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Pelvic dysfunction

Anna Stępniak
Uterine fibroids are considered to be the most common benign tumours in females. The vast majority of these tumours are incidental findings and do not require any treatment. Symptomatic fibroids, with ailments such as abnormal uterine bleeding, dysmenorrhoea, pelvic pain, impaired urination, bowel dysfunction, infertility, and recurrent pregnancy loss, are indicated for medical treatment. Surgery remains a first-line treatment of symptomatic uterine fibroids; however, minimally invasive techniques and pharmacological management have become more available and popular...
December 2018: Przeglad Menopauzalny, Menopause Review
Ulrike Hohenfellner
In specialist urology clinics, 50 - 70 % of patients have chronic urological diseases such as recurrent urinary tract infections, a somatoform overactive bladder, adult and infantile enuresis, a chronic pelvic pain syndrome, and the psychosomatic form of post-prostatectomy incontinence. The 12-month prevalence of psychological disorders in the general adult population is 28 % 1. As many as 20 % of children and adolescents are found to have psychological abnormalities 2. These are frequently accompanied by somatoform symptoms, often consisting of a psychosomatic voiding disorder with a consecutive complex pelvic floor dysfunction 3 4 5 6...
February 14, 2019: Aktuelle Urologie
Chumnan Kietpeerakool, Apiwat Aue-Aungkul, Khadra Galaal, Chetta Ngamjarus, Pisake Lumbiganon
BACKGROUND: Radical hysterectomy is one of the standard treatments for stage Ia2 to IIa cervical cancer. Bladder dysfunction caused by disruption of the pelvic autonomic nerves is a common complication following standard radical hysterectomy and can affect quality of life significantly. Nerve-sparing radical hysterectomy is a modified radical hysterectomy, developed to permit resection of oncologically relevant tissues surrounding the cervical lesion, while preserving the pelvic autonomic nerves...
February 12, 2019: Cochrane Database of Systematic Reviews
Kate V Meriwether, Ethan M Balk, Danielle D Antosh, Cedric K Olivera, Shunaha Kim-Fine, Miles Murphy, Cara L Grimes, Ambereen Sleemi, Ruchira Singh, Alexis A Dieter, Catrina C Crisp, David D Rahn
INTRODUCTION AND HYPOTHESIS: We aimed to systematically review the literature on pelvic organ prolapse (POP) surgery with uterine preservation (hysteropexy). We hypothesized that different hysteropexy surgeries would have similar POP outcomes but varying adverse event (AE) rates. METHODS: MEDLINE, Cochrane, and databases were reviewed from inception to January 2018 for comparative (any size) and single-arm studies (n ≥ 50) involving hysteropexy...
February 11, 2019: International Urogynecology Journal
Giorgio Bogani, Diego Rossetti, Antonino Ditto, Fabio Martinelli, Valentina Chiappa, Chiara Leone, Umberto Leone Roberti Maggiore, Domenica Lorusso, Francesco Raspagliesi
OBJECTIVES: Nerve-sparing radical hysterectomy has been implemented in order to reduce pelvic floor dysfunctions in women undergoing radical surgery for cervical cancer. Here, we aimed to investigate if the adoption of laparoscopic surgery impacts on patients' outcomes. METHODS: Data of consecutive patients affected by cervical cancer who had laparoscopic nerve-sparing radical hysterectomy were matched 1:1 with an historical cohort of patients undergoing open procedure...
November 27, 2018: Journal of Gynecologic Oncology
Vipul R Sheth, Pamela Duran, Jonathan Wong, Sameer Shah, Jiang Du, Karen L Christman, Eric Y Chang, Marianna Alperin
Pelvic floor disorders negatively impact millions of women worldwide. Although there is a strong epidemiological association with childbirth, the mechanisms leading to the dysfunction of the integral constituents of the female pelvic floor, including pelvic floor skeletal muscles, are not well understood. This is in part due to the constraints associated with directly probing these muscles, which are located deep in the pelvis. Thus, experimental models and non-invasive techniques are essential for advancing knowledge of various phenotypes of pelvic floor muscle injury and pathogenesis of muscle dysfunction, as well as developing minimally invasive approaches for the delivery of novel therapeutics...
February 10, 2019: Journal of Anatomy
Kaihui Sha, Mary H Palmer, SeonAe Yeo
BACKGROUND AND OBJECTIVES: Yoga is a mind and body practice that includes relaxation, meditation, breathing exercises, and body postures. It can be effective in enhancing the functioning of several body systems, including the lower urinary tract. Normal lower urinary tract functioning depends in part on the coordination of the bladder, urethra, pelvic floor and other muscles, and the nerves that control them. Lower urinary tract dysfunction can lead to symptoms, that is, stress urinary incontinence (UI), urinary frequency, nocturia, urinary urgency with and without incontinence, and mixed UI...
February 8, 2019: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
A Giannini, M Caretto, E Russo, P Mannella, T Simoncini
Pelvic floor dysfunctions are a complex condition in elderly women; pelvic organ prolapse, urinary or fecal incontinence, constipation, pelvic pain, and sexual dysfunction are common problems. The goal of surgical treatment is functional reconstruction with symptom management and repair of anatomic defects. The recent advancements in surgical treatment of pelvic floor dysfunction allow several good options for choosing the best surgery for each patient. The vaginal procedure is traditionally the gold standard approach for elderly patients, but abdominal surgery is increasing as a mini-invasive approach and the robotic approach is gaining acceptance for treatment of pelvic floor dysfunctions...
February 2019: Climacteric: the Journal of the International Menopause Society
Yidi Ma, Tao Xu, Ye Zhang, Meng Mao, Jia Kang, Lan Zhu
INTRODUCTION AND HYPOTHESIS: The objective of this study was to translate the short version of the Pelvic Floor Distress Inventory (PFDI-20) into Chinese and to evaluate its psychometric properties in Chinese women with symptomatic pelvic floor dysfunction according to the Consensus-Based Standards for the Selection of Health Status Measurement Instruments (COSMIN) checklist. METHODS: Between October 2017 and May 2018, a cross-sectional analysis of the clinical data of 126 patients who met the inclusion criteria was performed...
February 4, 2019: International Urogynecology Journal
Ui-Jae Hwang, Oh-Yun Kwon, Sung-Hoon Jung, Sun-Hee Ahn, Hyun-A Kim
BACKGROUND: Because patients with nonspecific chronic low back pain (NSCLBP) are heterogeneous, subgrouping patients with NSCLBP might clarify the research findings. NSCLBP in the direction of extension movement, namely active extension pattern (AEP), is common during prolonged standing. OBJECTIVE: Predictors of pain intensity and dysfunction were determined in prolonged standing service workers (PSSWs) with NSCLBP subclassified as AEP in the motor impairment subgroup...
January 28, 2019: Musculoskeletal Science & Practice
Marcelo Montenegro, Helena Slongo, Cassia Raquel Teatin Juliato, Vatche Arakel Minassian, Ali Tavakkoli, Luiz Gustavo Oliveira Brito
OBJECTIVE: to determine the effect of bariatric surgery (BS) on the prevalence of pelvic floor dysfunctions (PFD), specifically on urinary incontinence (UI), pelvic organ prolapse (POP) and fecal incontinence (FI) DATA SOURCES: a systematic review (PROSPERO registration CRD42017068452) with literature search was performed using PubMed, Scopus and Scielo databases for all publications related to BS and PFD, with no language restrictions from inception to September 2018. METHODS OF STUDY SELECTION: two authors screened for study eligibility and extracted data...
January 29, 2019: Journal of Minimally Invasive Gynecology
Lori J Tuttle, Taylor Autry, Caitlin Kemp, Monique Lassaga-Bishop, Michaela Mettenleiter, Haley Shetter, Janelle Zukowski
OBJECTIVE: Pelvic Floor Muscle Training (PFMT), an accepted treatment for incontinence and pelvic floor dysfunction, has good evidence, though it is unknown if adjunct therapies can be useful. Strengthening the obturator internus (OI), along with other hip external rotator muscles, may help strengthen the pelvic floor muscles (PFM) through fascial attachment. We hypothesized that strengthening the hip external rotators will improve intravaginal squeeze pressure in older women. METHODS: A total of 25 women (with or without pelvic floor dysfunction) greater than 55 years of age participated in monitored and home exercise sessions three times a week for 12 weeks...
February 1, 2019: Physiotherapy Theory and Practice
Dan Zhao, Bin Li, Yating Wang, Shuanghuan Liu, Yanan Zhang, Gongyi Zhang
Objective: The aim of this study was to investigate the feasibility of using ultrasonic scalpel combined with vascular clip in parametrial management, called limited energy parametrial resection/dissection (LEPRD), in laparoscopic nerve plane-sparing radical hysterectomy (NPSRH), a modified nerve-sparing radical hysterectomy (NSRH); and to evaluate its effectiveness in pelvic autonomic nerve preservation. Methods: From July 2012 to January 2016, 257 consecutive patients with stage IB1 to IIA2 cervical cancer who underwent NPSRH were included in this study...
December 2018: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Helene Mathilde Larsen, Mette Borre, Peter Christensen, Asbjørn Mohr Drewes, Søren Laurberg, Klaus Krogh, Janne Fassov
BACKGROUND: Chronic gastrointestinal symptoms are common among patients surviving surgery and/or radio-/chemotherapy for cancer in the pelvic organs. However, little is known about the pathophysiology behind symptoms or the effect of treatment. The aim of the present study was to present the results of clinical evaluation and treatment of patients with chronic bowel symptoms after treatment for cancer in the colon or pelvic organs. MATERIAL AND METHODS: All patients referred to our department of gastroenterology between May 2016 and June 2018 with chronic bowel symptoms after treatment for cancer in the colon or pelvic organs were prospectively evaluated...
January 30, 2019: Acta Oncologica
Merga Dheresa, Alemayehu Worku, Lemessa Oljira, Bezatu Mengistie, Nega Assefa, Yemane Berhane
Objective: To assess the prevalence of female sexual dysfunction and its association with pelvic floor disorder (PFD) in a large scale, community-based study. Materials and Methods: A total of 2389 women who were married and still in union at the time of the study were drawn from 3432 women who had ever been married who participated in a PFD study. Study participants were selected through a multistage sampling procedure based on Kersa Health and Demographic Surveillance System database...
December 2018: Turkish Journal of Obstetrics and Gynecology
João Cunha Salvador, Mónica Portela Coutinho, José Marques Venâncio, Bárbara Viamonte
Pelvic floor dysfunctions represent a range of functional disorders that frequently occur in adult women, carrying a significant burden on the quality of life, and its incidence tends to increase attending to the expected aging of the population. Pelvic floor dysfunctions can manifest as incontinence, constipation, and prolapsed pelvic organs. Since pelvic floor weakness is frequently generalized and clinically underdiagnosed, imaging evaluation is of major importance, especially prior to surgical correction...
January 28, 2019: Insights Into Imaging
A Petrikovets, I E Veizi, A Hijaz, S T Mahajan, F Daneshgari, Cat Buffington, P McCabe, T Chelimsky
OBJECTIVES: To evaluate whether voiding parameters differ in patients with the common overlapping pelvic pain disorders, interstitial cystitis/bladder pain syndrome (IC/BPS) and myofascial pelvic pain (MPP). METHODS: Uroflow and voiding diary assessed voiding phenotypes in this prospective cohort study (ICEPAC) of women comparing IC/BPS, IC/BPS +MPP, MPP, and healthy control (HC) subjects. RESULTS: In 36 HC, 24 IC/BPS, 37 IC/BPS+MPP, and 14 MPP subjects, the voiding diary measurements indicate lower voided volumes in IC/BPS and IC/BPS+MPP groups (185±24 mL, 169±20 mL, respectively) compared to HC and MPP groups (294 ±24 mL, 226 ±36 mL, respectively; p<0...
January 22, 2019: Urology
Christopher K Payne, Jasmine Abdulcadir, Charlemagne Ouedraogo, Sebastien Madzou, Fasnéwindé Aristide Kabore, Elise Jb De
Female genital mutilation/cutting (FGM/C)-also known as Female Genital Cutting or Mutilation-is defined as the partial or total removal of the female external genitalia for non-therapeutic reasons. This White Paper, prepared under the auspices of the International Continence Society (ICS), is intended by the ICS as a statement promoting the abandonment of this practice. The ICS also supports the respectful and evidence-based care or treatment of women and girls already affected by FGM/C, in keeping with the World Health Organization (WHO) Guidelines on the Management of Health Complications from Female Genital Mutilation...
January 25, 2019: Neurourology and Urodynamics
Carlos D'Ancona, Bernard Haylen, Matthias Oelke, Luis Abranches-Monteiro, Edwin Arnold, Howard Goldman, Rizwan Hamid, Yukio Homma, Tom Marcelissen, Kevin Rademakers, Alexis Schizas, Ajay Singla, Irela Soto, Vincent Tse, Stefan de Wachter, Sender Herschorn
INTRODUCTION: In the development of terminology of the lower urinary tract, due to its increasing complexity, the terminology for male lower urinary tract and pelvic floor symptoms and dysfunction needs to be updated using a male-specific approach and via a clinically-based consensus report. METHODS: This report combines the input of members of the Standardisation Committee of the International Continence Society (ICS) in a Working Group with recognized experts in the field, assisted by many external referees...
January 25, 2019: Neurourology and Urodynamics
Mikkel Fode, Giorgio I Russo, Paolo Verze
Low intensity extracorporal shock wave therapy (Li-ESWT) may induce tissue regeneration, neo-angiogenesis and improve endothelial function. This has shown promise in the treatment of erectile dysfunction (ED). The aim of this narrative review was to describe potential therapeutic areas of Li-ESWT in sexual medicine other than ED. An extensive literature search and review of the most recent guidelines revealed that Li-ESWT has been used in the treatment of Peyronie's disease (PD) and is being investigated as a method of improving stem cell therapy...
January 22, 2019: International Journal of Impotence Research
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