Anatomical and functional characteristics of the pelvic floor in women of various age groups
Bezmenko A.A., Zakharov I.S., Bezhenar V.F., Staroverova A.S., Bagramyan E.A., Ivanova O.A., Kapitanova M.V.
Objective: To evaluate the anatomical and functional characteristics of the pelvic floor in women of different age groups.
Materials and methods: This study was conducted at the Military Medical Academy and included 1,546 women who were divided into three age groups. Anatomical characteristics were assessed using the POP-Q system and transperineal ultrasound examinations. Functional characteristics were analyzed with the PERFECT system, and the PFDI-20 and SF-36 questionnaires were utilized. In addition, the Female Sexual Function Index was evaluated.
Results: The study revealed that women in the second group experienced age-related shifts in the locations of points Aa and Ba, along with a statistically significant increase in the angle of urethral inclination and bladder neck displacement (p=0.01). Women in group 3 showed a significant decrease in strength, endurance, and muscle contractions (p=0.001). The PFDI-20 questionnaire results indicated an increase in the severity of pelvic dysfunction symptoms, rising from 9.4 points in group 1 to 144.8 points in group 3 (p=0.001). The increase in prolapse symptoms and severity of pelvic dysfunction correlated with a decrease in both the physical (ρ=-0.56, p=0.001) and psychological components of health (ρ=-0.60, p=0.001).
Conclusion: This study demonstrated that anatomical and functional changes in most women begin long before menopause onset. The data obtained can be used to develop individualized prevention and treatment measures.
Authors’ contributions: Bezmenko A.A., Zakharov I.S., Bezhenar V.F. – conception and design of the study, data analysis and interpretation, drafting and final approval of the manuscript; Bezmenko A.A., Zakharov I.S., Staroverova A.S., Bagramyan E.A., Ivanova O.A., Kapitanova M.V. – data collection and processing, data analysis and interpretation, drafting of the manuscript.
All authors read and approved the final version before submission.
Conflicts of interest: The authors have no conflicts of interest to declare.
Funding: There was no funding for this study.
Ethical Approval: The study was reviewed and approved by the Research Ethics Committee of the 1S.M. Kirov Military Medical Academy.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Bezmenko A.A., Zakharov I.S., Bezhenar V.F., Staroverova A.S., Bagramyan E.A., Ivanova O.A., Kapitanova M.V. Anatomical and functional characteristics of the pelvic floor in women of various age groups.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (6): 131-138 (in Russian)
https://dx.doi.org/10.18565/aig.2025.101
Keywords
pelvic floor
anatomical and functional characteristics
age-related changes
pelvic organ prolapse
pelvic dysfunction
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Received 11.04.2025
Accepted 28.05.2025
About the Authors
Alexander A. Bezmenko, PhD, Head of the Department of Obstetrics and Gynecology, Military Medical Academy, 6g, Ac. Lebedev str., St. Petersburg, Russia,194044, bezmenko@yandex.ru, https://orcid.org/0000-0003-2837-1260
Igor S. Zakharov, Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology, Military Medical Academy, 6g Acad. Lebedev str., St. Petersburg, 194044, Russia, isza@mail.ru, https://orcid.org/0000-0001-6167-2968
Vitaly F. Bezhenar, Professor, Head of the Department of Obstetrics, Gynecology and Neonatology, I.P. Pavlov First St. Petersburg State Medical University,
Ministry of Health of Russia, 6-8 Lva Tolstogo str, St. Petersburg, 197022, Russia, bez-vitaly@yandex.ru, https://orcid.org/0000-0002-7807-4929
Anna S. Staroverova, Head of the Obstetric (Observation) Department of the Clinic of Obstetrics and Gynecology, Military Medical Academy, 6g Acad. Lebedev str.,
St. Petersburg, 194044, Russia, staroverova.anna85@mail.ru, https://orcid.org/0000-0003-0916-4012
Elina A. Bagramyan, Resident at the Clinic of Obstetrics and Gynecology, Military Medical Academy, 6g Acad. Lebedev str., St. Petersburg, 194044, Russia,
elin.bagramian@yandex.ru, https://orcid.org/0009-0009-8650-2426
Olga A. Ivanova, Physician at the Ultrasound Diagnostics Department, Military Medical Academy, 6g Acad. Lebedev str., St. Petersburg, 194044, Russia,
oa_ivanova_63@mail.ru, https://orcid.org/0009-0007-7125-4736
Margarita V. Kapitanova, Physician at the Ultrasound Diagnostics Department, Military Medical Academy, 6g Acad. Lebedev str., St. Petersburg, 194044, Russia,
Lysya08@mail.ru, https://orcid.org/0009-0005-7331-4099
Corresponding author: Igor S. Zakharov, isza@mail.ru
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