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Women's Sexual Health and Lifestyle Medicine
Published in Michelle Tollefson, Nancy Eriksen, Neha Pathak, Improving Women's Health Across the Lifespan, 2021
Megan Alexander, Shannon Worthman, Rashmi Kudesia, Michelle Tollefson
In summary, physical activity holds promise as a treatment modality for sexual dysfunction. Suggested aerobic activity levels follow recommendations from the World Health Organization (150–300 minutes weekly of moderate-intensity, or 75–150 minutes of vigorous-intensity activity, or an equivalent combination),15,69–72 though older women might see benefits with as little as walking at least 1–2 times weekly.15 Pelvic floor muscle training, particularly for those with pelvic floor dysfunction, can improve sexual function in women across the life course.73–75 Although data is limited to inform the choice of how to exercise, interventional studies support structured mind-body programs based on the Pilates or yoga traditions as beneficial to sexual health.76–79
Considerations for the Focused Neuro-Urologic History and Physical Exam
Published in Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg, Essentials of the Adult Neurogenic Bladder, 2020
Laura L. Giusto, Patricia M. Zahner, Howard B. Goldman
The key aspects of sexual function for the female patient differ from those of a male patient (Table 19.6). While some of her function may be dependent on whether she is neurologically intact, some function may also depend on portions of her gynecologic history. It is therefore helpful to ask about pregnancies and deliveries, if she has had a hysterectomy, and previous pelvic surgeries. In addition, we ask the patient if she is sexually active and if she has any discomfort with vaginal intercourse. Previous surgical history, menopausal status, and neurologic history may all contribute to pelvic floor dysfunction.
Chronic pelvic pain and endometriosis
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Joseph S. Sanfilippo, Jessica Papillon Smith, M. Jonathon Solnik
Both acute and chronic pelvic pain can be associated with trigger points in the abdomen, vagina, or sacral area. The referred pain can also be visceral in nature, similar to and complicating the picture associated with dysmenorrhea. Treatment involves injection of local anesthetics, such as 0.25% bupivacaine or 1% procaine, into the trigger points. Pelvic floor physical therapy, with or without injections, provides exceptional relief for many patients with pain related to pelvic floor dysfunction.25 Vasocoolants and stretching have also been advocated as well as chiropractic flexion-distraction in combination with trigger points.26,27 Other drugs such as neuroleptics (e.g., tricyclic antidepressants or gabapentinoids) have been successfully used in adults to treat MSK-associated pain. Some of these have been tested in the treatment of pain disorders in pediatrics and can be considered to address CPP in this population.28
Implementation of sacral neuromodulation for urinary indications. A Danish prospective study during the initial 15 months of a new service in a tertiary referral hospital
Published in Scandinavian Journal of Urology, 2022
Hanne Kobberø, Margrethe Andersen, Karin Andersen, Torben Brøchner Pedersen, Mads Hvid Poulsen
Various symptoms underline the complexity of treating patients presenting with LUTD of different etiology and the need for a multidisciplinary approach. Berghmans et al. conducted two extensive epidemiological studies concerning the prevalence and triage of first-contact complaints on pelvic floor dysfunctions. The study included male and female patients referred from other hospitals for a second or third opinion, which is comparable with the status of our department [26,27]. The patients were asked about their pelvic floor dysfunction during the last six months, and the severity was registered on a scale of 0 to 10. They concluded that females and males presented multifactorial problems, needing more than one specialist. Our results reflect the same tendency with an equal distribution between LUTD and nLUTD.
Advances in surgical strategies for prolapse
Published in Climacteric, 2019
A. Giannini, M. Caretto, E. Russo, P. Mannella, T. Simoncini
Pelvic floor dysfunction globally affects micturition, defecation, and sexual activity. Female pelvic organ prolapse (POP), sexual dysfunction, urinary incontinence (UI), chronic obstructive defecation syndrome, and constipation are just a few of the many aspects of pelvic floor dysfunction, and their incidence increases dramatically with age and menopause. The pelvic floor in women is a complex and highly vulnerable structure. Injuries and functional modifications of this complex due to pregnancy, life events, and aging often lead to POP. This anatomical and functional defect determines a variable association of complaints related to the urinary, genital, and low intestinal tracts. Such symptoms are extremely common in aging individuals. They also often impair quality of life significantly. The pathophysiology of POP is unique in each patient, and its thorough understanding is key to successful treatment.
Pelvic floor symptoms, physical, and psychological outcomes of patients following surgery for colorectal cancer
Published in Physiotherapy Theory and Practice, 2018
Kuan-Yin Lin, Linda Denehy, Helena C. Frawley, Lisa Wilson, Catherine L. Granger
Pelvic floor dysfunction is common in community-dwelling adults (11% in men and 46% in women) (MacLennan, Taylor, Wilson, and Wilson, 2000), and pelvic floor muscle training is frequently used by physiotherapists to treat pelvic floor symptoms (Norton and Cody, 2012). However, few studies have investigated the effectiveness of this treatment in patients with CRC (Lin, Granger, Denehy, and Frawley, 2015). Despite the high prevalence of pelvic floor symptoms in the community and in patients before and following rectal cancer surgery (John, George, Primrose, and Fozard, 2011; Scheer et al., 2011), only two small studies have shown that patients with colon cancer also suffer from pelvic floor dysfunction following surgery (Phipps, Braitman, Stites, and Leighton, 2008; Tomoda and Furusawa, 1985). As pelvic floor dysfunction is associated with poorer health-related quality of life (HRQoL) after potentially curative surgery for CRC (Knowles et al., 2013), it is important to understand the severity of these symptoms in patients following surgery for both rectal and colon cancer, before an appropriate intervention can be designed to treat these symptoms.