The Journal of Sexual Medicine

Volume 9, Issue 11 Pages 2733 - 2981, November 2012

New Device for Simultaneous Measurement of Pelvic Floor Muscle Activity and Vaginal Blood Flow: A Test in a Nonclinical Sample

http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2012.02910.x/abstract

Multilevel Local Anesthetic Nerve Blockade for the Treatment of Generalized Vulvodynia: A Pilot Study

http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2012.02909.x/abstract

Newly published

Does improved functional performance help to reduce urinary incontinence in institutionalized older women? a multicenter randomized clinical trial. Tak EC, Van Hespen A, van Dommelen P, Hopman-Rock M. BMC Geriatr. 2012 Sep 6;12(1):51. [Epub ahead of print] Free Article

 

Biofeedback and/or sphincter exercises for the treatment of faecal incontinence in adults. Norton C, Cody JD.  Cochrane Database Syst Rev. 2012 Jul 11;7:CD002111. Review.

Exploring the association between lifetime physical activity and pelvic floor disorders: study and design challenges. Nygaard I, Shaw J, Egger MJ. Contemp Clin Trials. 2012 Jul;33(4):819-27. Epub 2012 Apr 12.

 Nonsurgical management of pelvic organ prolapse. Culligan PJ. Obstet Gynecol. 2012 Apr;119(4):852-60. Review.

Managing Pregnancy and Delivery in Women with Sexual Pain Disorders.

Rosenbaum TY, Padoa A.  J Sex Med 2012; 9: 1726-1735.
MJ Strauhal, PT, BCB-PMD
Journal Club 10-10-12

This journal club involved discussion of the following topics related to the article.  There is a lot more on the recording. 

Listening / downloading recordings

• Meetings will be recorded so they can be shared with others who were not able to attend
• https://www.freeconferencecall.com
• Top right corner – “log in”
• Access code – 436790

Dial-in number – (209) 647-1000

Subscriber PIN – 883352

• Choose the date you want to access – you can playback or download in several formats.  If you want to save it to your computer you click “wav” and choose “save” – name the file and choose the location to save it. 

 Application to pelvic floor (PF) physical therapy:

·         The PF physical therapist may be the first (or one of many) provider to have a discussion regarding the desires or fears associated with pregnancy and labor/ delivery with the patient suffering from a sexual pain disorder (SPD)

·         The PF PT should be knowledgeable about the practical concerns of their SPD patients regarding pregnancy and labor/ delivery

·         The PF PT should be knowledgeable about the safety of PT interventions for women with SPD that are either trying to conceive or are currently pregnant

Predictors of a favorable outcome of physiotherapy in fecal incontinence: secondary analysis of a randomized trial. Bols E, Hendriks E, de Bie R, Baeten, Berghmans B. Neurourol and Urodynam 2012;31:1156-1160.

We have good data on predictors on success with PT in UI – see blog posts  http://pelvicpt.blogspot.com/2011/03/march-9-2011-pelvic-physiotherapy_10.html#more  http://pelvicpt.blogspot.com/2011/11/predictors-of-success-for-physiotherapy.html#more 

PT treatment of fecal incontinence (FI)  has not enjoyed as much attention and many feel is not as successful.  This article is a secondary analysis of a RCT adding rectal balloon training to PFM exercises.  Overall 46.3% had some improvement.  Multivariate analysis showed predictors of success where: use of constipating medication (like Imodium to thicken stool, it is a must in my book), experiencing minor embarrassment (I guess more motivated?), and “any obstetrical factor” (this included large baby weight, episiotomy, long labor, breech delivery, theory is that these would probably traumatize tissues which can benefit from PT).  Those less likely to benefit had a longer time since FI onset.  Good to see more research in this area.

Treatment of UI in NH residents - free article

Clin Interv Aging. 2012;7:45-50. Epub 2012 Feb 8.

Effect of physical training on urinary incontinence: a randomized parallel group trial in nursing homes.

Vinsnes AG, Helbostad JL, Nyrønning S, Harkless GE, Granbo R, Seim A.

Abstract

BACKGROUND:

Residents in nursing homes (NHs) are often frail older persons who have impaired physical activity. Urinary incontinence (UI) is a common complaint for residents in NHs. Reduced functional ability and residence in NHs are documented to be risk factors for UI.