The association between different measures of pelvic floor muscle function and female pelvic organ prolapse.

Oversand SH, Atan IK, Shek KL, Dietz HP. Int Urogynecol J (2015) 26;1777-1781.
Pelvic PT Distance Journal Club February 3, 2015
Beth Shelly

 

 

 

Risk factors for POP

·         Vaginal delivery

·         Genetics

·         High BMI

·         Hysterectomy

 Measurements of PFM function

·         Vaginal palpation - Modified Oxford scale

·         Translabial ultrasound - "measure of displacement are crucially dependant on tissue compliance or elasticity rather than just muscle strength or endurance"

Retrospective study of 726 females with "PFM dysfunction"

·         Subjective bother 0 to 10

o   51.4% reported POP sx with mean bother score of 5.8

o   SUI 73.2%

o   UUI 72%

·         POPQ with significant POP graded as more than stage 2

o   77.1% had POP

o   57% cyctocele

o   55% rectocele

o   11.2% uterine prolapse

o   3.3% enterocele

·         4D Translabial ultrasound

o   54.6% had POP

o   Levator avulsion 22.6%

o   Mean hiatal area 29.5 cm2

o   Mean BN cranial shift with contraction 7.11 mm

·         Modified Oxford scale (MOS) (authors comment on the low reproducibility)

o   Mean average 2.4/5

o   Univariate analysis - only MOS was strongly associated

§  Sx by questionnaire (2.15 vs 2.57)

§  Bother

§  POPQ (2.25 vs 2.74)

§  Sig POP on US (2.18 vs 2.57)

"Whether a given contraction force results in greater or lesser displacement will crucially depend on tissue elasticity or stiffness."