cirurgia , Transplante de Células-Tronco Mesenquimais/métodos , Ratos , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/metabolismo , Cicatrização , Metaloproteinase 9 da Matriz/metabolismo , Prolapso de Órgão Pélvico/cirurgia , Fenômenos Biomecânicos , Ratos Sprague-Dawley
16.
Int Urogynecol J ; 35(7): 1487-1493, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38861006

RESUMO

INTRODUCTION AND HYPOTHESIS: Self-efficacy for pelvic floor exercises, i.e. confidence in achieving pelvic floor contractions, may predict adherence to treatment. However, there is a paucity of literature investigating the clinical relevance of this outcome. The aim was to determine the relationship between self-efficacy for pelvic floor exercise and symptom severity, pelvic floor distress and impact on quality of life, as well as sociodemographic characteristics and pelvic floor muscle strength in women with stress urinary incontinence (SUI). METHODS: A cross-sectional study was conducted in women with SUI. The Spanish version of the Broome Pelvic Muscle Self-Efficacy Scale was used to assess self-efficacy for pelvic floor exercise. The dependent variables were: urinary incontinence symptoms using the International Consultation on Incontinence Questionnaire, short form (ICIQ-SF), pelvic floor distress symptoms using the Urogenital Distress Inventory-6, impact on quality of life using the Incontinence Impact Questionnaire (IIQ-7), leakage using the 1-h pad test, number of SUI episodes per week and pelvic floor muscle strength. RESULTS: A total of 56 women with a median age of 44.5 years were included. Self-efficacy for pelvic floor exercise correlated negatively and moderately with the ICIQ-SF (r = -0.529; p < 0.001), IIQ-7 (r = -0.442; p = 0.001), 1-h pad test (rs = -0.467; p < 0.001); and number of SUI episodes/week (rs = -0.489; p < 0.001). Correlation with the other outcomes was weak or non-existent. Linear regression with forward selection showed that the ICIQ-SF was the variable most related to self-efficacy (ß: -3.01, 95% CI: -4.03 to -1.69). CONCLUSIONS: These findings highlight the importance of assessing self-efficacy for pelvic floor exercise in the treatment of women with SUI. Future prospective studies are needed to confirm these findings.


Assuntos
Terapia por Exercício , Força Muscular , Diafragma da Pelve , Qualidade de Vida , Autoeficácia , Incontinência Urinária por Estresse , Humanos , Feminino , Incontinência Urinária por Estresse/terapia , Incontinência Urinária por Estresse/fisiopatologia , Incontinência Urinária por Estresse/psicologia , Diafragma da Pelve/fisiopatologia , Estudos Transversais , Pessoa de Meia-Idade , Adulto , Terapia por Exercício/métodos , Inquéritos e Questionários , Índice de Gravidade de Doença
17.
Int Urogynecol J ; 35(6): 1211-1218, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38722559

RESUMO

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.


Assuntos
Distúrbios do Assoalho Pélvico , Qualidade de Vida , Incontinência Urinária , Humanos , Feminino , Peru/epidemiologia , Adulto , Estudos Transversais , Pessoa de Meia-Idade , Distúrbios do Assoalho Pélvico/epidemiologia , Distúrbios do Assoalho Pélvico/etiologia , Prevalência , Incontinência Urinária/epidemiologia , Incontinência Urinária/etiologia , Paridade
18.
Int Urogynecol J ; 35(7): 1435-1446, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38819689

RESUMO

INTRODUCTION AND HYPOTHESIS: Pelvic floor disorders (PFDs), significantly impacting women's quality of life, are often underdiscussed owing to misconceptions and limited understanding of treatment options. This study is aimed at validating an Arabic version of the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) to assess knowledge of pelvic organ prolapse (POP) and urinary incontinence (UI) among Arabic-speaking women, addressing knowledge gaps in these areas. METHODS: The study obtained ethical approval and followed a two-stage process, including a pilot study for preliminary validation and a larger study involving 300 participants. The PIKQ, a self-administered tool with two scales focusing on UI and POP, was translated into Arabic with cultural and linguistic adaptations. The study evaluated the reliability and validity of the Arabic PIKQ, employing Cronbach's alpha, intraclass correlation coefficient (ICC), and Spearman's rho for reliability assessments, as well as factor analysis for construct validity. RESULTS: The Arabic PIKQ demonstrated high internal consistency (Cronbach's alpha > 0.8) and test-retest reliability (ICC > 0.79) for both the UI and the POP scales. The questionnaire also showed significant construct validity. Among the 300 participants, knowledge gaps were evident, influenced by educational and professional backgrounds. Notably, 22% reported UI and 14.7% reported pelvic organ prolapse, with less than half seeking treatment. CONCLUSIONS: The Arabic PIKQ has been validated as a reliable tool for improving knowledge and addressing misconceptions regarding PFDs among Arabic-speaking women. The study underscores the importance of culturally sensitive educational tools in enhancing awareness and facilitating access to medical care for pelvic floor disorders.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Prolapso de Órgão Pélvico , Incontinência Urinária , Humanos , Feminino , Inquéritos e Questionários/normas , Prolapso de Órgão Pélvico/psicologia , Pessoa de Meia-Idade , Incontinência Urinária/psicologia , Incontinência Urinária/diagnóstico , Reprodutibilidade dos Testes , Adulto , Idoso , Traduções , Projetos Piloto , Idioma
19.
Surg Clin North Am ; 104(3): 565-578, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38677821

RESUMO

Constipation encompasses symptoms of decreased colonic motility or difficulty with the defecation process. As a broad definition, this can be inclusive of functional constipation (FC) or colonic inertia, obstructed defecation (OD), and irritable bowel syndrome-constipation type (IBS-CS). After excluding IBS-C, FC and OD diagnosis and management require a multidisciplinary approach often involving nutritionists, pelvic floor therapists, urogynecologists, and colon and rectal surgeons. Differentiating the presence or absence of each can direct therapy and prognosticate chances for improvement in this often complex combination of disorders.


Assuntos
Constipação Intestinal , Defecação , Humanos , Constipação Intestinal/fisiopatologia , Constipação Intestinal/diagnóstico , Constipação Intestinal/etiologia , Constipação Intestinal/terapia , Defecação/fisiologia , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/fisiopatologia , Obstrução Intestinal/etiologia , Síndrome do Intestino Irritável/fisiopatologia , Síndrome do Intestino Irritável/complicações , Síndrome do Intestino Irritável/diagnóstico
20.
J Pers Med ; 14(3)2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38541062

RESUMO

Pelvic floor disorders, the impact of their symptoms, and their association with sleep quality and sleep disorders is a little studied area. The aim of this study was to determine if an association exists between pelvic floor disorders in women and sleep disorders. An observational study was conducted among women in Spain during 2021 and 2022. A self-developed questionnaire was used to collect sociodemographic and employment data, previous medical history and health status, lifestyle and habits, obstetric history, and health problems. A validated questionnaire, the Pittsburgh Sleep Quality Index (PSQI), was used to assess the quality of sleep. The presence and impact of pelvic floor problems was assessed with the Pelvic Floor Distress Inventory (PFDI-20). Odds ratios (OR) and adjusted odds ratios (aOR) with their respective 95% confidence intervals were calculated using logistic regression. A total of 1396 women participated in the study. The total PSQI indicated that 75.36% (1052) of women have altered general sleep quality. Women with pelvic floor disorders have a higher probability of developing sleep alterations (aOR: 1.32; 95% CI: 1.22-1.42; for every 20 points). A high BMI (aOR: 1.04; 95% CI: 1.01-1.07; for each point) and the presence of musculoskeletal disorders (aOR: 3.14; 95% CI: 1.20-8.27) are also associated with sleep quality in women. Women with pelvic floor disorders are more likely to develop sleep disorders, probably due to all the discomfort they entail.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA