LACK OF EMPHASIS ON PELVIC FLOOR REHABILITATION

It has been observed that most patients with pelvic floor diseases are unaware of the problems they are facing in terms of emotional, psychological, and physical wellbeing. Pelvic floor problems are difficult to diagnose and treat; hence, bothersome for patients who are living with it. The perception about pelvic floor rehabilitation is misplaced, becoming a socioeconomic burden for the country. Since, pelvic floor disorders include incontinence; pelvic organ prolapsed, over active bladder, chronic pelvic pain, and sexual dysfunctions.

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Chronic pelvic pain and pelvic organ prolapse: a consequence of upright position?

Pelviperineology ◽

10.34057/ppj.2020.39.02.005 ◽

2020 ◽

pp. 55-59

Author(s):

KLAUS GOESCHEN ◽

BERNHARD LIEDL

Keyword(s):

Soft Tissue ◽

Pelvic Floor ◽

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Pelvic Organ ◽

Upright Position ◽

Organ Support ◽

Human Beings ◽

Bony Pelvis ◽

Age Dependent

Objective: The pathogenesis of chronic pelvic pain (CPP) is still incompletely understood. Generally accepted is, that soft tissue structures mutate with age, loose tension and by this can provoke CPP. This raises the question, of whether the bony pelvis underlies comparable age-dependent changes and if so, how this alteration has impact on the static anatomy of the pelvic floor and the suspension and supporting system. Materials and Methods: In order to answer this question we analysed the biological evolution of human beings and checked the historical literature regarding age-dependent static changes of the bony pelvis. Results: The vertical spine position is primarily due to an angulation of the lumbar spine against the sacrum causing a lordotic curve. The upright position of human beings forces the sacrum to curve, age dependent more and more. This leads to a descent of the promontorium causing a lifting of the coccyx and the pubic symphysis. This rotation causes a flatter pelvic floor. Conclusion: The age-dependent, now horizontal positioned pelvic floor provokes an unphysiological stretching on the soft-tissue-pelvic-floor structures causing and boosting a decompensation of the pelvic organ support and suspension system. Overstretched connective tissue, ligaments, nerves and muscles react with pain.

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How Do We Assess Patient Skills in a Competence-Based Program? Assessment of Patient Competences Using the Spanish Version of the Prolapse and Incontinence Knowledge Questionnaire and Real Practical Cases in Women with Pelvic Floor Disorders

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052377 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2377

Author(s):

Beatriz Sánchez-Sánchez ◽

Beatriz Arranz-Martín ◽

Beatriz Navarro-Brazález ◽

Fernando Vergara-Pérez ◽

Javier Bailón-Cerezo ◽

...

Keyword(s):

Decision Making ◽

Pelvic Floor ◽

Discriminant Validity ◽

Pelvic Floor Disorders ◽

Assessment Tool ◽

Pelvic Organ ◽

Assessment Tools ◽

Measurement Properties ◽

Competence Assessment ◽

Knowledge Questionnaire

Therapeutic patient education programs must assess the competences that patients achieve. Evaluation in the pedagogical domain ensures that learning has taken place among patients. The Prolapse and Incontinence Knowledge Questionnaire (PIKQ) is a tool for assessing patient knowledge about urinary (UI) and pelvic organ prolapse (POP) conditions. The aim of this study was to translate the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) into Spanish and test its measurement properties, as well as propose real practical cases as a competence assessment tool. The cross-cultural adaptation was conducted by a standardized translation/back-translation method. Measurement properties analysis was performed by assessing the validity, reliability, responsiveness, and interpretability. A total of 275 women were recruited. The discriminant validity showed statistically significant differences in the PIKQ scores between patients and expert groups. Cronbach’s alpha revealed good internal consistency. The test–retest reliability showed excellent correlation with UI and POP scales. Regarding responsiveness, the effect size, and standardized response mean demonstrated excellent values. No floor or ceiling effects were shown. In addition, three “real practical cases” evaluating skills in identifying and analyzing, decision making, and problem-solving were developed and tested. The Spanish PIKQ is a comprehensible, valid, reliable, and responsive tool for the Spanish population. Real practical cases are useful competence assessment tools that are well accepted by women with pelvic floor disorders (PFD), improving their understanding and their decision-making regarding PFD.

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Use of Pelvic Floor Ultrasound to Assess Pelvic Floor Muscle Function in Urological Chronic Pelvic Pain Syndrome in Men

Journal of Sexual Medicine ◽

10.1111/j.1743-6109.2011.02452.x ◽

2011 ◽

Vol 8 (11) ◽

pp. 3173-3180 ◽

Cited By ~ 27

Author(s):

Seth N. Davis ◽

Melanie Morin ◽

Yitzchak M. Binik ◽

Samir Khalife ◽

Serge Carrier

Keyword(s):

Pelvic Floor ◽

Pelvic Pain ◽

Muscle Function ◽

Chronic Pelvic Pain ◽

Pelvic Floor Muscle ◽

Chronic Pelvic Pain Syndrome ◽

Pain Syndrome ◽

Pelvic Pain Syndrome ◽

Pelvic Floor Ultrasound ◽

Pelvic Floor Muscle Function

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Sexual function in women with pelvic floor disorders

Canadian Urological Association Journal ◽

10.5489/cuaj.1625 ◽

2013 ◽

Vol 7 (9-10) ◽

pp. 199 ◽

Cited By ~ 11

Author(s):

Rebecca G. Rogers

Keyword(s):

Urinary Incontinence ◽

Pelvic Organ Prolapse ◽

Stress Urinary Incontinence ◽

Sexual Function ◽

Pelvic Floor ◽

Pelvic Floor Disorders ◽

Pelvic Floor Dysfunction ◽

Pelvic Organ ◽

The Impact

Pelvic floor disorders (PFDs) can impact sexual function. This summary provides an overview of the impact of stress urinary incontinence and pelvic organ prolapse and their treatments on sexual function. In general, interventions that successfully address PFDs will generally improve sexual function as well. However, there are patients whose sexual function will remain unchanged despite treatment, and a small but significant minority who will report worsened sexual function following treatment for their pelvic floor dysfunction.

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Attachment of the levator ani muscle extends to the superior ramus of the pubic bone through electrophysiological and anatomical examinations

Scientific Reports ◽

10.1038/s41598-021-89041-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hung-Yen Chin ◽

Chih-Wei Peng ◽

Ming-Ping Wu ◽

Chih-Hwa Chen ◽

Yu-Ting Feng ◽

...

Keyword(s):

Pelvic Floor ◽

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Pelvic Floor Muscle ◽

Levator Ani ◽

Pubic Bone ◽

Levator Ani Muscle ◽

Cadaver Dissection ◽

Inferior Border ◽

Stimulation Of

AbstractMyofascial pelvic pain (MFPP) of pelvic floor muscles is a common cause of chronic pelvic pain (CPP). The pathological mechanisms and treatments of MFPP are complex and still unclear until now. The levator ani muscle (LAM) is the major pelvic floor muscle. The purpose of this study was to examine the fascia and attachment of LAM through the electromyogram (EMG) and cadaver dissection. Electrophysiological stimulation of the obturator fascia above the arcus tendinous levator ani (ATLA) could trigger contraction and electrophysiological changes in LAM insertion. The LAM of embalmed adult cadavers was examined especially in the area above the ATLA. Some skeletal muscle fibers were found above the ATLA within the obturator fascia and were confirmed by Masson’s trichrome section staining. Our electromyography (EMG) and anatomical data implied that the attachment of LAM aponeurosis extended beyond ATLA to the inferior border of the superior ramus of the pubic bone. The new discovered attachment of LAM could provide a reference position for clinical diagnosis and treatment of MFPP or CPP.

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