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Friday, September 26, 2014

IUGA / AUGS Annual Meeting

Highlights of the IUGA / AUGS Annual Meeting webinar is a review of some of the best research from the meeting in Washington DC July 2014. John DeLancey gives a great state of the art on imaging.  It's free, take a look and LIKE to IUGA page for more updates and free stuff.

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Monday, September 15, 2014

Do stages of menopause affect the outcomes of pelvic floor muscle training?

Tosum OC, Mutle EK, Tosun G, Ergenoglu AM, Yeniel AO, Malkoc M, Askar N, Itil IM.  Menopause.  2014; 22(2): 1-10. DOI: 10.1097/gme.0000000000000278.

Ann Dunbar PT, DPT, MS, WCS
September 10, 2014

Introduction: UI is a common complaint. Numerous hormonal changes occur during the menopause transition.  A relationship exists between hormone levels and the urinary system.  A relationship also exists between hormonal changes and muscle mass including decreases in the ratio of connective tissues to muscle fibrils in the urethral stricture and pelvic floor.  Pelvic floor exercise is recommended as the first line of treatment for stress urinary incontinence (SUI).  Little research exists on the impact of menopausal changes on PFMT.

Primary Aim:  (1) Determine impact of pelvic floor muscle training (PFMT) on increases in PFM strength during different stages of menopause.

Subjects: 122 women with stress and mixed urinary incontinence; separated into 3 groups according to stage of menopause

Study Design:  Prospective controlled clinical trial

Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicenter randomized controlled trial

Hagen S, Stark D, Glazener C, Dickson S, Barry S, Elders A, Frawley H, Galea MP, Logan J, Mc Donald A, McPherson G, Moore KH, Norrie J, Walker A, Wilson D. Lancet. 2014; 383:796-806.

Ann Dunbar PT, DPT, MS, WCS
September 10, 2014

Introduction:  

  • Pelvic organ prolapse (P)to some degree is found on examination in 40% of women over 50
  • Women with prolapse may present with bladder, vaginal, bowel, abdominal, back and sexual sx affecting daily living and QOL
  • Conservative intervention offered for women who are not candidates for surgery or who have P low in severity; Interventions could include physical, mechanical, and lifestyle interventions as well as care offered by women’s health PTs
  • Physiotherapists (PTs) provide pelvic floor muscle training (PFMT) aimed at improving strength, endurance, and coordination of PFMs
  • Additional research needed to determine medium and long term effectiveness of PFMT as well as cost-effectiveness   
Primary Aim:  To assess whether (1)   One-on-one PFMT would reduce sx of P as well as the need for further treatment.  (2)  One-to-one PFMT would be cost effective compared with patient education handout on P lifestyle advice.
Study Design:  RCT