Significance of pelvic floor muscles in anal incontinence

Childbirth-related injuries are one of the main causes of pelvic floor dysfunction. To attempt to avoid serious tears during delivery, an episiotomy can be performed. In this study, we intended to investigate the biomechanical performance of the pelvic floor muscles after performing different episiotomies using a physics-based computational model which includes the pelvic floor muscles and the fetus. Previous biomechanical studies have analysed the mechanical effects of single incisions of different lengths; in this study, we intend to analyse the implications of multiple small incisions, evaluating the reaction forces, the stress on the muscles and the loss of tissue integrity sustained by the pelvic floor. The obtained results predict that an episiotomy delivery reduces the likelihood of macroscopic levator trauma by decreasing the stress on the region of insertion of the rectal area of the levator ani in the symphysis pubis . From the mechanical point of view, multiple incisions do not bring benefits compared to larger incisions. However, nothing can be ascertained about the clinical benefit of such an approach.

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Assessment of pelvic floor muscles with 3D/4D transperineal ultrasound in women with deep infiltrating endometriosis and superficial dyspareunia treated with pelvic floor muscle physiotherapy: a randomized controlled trial

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.23590 ◽

2021 ◽

Author(s):

S. Del Forno ◽

A. Arena ◽

V. Pellizzone ◽

J. Lenzi ◽

D. Raimondo ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Pelvic Floor ◽

Pelvic Floor Muscle ◽

Controlled Trial ◽

Pelvic Floor Muscles ◽

Transperineal Ultrasound ◽

Deep Infiltrating Endometriosis ◽

Randomized Controlled ◽

Infiltrating Endometriosis

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Urinary and anal incontinence among female gymnasts and cheerleaders—bother and associated factors. A cross-sectional study

International Urogynecology Journal ◽

10.1007/s00192-021-04696-z ◽

2021 ◽

Author(s):

Kristina Lindquist Skaug ◽

Marie Ellström Engh ◽

Helena Frawley ◽

Kari Bø

Keyword(s):

Pelvic Floor ◽

Anal Incontinence ◽

Female Athletes ◽

Cross Sectional Study ◽

Sport Performance ◽

Sports Performance ◽

International Consensus ◽

Cross Sectional ◽

Negative Effect ◽

Female Gymnasts

Abstract Introduction and hypothesis Artistic gymnastics, team gymnastics and cheerleading are sports including high-impact activities. It is presumed that the athletes’ pelvic floor must be functioning well to prevent urinary (UI) and anal incontinence (AI) during sports. The aim of this study was to investigate the prevalence and risk factors for UI and AI in female artistic gymnasts, team gymnasts and cheerleaders; the influence of UI and AI on daily living and sport performance; and the athletes’ knowledge about the pelvic floor muscles (PFM). Methods All female athletes ≥ 12 years of age competing in ≥ 1 National Championship in artistic gymnastics, team gymnastics or cheerleading in 2018/2019 were invited. International Consensus on Incontinence Questionnaires were used to assess the prevalence/bother of UI and AI. Results Among the 319 gymnasts and cheerleaders who participated, the prevalence of UI and AI was 67% and 84%, respectively. Age, training ≥ 4 days/week and straining to void were significantly associated with stress urinary incontinence (SUI) and years of training with AI. Eighty-three percent of athletes with SUI reported a negative effect on sports performance, 22% would occasionally avoid training or specific exercises because of leakage, and 28% used pads for protection. Forty-one percent of the athletes had never heard about the PFM, and 74% reported an interest in PFM training to prevent/treat UI or AI. Conclusions UI and AI were prevalent in female gymnasts and cheerleaders, and SUI negatively influenced sport performance. The athletes’ knowledge about the PFM was limited.

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