scholarly journals A Case Report on Pelvic Floor Dysfunction

2021 ◽  
pp. 556-561
Author(s):  
Dipali D. Zade ◽  
Pooja Kasatwar ◽  
Rupali Thorat
Keyword(s):  
Pelvic Floor ◽  
Myofascial Pain ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Dysfunction ◽  
Treatment Options ◽  
Case Presentation ◽  
Strengthening Exercises ◽  
History Of ◽  
Definition Of ◽  
The Relationship

Background: Pelvic floor dysfunction and pelvic myofascial pain are treatable and common musculoskeletal conditions. Understanding the relationship between pelvic girdle and pelvic floor muscles (PFM), hips and spine will help the practitioner to diagnose and treat these conditions. Pelvic floor dysfunction and pelvic pain are treated with clinical examination and complete medical history of PFMs. Treatment is a in cooperatives approach, which consists of medications, pelvic floor physical therapy, injection and other treatment options. Case Presentation: We are presenting case of 40 female with complaints of pain in abdomen and discomfort during micturition. On evaluation she was diagnosed with the pelvic floor muscle dysfunction. For the management of same she was referred to physiotherapy department. Treatment: For the management of pelvic floor dysfunction, various levels of physiotherapeutic interventions were given to the patient, which includes strengthening exercises, endurance exercises to improve the overall functional capacity of the patient. Conclusion: This examines the physical and anatomical examination of the pelvic floor, discusses the epidemiology and definition of pelvic floor dysfunction and explains the physiotherapy approach to treating these common conditions.

scholarly journals Pelvic Floor Myofascial Pain Might Influence Treatment Outcome of Interstitial Cystitis/bladder Pain Syndrome

2021 ◽  
Author(s):  
Wan-Ru Yu ◽  
Fei-Chi Chuang ◽  
Wei-Chuan Chang ◽  
Hann-Chorng Kuo
Keyword(s):  
Pelvic Floor ◽  
Interstitial Cystitis ◽  
Myofascial Pain ◽  
Pelvic Floor Muscle ◽  
Pain Syndrome ◽  
Response Assessment ◽  
Bladder Capacity ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
The Relationship

Abstract IntroductionIn patients with interstitial cystitis or bladder pain syndrome (IC/BPS), 85% were found to have pelvic floor myofascial pain (PFMP) and hypertonicity (PFH). However, they are not typically trained to consider or assess PFMP as a contributing factor to patients’ IC/BPS symptoms. This study aimed to explore the relationship between PFMP and treatment outcomes in women with IC/BPS.MethodsPatients with IC/BPS who received any type of treatment were prospectively enrolled. They underwent vaginal digital examination at baseline. PFMP severity was quantified on the visual analog scale (VAS). Subject assessment items included O’Leary-Sant symptom score (OSS), Global Response Assessment (GRA), and Beck’s anxiety inventory. Object assessment items included bladder computed tomography (CT), urodynamic parameters, maximum bladder capacity, and grade of glomerulation.ResultsA total of 65 women with IC/BPS (mean age, 57.1 ± 11.3 years) were enrolled in the study. Patients with more severe PFMP had significantly higher rate of dyspareunia (p = .031); more comorbidities (p = .010); higher number of PFMP sites (p < .001); and higher OSS (p = .012). PFMP severity was not significantly correlated with bladder conditions, whether subjective or objective. Moreover, PFMP severity (VAS) was significantly negatively associated with GRA score.ConclusionPFMP might affect the subjective results of IC/BPS treatment but not the bladder condition. Therefore, in the future treatment of patients with IC/BPS, digital vaginal examinations of pelvic floor muscles should be performed and focused more on the PFM-related conditions, and necessary PFM treatments, such as the vaginal pelvic floor muscle message, should be scheduled.

Diseases of the cervix – non-obvious consequences of pelvic floor muscle failure

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. 131-136
Author(s):  
Mekan R. Orazov ◽  
Liliia R. Toktar ◽  
Gulirano A. Karimova ◽  
Veronica Pak ◽  
Ksenia Li
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Dysfunction ◽  
Intraepithelial Neoplasia ◽  
The Past ◽  
Cervical Diseases ◽  
The Relationship ◽  
Methods Of Treatment

The literature review presents domestic and foreign data on the relationship between pelvic floor dysfunction (PFD) and cervical diseases found in PubMed, Scopus, Embase and eLibrary systems over the past 10 years. This relationship is mainly realized due to alterations in vaginal biocenosis as the earliest clinical manifestation of PFD. The article describes PFD prevalence, classification, and risk factors for PFD. It also describes main methods of treatment and their side effects. The article provides data on changes in the vaginal biocenosis in PFD. Attention is paid to the risk for cervical intraepithelial neoplasia and cervical cancer in PFD.

scholarly journals Dynamics of male pelvic floor muscle contraction observed with transperineal ultrasound imaging differ between voluntary and evoked coughs

2014 ◽  
Vol 116 (8) ◽  
pp. 953-960 ◽  
Author(s):  
Ryan E. Stafford ◽  
Stuart Mazzone ◽  
James A. Ashton-Miller ◽  
Christos Constantinou ◽  
Paul W. Hodges
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Dysfunction ◽  
Levator Ani ◽  
Transperineal Ultrasound ◽  
Intraabdominal Pressure ◽  
Voluntary Cough ◽  
Bladder Base ◽  
History Of ◽  
Urological Disorders

Coughing provokes stress urinary incontinence, and voluntary coughs are employed clinically to assess pelvic floor dysfunction. Understanding urethral dynamics during coughing in men is limited, and it is unclear whether voluntary coughs are an appropriate surrogate for spontaneous coughs. We aimed to investigate the dynamics of urethral motion in continent men during voluntary and evoked coughs. Thirteen men (28–42 years) with no history of urological disorders volunteered to participate. Transperineal ultrasound (US) images were recorded and synchronized with measures of intraabdominal pressure (IAP), airflow, and abdominal/chest wall electromyography during voluntary coughs and coughs evoked by inhalation of nebulized capsaicin. Temporal and spatial aspects of urethral movement induced by contraction of the striated urethral sphincter (SUS), levator ani (LA), and bulbocavernosus (BC) muscles and mechanical aspects of cough generation were investigated. Results showed coughing involved complex urethral dynamics. Urethral motion implied SUS and BC shortening and LA lengthening during preparatory and expulsion phases. Evoked coughs resulted in greater IAP, greater bladder base descent (LA lengthening), and greater midurethral displacement (SUS shortening). The preparatory inspiration cough phase was shorter during evoked coughs, as was the latency between onset of midurethral displacement and expulsion. Maximum midurethral displacement coincided with maximal bladder base descent during voluntary cough, but followed it during evoked cough. The data revealed complex interaction between muscles involved in continence in men. Spatial and temporal differences in urethral dynamics and cough mechanics between cough types suggest that voluntary coughing may not adequately assess capacity of the continence mechanism.

scholarly journals The relationship of severity in diastasis recti abdominis and pelvic floor dysfunction: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hui Fei ◽  
Yun Liu ◽  
Mengxiong Li ◽  
Juan He ◽  
Lixiang Liu ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Dysfunction ◽  
Pelvic Organ ◽  
Rectus Abdominis ◽  
Rectus Abdominis Muscle ◽  
Diastasis Recti ◽  
Relationship Of ◽  
The Relationship ◽  
Diastasis Recti Abdominis

Abstract Background Diastasis of rectus abdominis (DRA) refers to a separation of the rectus abdominis from the linea alba. This study aimed to investigate the association with the severity of DRA for developing pelvic floor dysfunction among women during the first year postpartum. Methods This is a retrospective cohort study which collected data from 229 postpartum women. DRA was defined as a separation of ≥ 20 mm at any point 4.5 cm above, at and 4.5 cm below the umbilicus. The data for analysis includes pelvic organ prolapse quantification (POP-Q), medical history of urinary incontinence (UI), the strength of rectus abdominis muscle and pelvic floor muscle. The differences in women with and without DRA were compared with independent samples t-test and Chi-square test. Results Prevalence of DRA was 82.6% during the first postpartum year. Cesarean section and multiple parturitions are recognized as risk factors for DRA due to the odds ratio in our study were 3.48 (95% CI 1.42–8.56), 3.20 (95% CI 1.59–6.45) respectively. There was no difference in the occurrence of UI and pelvic organ prolapse (POP) comparing women with and without DRA, even changing the cut-off values (inter-rectus distance = 20 mm, 30 mm, 40 mm, 50 mm) for determining DRA. The women with weak rectus abdominis muscle and pelvic floor muscle have no statistical difference in two group. Conclusion The relationship of the diastasis recti abdominis and pelvic floor dysfunction has no connection, even with the severity of inter-rectus distance increasing.

Possibilities of using neodymium laser (Nd:YAG) in patients with concomitant diseases which are accompanied by pathological discharge from the genital tract

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. 75-81
Author(s):  
Olga A. Pauzina ◽  
Inna A. Apolikhina ◽  
Darya A. Malyshkina
Keyword(s):  
Drug Therapy ◽  
Pelvic Floor ◽  
Genital Tract ◽  
Vaginal Discharge ◽  
Muscle Tone ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Dysfunction ◽  
Vaginal Wall ◽  
Neodymium Laser ◽  
Frequent Relapses

Background. Pathological vaginal discharge is the most common disorder in women after giving birth who have vaginal relaxation syndrome and vaginal wall prolapse, as well as in women during menopause. To date, there are no clear treatment regimens for mixed vulvovaginal infections, and the use of only drug therapy in patients with pelvic organ prolapse and genitourinary syndrome of menopause in combination with diseases which are accompanied by pathological vaginal discharge does not give a long lasting result and is characterized by frequent relapses. In this regard, the use of laser methods in combination with drug therapy may lead to the recovery of vaginal microbiocenosis and a decrease in the number of relapses of diseases which are accompanied by pathological discharge from the genital tract. Results. Description. This article presents a clinical case and description of the experience of using a neodymium laser for the treatment of a patient with recurrent mixed vulvovaginitis, 2nd- degree vaginal wall prolapse, loss of pelvic floor muscle tone, vaginal relaxation syndrome and sexual dysfunction using neodymium laser. The woman received 3 procedures of exposure to a neodymium laser with an interval of 2830 days. After 3 procedures of exposure to a neodymium laser, the patient has a good clinical efficacy in the recovery of vaginal microbiocenosis. Conclusions. An innovative technique of exposure to Nd:YAG neodymium laser in the practice of a gynecologist has shown high clinical efficiency in the treatment of not only pelvic floor dysfunction, but also mixed vulvovaginitis. And, despite this aspect of the use of laser technologies requires further study, we can use a neodymium laser in combination with traditional drug therapy to treat diseases which are accompanied by pathological discharge from the genital tract in cases of ineffective drug monotherapy and frequent relapses.

Safety of a Clozapine Trial Following Quetiapine-Induced Leukopenia: A Case Report

2019 ◽  
Vol 14 (1) ◽  
pp. 80-83 ◽  
Author(s):  
Asma H. Almaghrebi
Keyword(s):  
Treatment Options ◽  
Young Female ◽  
Similar Reaction ◽  
Careful Monitoring ◽  
Treatment Resistant ◽  
Blood Cell Count ◽  
Antipsychotic Medications ◽  
Case Presentation ◽  
Clozapine Treatment ◽  
History Of

Background: The clozapine-derivative quetiapine has been shown in some cases to cause leukopenia and neutropenia. Case Presentation: We reported on a case of a young female diagnosed with treatment-resistant schizophrenia. After failed trials of three antipsychotic medications and despite a history of quetiapineinduced leukopenia, clozapine treatment was introduced due to the severity of the patient’s symptoms, the limited effective treatment options, and a lack of guidelines on this issue. Result: Over a ten-week period of clozapine treatment at 700 mg per day, the patient developed agranulocytosis. Her white blood cell count sharply dropped to 1.6 &#215; 10<sup>9</sup> L, and her neutrophils decreased to 0.1 &#215; 10<sup>9</sup> L. There had been no similar reaction to her previous medications (carbamazepine, risperidone, and haloperidol). Conclusion: The safety of clozapine in a patient who has previously experienced leukopenia and neutropenia with quetiapine requires further investigation. Increased attention should be paid to such cases. Careful monitoring and slow titration are advisable.

scholarly journals Pelvic-Floor Dysfunction Prevention in Prepartum and Postpartum Periods

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 387
Author(s):  
Karolina Eva Romeikienė ◽  
Daiva Bartkevičienė
Keyword(s):  
Clinical Trials ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Randomized Clinical Trials ◽  
Pelvic Floor Muscle Training ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Dysfunction ◽  
Pelvic Organ ◽  
Cochrane Library ◽  
Muscle Training

Every woman needs to know about the importance of the function of pelvic-floor muscles and pelvic organ prolapse prevention, especially pregnant women because parity and labor are the factors which have the biggest influence on having pelvic organ prolapse in the future. In this article, we searched for methods of training and rehabilitation in prepartum and postpartum periods and their effectiveness. The search for publications in English was made in two databases during the period from August 2020 to October 2020 in Cochrane Library and PubMed. 77 articles were left in total after selection—9 systematic reviews and 68 clinical trials. Existing full-text papers were reviewed after this selection. Unfinished randomized clinical trials, those which were designed as strategies for national health systems, and those which were not pelvic-floor muscle-training-specified were excluded after this step. Most trials were high to moderate overall risk of bias. Many of reviews had low quality of evidence. Despite clinical heterogeneity among the clinical trials, pelvic-floor muscle training shows promising results. Most of the studies demonstrate the positive effect of pelvic-floor muscle training in prepartum and postpartum periods on pelvic-floor dysfunction prevention, in particular in urinary incontinence symptoms. However more high-quality, standardized, long-follow-up-period studies are needed.

scholarly journals Rare Treatments for Rare Dyslipidemias: New Perspectives in the Treatment of Homozygous Familial Hypercholesterolemia (HoFH) and Familial Chylomicronemia Syndrome (FCS)

2021 ◽  
Vol 23 (11) ◽  
Author(s):  
Laura D’Erasmo ◽  
Simone Bini ◽  
Marcello Arca
Keyword(s):  
Familial Hypercholesterolemia ◽  
Treatment Options ◽  
New Drugs ◽  
Lipid Lowering ◽  
Homozygous Familial Hypercholesterolemia ◽  
Published Evidence ◽  
Novel Drugs ◽  
Life Threatening ◽  
History Of ◽  
Definition Of

Abstract Purpose of Review This review aims to summarize the most recent published literature concerning lomitapide and volanesorsen that are approved for the use in HoFH and FCS patients, respectively. Moreover, it will briefly revise the published evidence on novel, non-approved treatments that are under evaluation for the management of these rare forms of dyslipidemias Recent Findings The definition of rare dyslipidemias identifies a large number of severe disorders of lipid metabolism of genetic origin. Among them were homozygous familial hypercholesterolemia (HoFH) (OMIM #143890) and familial chylomicronemia syndrome (FCS) (OMIM #238600), which are characterized by a markedly impaired cholesterol- and triglyceride-containing lipoproteins metabolism. They are being particularly associated with poor health outcomes and quality of life. Considering the severity of these diseases, common lipid-lowering drugs are often ineffective or do not allow to achieve the recommended lipid targets to prevent the development of complications. Nowadays, several new drugs have been found to effectively treat HoFH and FCS with an acceptable safety profile. Summary Treating patients with HoFH and FCS remains very challenging. However, novel treatment options are emerging and might be considered in addition to conventional therapy for managing these diseases. These novel drugs will possibly change the natural history of these two rare and life-threatening diseases.

Parody—Nature and Definition

2019 ◽  
pp. 1-37
Author(s):  
Sabine Jacques
Keyword(s):  
The United States ◽  
Copyright Law ◽  
The European Union ◽  
International Human Rights ◽  
The United Kingdom ◽  
The Arts ◽  
History Of ◽  
Definition Of ◽  
Relationship Of ◽  
The Relationship

This chapter provides an overview of the nature and definition of parody in the context of copyright law. The Court of Justice of the European Union (CJEU) has introduced two requirements that must be satisfied before a work may be considered a ‘parody’: firstly, it must ‘evoke an existing work while being noticeably different from it’, and secondly, it must ‘constitute an expression of humour or mockery’. The chapter first traces the origin and history of parody in the arts, including music, before discussing the relationship of parody with concepts such as satire, caricature, and pastiche. It then examines why a parody exception has been considered necessary in copyright law. The chapter goes on to analyse the legal evolution of parody in France, Australia, Canada, the United States, and the United Kingdom, showing that the existing international human rights framework may influence the definition of parody in intellectual property law.

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