scholarly journals Vestibular Anatomic Localization of Pain Sensitivity in Women with Insertional Dyspareunia: A Different Approach to Address the Variability of Painful Intercourse

2020 ◽  
Vol 9 (7) ◽  
pp. 2023
Author(s):  
Ahinoam Lev-Sagie ◽  
Osnat Wertman ◽  
Yoav Lavee ◽  
Michal Granot
Keyword(s):  
Pelvic Floor ◽  
Hormonal Contraception ◽  
Pelvic Floor Muscles ◽  
Pain Experience ◽  
Pain Hypersensitivity ◽  
Contraception Use ◽  
Painful Intercourse ◽  
Tip Test ◽  
Anatomic Localization

The pathophysiology underlying painful intercourse is challenging due to variability in manifestations of vulvar pain hypersensitivity. This study aimed to address whether the anatomic location of vestibular-provoked pain is associated with specific, possible causes for insertional dyspareunia. Women (n = 113) were assessed for “anterior” and “posterior” provoked vestibular pain based on vestibular tenderness location evoked by a Q-tip test. Pain evoked during vaginal intercourse, pain evoked by deep muscle palpation, and the severity of pelvic floor muscles hypertonicity were assessed. The role of potential confounders (vestibular atrophy, umbilical pain hypersensitivity, hyper-tonus of pelvic floor muscles and presence of a constricting hymenal-ring) was analyzed to define whether distinctive subgroups exist. Q-tip stimulation provoked posterior vestibular tenderness in all participants (6.20 ± 1.9). However, 41 patients also demonstrated anterior vestibular pain hypersensitivity (5.24 ± 1.5). This group (circumferential vestibular tenderness), presented with either vestibular atrophy associated with hormonal contraception use (n = 21), or augmented tactile umbilical-hypersensitivity (n = 20). The posterior-only vestibular tenderness group included either women with a constricting hymenal-ring (n = 37) or with pelvic floor hypertonicity (n = 35). Interestingly, pain evoked during intercourse did not differ between groups. Linear regression analyses revealed augmented coital pain experience, umbilical-hypersensitivity and vestibular atrophy predicted enhanced pain hypersensitivity evoked at the anterior, but not at the posterior vestibule (R = 0.497, p < 0.001). Distinguishing tactile hypersensitivity in anterior and posterior vestibule and recognition of additional nociceptive markers can lead to clinical subgrouping.

The role of pelvic floor muscles in fecal incontinence

2000 ◽  
Vol 118 (4) ◽  
pp. A126
Author(s):  
Jose Fraga ◽  
Fernando Azpiroz ◽  
Juan -R Malagelada
Keyword(s):  
Fecal Incontinence ◽  
Pelvic Floor ◽  
Pelvic Floor Muscles

scholarly journals The role of vaginal palpation in motor learning of the pelvic floor muscles for women with stress urinary incontinence: study protocol for a randomized controlled trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Letícia de Azevedo Ferreira ◽  
Fátima Faní Fitz ◽  
Márcia Maria Gimenez ◽  
Mayanni Magda Pereira Matias ◽  
Maria Augusta Tezelli Bortolini ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Motor Learning ◽  
Pelvic Floor ◽  
Study Protocol ◽  
Controlled Trial ◽  
Pelvic Floor Muscles ◽  
Randomized Controlled

scholarly journals The Role of Pelvic Floor Muscles Exercises with Biofeedback as Adjuvant Treatment in Men with Erectile Dysfunction

1970 ◽  
Vol 3 (01) ◽  
pp. 25-32
Author(s):  
Guido O Vianney ◽  
Ratna D Haryadi ◽  
Rwahita Satyawati ◽  
Onny P Sono
Keyword(s):  
Erectile Dysfunction ◽  
Pelvic Floor ◽  
Erectile Function ◽  
Pelvic Floor Muscle ◽  
Intervention Group ◽  
Pelvic Floor Muscles ◽  
Pelvic Floor Muscle Strength ◽  
Pelvic Floor Muscle Exercises ◽  
Strength Based

Objective: To evaluate the efficacy of pelvic floor muscle exercise programs for men with erectile dysfunction problems.Methods: A randomized controlled group designed study. Sixteen men with erectile dysfunction who had undergone pharmacological treatment from the Andrology Clinic and were referred to thePhysical Medicine and Rehabilitation Department Dr. Soetomo Hospital were divided into 2 groups. The first group was treated with pelvic floor muscle exercises for 12 weeks, while the second groupacted as control. The parameters of this study were evaluated in weeks 4, 8 and 12. This consisted of an evaluation of pelvic floor muscle strength, which was performed by digital anal assessment, and pressurebiofeedback Myomed 932. The evaluation of erectile function was based on the IIEF-5 (International Index of Erectile Function – 5) questionnaire and the EHS (Erectile Hardness Score).Results: An increase in the maximum contraction of pelvic floor muscles was seen in the intervention group after 8 weeks of treatment (p=0.011). Six subjects in the intervention group (75%) gained anormal anal strength based on digital anal assessment at the end of study. The IIEF-5 score of the intervention group improved after 8 weeks of treatment (p=0.012). Threesubjects (37.5%) in the intervention group got a maximum hardness score and 4 subjects (50%) gained an improvement of the hardness score.Conclusion: Comparing of the results of the protocol reported here shows that pelvic floor muscle exercises improve erectile function in men with erectile dysfunction problems.Keywords: pelvic floor muscle exercises, biofeedback, erectile dysfunction

On the role of the constitution and the angle of inclination of the pelvis in the etiology of prolapse of the female genital organs

1930 ◽  
Vol 26 (10) ◽  
pp. 996-1001
Author(s):  
V. I. Davydov
Keyword(s):  
Adipose Tissue ◽  
Spina Bifida ◽  
Pelvic Floor ◽  
Pelvic Floor Muscles ◽  
Hard Work ◽  
Abdominal Pressure ◽  
Sacral Nerves ◽  
Poor Nutrition ◽  
Female Genital

If all authors agree that the direct cause of prolapse of the genitals in a woman is increased intra-abdominal pressure, then regarding the anatomical moments contributing to the occurrence of this anomaly, the opinions of the authors differ sharply: some attribute here an important role to innate moments, which may be - spina bifida lumbo -sacralis, in which there is a paralysis of the sacral nerves innervating the pelvic floor, then congenital hypoplasia of the pelvic floor muscles, excessive depth of the posterior Doug-Jas'ova pocket, observed in infantilism and accompanied by a very low position of the levator'a ani, etc .; others see the main reason for prolapse in acquired relaxations and violations of the integrity of the musculo-fascial base of the pelvic floor, especially the levator'a ani and the urogenital diaphragm; still others, considering the prolapse as a hernia, see the main predisposing reason for its development in the excessive width of the hiatus genitalis; fourth, on the basis of the fact that prolapse of the uterus, especially complete, is observed mainly in old women, in the first place among the etiological moments leading to prolapse, put climacteric changes in the ligamentous apparatus of the uterus, walls of the genital canal, etc.; fifths put forward retroflection of the uterus as an important etiological moment of prolapse, sixth - insufficiency of parametric, paravaginal and especially paravesical tissue, which failure is sometimes the result of poor nutrition, hard work, etc., moments that cause the disappearance of adipose tissue, altering the elasticity of the muscle-fascial septum pelvic floor, etc.

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