Vaginal Approach to Fixation of Vaginal Apex
Linda Cardozo, Staskin David in Textbook of Female Urology and Urogynecology - Two-Volume Set, 2017
Caring for women with pelvic floor disorders has become an increasingly important component of women's health care. Pelvic organ prolapse (POP) is a major health issue for women; it affects almost half of all women over 50 years of age, with a lifetime prevalence of 30%–50% [1]. It is estimated that the lifetime risk of surgery for either stress urinary incontinence (SUI) or pop is 20.0% by the age of 80 years [2]. With the current generation of women maintaining a more active lifestyle into an older age, it is likely that an increasing number of women will seek treatment for prolapse, conditions requiring increasing expertise on the part of the urogynecologist and pelvic reconstructive surgeons in the management of these conditions. It has been projected that the demand for care for pelvic floor disorders will increase by 35% between 2010 and 2030 [3].
Urogenital prolapse
David M. Luesley, Mark D. Kilby in Obstetrics & Gynaecology, 2016
This chapter examines the aetiology of urogenital prolapse and preventative measures. Urogenital prolapse occurs when there is a weakness in the supporting structures of the pelvic floor allowing the pelvic viscera to descend and ultimately fall through the anatomical defect. The incidence of urogenital prolapse increases with increasing age, with approximately 60 percent of elderly women having some degree of prolapse and up to half of all women over the age of 50 years complaining of symptomatic prolapse. Urogenital prolapse is more common following childbirth, although it may be asymptomatic. The pelvic floor provides support to the pelvic viscera and consists of the levator ani muscles, urogenital diaphragm, endopelvic fascia and perineal body. The urogenital diaphragm is a triangular sheet of dense fibrous tissue spanning the anterior half of the pelvic outlet, which is pierced by the vagina and urethra. Pelvic surgery may have an effect on the occurrence of urogenital prolapse.
Pelvic floor, ischio-anal fossa
Ian Parkin, Bari Logan, Mark McCarthy in Core Anatomy - Illustrated, 2007
The pelvic cavity is superior to the muscular pelvic floor (or diaphragm), and the perineum is inferior to it. The sacrospinous ligament (1) gives origin to some of the pelvic floor muscles. The lesser sciatic foramen (2) lies inferior to the ligament, therefore inferior to the pelvic floor. Nerves and vessels passing through the lesser sciatic foramen enter the perineum, as do structures that pass through the pelvic floor.
Effectiveness of pelvic floor muscle and abdominal training in women with stress urinary incontinence
Published in Psychology, Health & Medicine, 2021
Burcu Kucukkaya, Hatice Kahyaoglu Sut
ABSTRACT The aim of this study was to investigate the effectiveness of pelvic floor muscle training and abdominal training in women with stress urinary incontinence. The study included 64 female patients (aged 18 to 49 years) with stress urinary incontinence. Patients were randomly allocated into the pelvic floor muscle training (PFMT) or pelvic floor muscle plus abdominal training (PFMT+AT) groups. Clinical data included stress test results, pelvic floor activity measurements, and Urinary Distress Inventory, and Incontinence Impact Questionnaire responses. The increase in the pelvic floor muscle activity (from the 0th to the 4th week, from the 4th to the 8th week, and from the 0th to the 8th week) was significantly greater for the PFMT+AT group than for the PFMT group (p < 0.05). The negativity rate of the stress test at the 4th week was significantly higher for the PFMT+AT group (93.7%) than for the PFMT group (53.1%) (p < 0.001). Women with stress urinary incontinence benefit more from pelvic floor muscle training plus abdominal training than from pelvic floor muscle training alone in terms of increasing their pelvic floor muscle activity and quality of life, and they also experience an earlier recovery.
Sexual function and pelvic floor activity in women: the role of traumatic events and PTSD symptoms
Published in European Journal of Psychotraumatology, 2020
Matty D. A. Karsten, Vincent Wekker, Anne Bakker, Henk Groen, Miranda Olff, Annemieke Hoek, Ellen T. M. Laan, Tessa J. Roseboom
ABSTRACT Background Traumatic sexual experiences can negatively affect sexual functioning and increase pelvic floor activity in women, especially when post-traumatic stress disorder (PTSD) is developed. However, little is known about the effect of other types of interpersonal and non-interpersonal, traumatic experiences on sexual function and pelvic floor overactivity. Objective The aim of this study was to examine the effects of lifetime traumatic experiences and subsequent PTSD symptoms on sexual function and pelvic floor activity and to investigate whether the effects differ for interpersonal and non-interpersonal trauma. Methods Women (N=82) with obesity and a history of infertility, participating in a follow-up study of an RCT investigating a lifestyle intervention programme, completed questionnaires on lifetime exposure to traumatic events (LEC-5), PTSD symptoms (PC-PTSD-5), sexual function (MFSQ) and pelvic floor activity (AOPFS-SV). Results A large majority of women (85%) reported exposure to at least one traumatic event during their lifetime. Sexual function and pelvic floor activity did not differ between women who experienced non-interpersonal or interpersonal (including sexual) trauma and those who did not experience traumatic events during their lifetime. Women who had developed PTSD symptoms, however, did have higher pelvic floor activity, but sexual function was not affected. Women with a positive screen for PTSD had the highest pelvic floor activity score, and individual PTSD symptoms nightmares and hypervigilance were associated with significantly higher pelvic floor activity scores. Conclusion Trauma exposure is associated with pelvic floor overactivity in women with a positive screen for PTSD, such that pelvic floor overactivity is more severe with greater PTSD severity. These findings suggest that the development of PTSD after interpersonal trauma is pivotal in this association. Sexual function was unrelated to trauma exposure and pelvic floor function, perhaps related to the fact that the interpersonal trauma events reported in this study were mainly non-sexual.
Measurement of pelvic floor function during physical activity: A feasibility study
Published in Scandinavian Journal of Urology and Nephrology, 2009
Objective. Pelvic floor function is closely related to bladder storage or voiding dysfunctions. So far, however, pelvic floor activity has not been reliably measured during physical activity. Material and methods. In 14 female healthy volunteers, the activity of the pelvic floor was evaluated during a standardized horseback riding course by a biofeedback device. Results. Pelvic floor activity could be reliably measured during horseback riding. Each pace was associated with corresponding electromyographic (EMG) activity that was similar in the overwhelming majority of participants. Different paces demonstrated distinctly different EMG activities. Conclusions. To the authors’ knowledge, this study is the first to demonstrate that pelvic floor activity can be reliably measured during physical activity with a commercially available biofeedback device.
Related Knowledge Centers
- Connective Tissue
- Perineum
- Pelvic Cavity
- Pelvis
- Levator Ani