Pelvic floor symptoms are an overlooked barrier to exercise participation: a survey of 4556 symptomatic women

Abstract Background Female Genital Mutilation/Cutting (FGM/C) concerns over 200 million women and girls worldwide and is associated with obstetric trauma and long-term urogynaecological and psychosexual complications that are often under-investigated and undertreated. The aim of this study was to assess the pelvic floor distress and the impact of pelvic floor and psychosexual symptoms among migrant women with different types of FGM/C. Methods This cross-sectional study was conducted between April 2016 and January 2019 at the Division of Gynaecology of the Geneva University Hospitals. The participants were interviewed on socio-demographic and background information, underwent a systematic gynaecological examination to assess the presence and type of FGM/C and eventual Pelvic Organ Prolapse (POP), and completed six validated questionnaires on pelvic floor and psychosexual symptoms (PFDI-20 and PFIQ7 on pelvic floor distress and impact, FISI and WCS on faecal incontinence and constipation, PISQ-IR and FGSIS on sexual function and genital self-image). The participants’ scores were compared with scores of uncut women available from the literature. The association between selected variables and higher scores for distress and impact of pelvic floor symptoms was assessed using univariate and multivariable linear regression models. Results 124 women with a mean age of 31.5 (± 7.5), mostly with a normal BMI, and with no significant POP were included. PFDI-20 and PFIQ-7 mean (± SD) scores were of 49.5 (± 52.0) and 40.7 (± 53.6) respectively. In comparison with the available literature, the participants’ scores were lower than those of uncut women with pelvic floor dysfunction but higher than those of uncut women without such disorders. Past violent events other than FGM/C and forced or arranged marriage, age at FGM/C of more than 10, a period of staying in Switzerland of less than 6 months, and nulliparity were significantly associated with higher scores for distress and impact of pelvic floor symptoms, independently of known risk factors such as age, weight, ongoing pregnancy and history of episiotomy. Conclusions Women with various types of FGM/C, without POP, can suffer from pelvic floor symptoms responsible for distress and impact on their daily life. Trial registration. The study protocol was approved by the Swiss Ethics Committee on research involving humans (protocol n°15-224).

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1879 ASSOCIATION OF PELVIC FLOOR SYMPTOMS AND BONE MINERAL DENSITY IN WOMEN PRESENTING FOR OSTEOPOROSIS EVALUATION

The Journal of Urology ◽

10.1016/j.juro.2012.02.2033 ◽

2012 ◽

Vol 187 (4S) ◽

Author(s):

Holly Richter ◽

Sarah Morgan ◽

Jonathan Gleason ◽

Ligong Chen ◽

Jeffrey Szychowski ◽

...

Keyword(s):

Bone Mineral Density ◽

Pelvic Floor ◽

Bone Mineral ◽

Mineral Density ◽

Pelvic Floor Symptoms

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Pelvic Floor Symptoms and Lifestyle Factors in Older Women

Journal of Women s Health ◽

10.1089/jwh.2005.14.128 ◽

2005 ◽

Vol 14 (2) ◽

pp. 128-136 ◽

Cited By ~ 37

Author(s):

Catherine S. Bradley ◽

Colleen M. Kennedy ◽

Ingrid E. Nygaard

Keyword(s):

Pelvic Floor ◽

Older Women ◽

Lifestyle Factors ◽

Pelvic Floor Symptoms

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Pelvic Floor Symptoms Improve Similarly After Pessary and Behavioral Treatment for Stress Incontinence

Female Pelvic Medicine & Reconstructive Surgery ◽

10.1097/spv.0b013e31824a021d ◽

2012 ◽

Vol 18 (2) ◽

pp. 118-121 ◽

Cited By ~ 11

Author(s):

Kimberly Kenton ◽

Matthew Barber ◽

Lu Wang ◽

Yvonne Hsu ◽

David Rahn ◽

...

Keyword(s):

Pelvic Floor ◽

Stress Incontinence ◽

Behavioral Treatment ◽

Pelvic Floor Symptoms

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Prevalence of pelvic floor symptoms in female patients attending the two-week wait clinic with suspected colorectal cancer

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2016.0147 ◽

2016 ◽

Vol 98 (6) ◽

pp. 413-418 ◽

Cited By ~ 1

Author(s):

J Bennett ◽

A Greenwood ◽

P Durdey ◽

D Glancy

Keyword(s):

Colorectal Cancer ◽

Pelvic Floor ◽

Pelvic Floor Dysfunction ◽

Obstructed Defecation ◽

Bowel Habit ◽

Wexner Score ◽

Exact Test ◽

Female Patients ◽

Presenting Symptoms ◽

Pelvic Floor Symptoms

Introduction The aim of this study was to establish the prevalence of pelvic floor symptoms in women referred to a colorectal two-week wait (2WW) clinic with suspected colorectal cancer. Methods A questionnaire assessing faecal incontinence (FI) (Wexner score) and obstructed defecation syndrome (ODS) (Renzi score) was offered to 98 consecutive female patients attending a colorectal 2WW clinic at a single trust. Results Overall, 56 (57%) of the 98 patients had significant ODS and/or FI (scores >9/20), 33 (34%) had ODS and 40 (41%) had FI. Seventeen patients (17%) had both ODS and FI. Analysis of the 63 patients referred with a change in bowel habit (CIBH) showed 40 (63%) to be Renzi and/or Wexner positive compared with 16 (46%) of the 35 patients who presented without CIBH (p=0.095, Fisher’s exact test). Further analysis showed that 31 (78%) of the 40 patients with FI presented with CIBH compared with 32 (55%) of the 58 without FI (p=0.032). In terms of ODS, 23 (70%) of the 33 patients with ODS presented with CIBH compared with 40 (62%) of the 65 without ODS (p=0.506). Conclusions Over half of the female patients attending our colorectal 2WW clinic had significant pelvic floor dysfunction (FI/ODS), which may account for their symptoms (especially in the CIBH referral category). While it is important for malignancy to be excluded, many patients may benefit from investigation and management of their pelvic floor dysfunction as the cause for their presenting symptoms.

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