The prevalence of pelvic floor dysfunction symptoms in reproductive-aged women

Artymuk N.V., Khapacheva S.Yu.

Kemerovo State Medical University, Kemerovo, Russia
Objective. To estimate the prevalence of pelvic floor dysfunction (PFD) symptoms in reproductive-aged women and their association with childbirth.
Subjects and methods. A total of 1637 women aged 18 to 45 years (mean age, 30.8±5.7 years) underwent an anonymous survey using the Pelvic Floor Distress Inventory-20 (PFDI-20) and FSFI (Female Sexual Function Index) questionnaires.
Results. The symptoms of pelvic organ prolapse (POP) were recorded in 46.6% of the respondents; there were colo-recto-anal, urinary, and sexual disorders in 43.3, 49.7, and 80.7%, respectively. A relationship was found between PFD symptoms and childbirth: POP (χ 2 = 92.96, p = 0.0001), colo-recto-anal (χ2 = 132.22, p = 0.0001), and urinary (χ2 =123.68, p = 0.0001) disorders. There was no relationship of sexual disorders to the number of births in the history (χ2 = 0.1005, p = 0.751).
Conclusion. The investigation established the high prevalence of PFD symptoms in reproductive-aged women and its association with childbirth, which requires the development of a package of measures for the prevention of these disorders in women in the postpartum period.

Keywords

pelvic floor dysfunction
prolapse
urinary incontinence
fecal incontinence
sexual dysfunction

References

1. Memon H.U., Handa V.L. Vaginal childbirth and pelvic floor disorders. Womens Health (Lond.). 2013; 9(3): 265-77.

2. Awwad J., Sayegh R., Yeretzian J., Deeb M.E. Prevalence, risk factors, and predictors of pelvic organ prolapse: a community-based study. Menopause. 2012; 19(11): 1235-41.

3. Хапачева С.Ю., Артымук Н.В. Профилактика дисфункции тазовых органов после родов с применением физических методов. Обзор литературы. Мать и дитя в Кузбассе. 2017; 4: 4-9. [Khapacheva S.Yu., Artymuk N.V. Prevention of dysfunction of the pelvic organs after childbirth with the use of physical methods. Review of literature. Mat' i ditya v Kuzbasse. 2017; 4: 4-9. (in Russian)]

4. Кочев Д.М., Дикке Г.Б. Дисфункция тазового дна до и после родов и превентивные стратегии в акушерской практике. Акушерство и гинекология. 2017; 5: 9-15. [Kochev D.M., Dikke G.B. Pelvic floor dysfunction before and after childbirth and preventive strategies in obstetric practice. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (5): 9-15. (in Russian)] http://dx.doi.org/10.18565/aig.2017.5.9-15

5. Pelvic Floor Disability Index (PFDI-20). In: Bent A.E., Cundiff G.W., Swift S.E., eds. Ostergard's urogynecology and pelvic floor dysfunction. 6th ed. London: Lippincott Williams & Wilkins; 2008. 592р.

6. Rosen R., Brown C., Heiman J., Leiblum S., Meston C., Shabsigh R. et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J. Sex Marital Ther. 2000; 26(2): 191-208.

7. Дикке Г.Б. 5 STEPS: Алгоритм ранней диагностики пролапса половых органов и недержания мочи. М.; 2016. 16с. [Dikke G.B. 5 STEPS: Algorithm of early diagnosis of prolapse of genital organs and urinary incontinence. Moscow; 2016. 16p. (in Russian)]

8. Куликов А.А., Пересада О.А., Соловей С.В., Котов Г.С. Возможности консервативного лечения пролапса тазовых органов у женщин. Охрана материнства и детства. 2016; 2: 58-63. [Kulikov A.A., Peresada O.A., Solovey S.V., Kotov G.S. Possibilities of conservative treatment of prolapse of pelvic organs in women. Okhrana materinstva i detstva. 2016; 2: 58-63. (in Russian)]

9. Караева К.Ю., Владимиров В.Г., Каппушева Л.М., Курцер М.А. Динамика клинических проявлений пролапса тазового дна от первых симптомов до развития полного симптомокомплекса. Вестник Российского государственного медицинского университета. 2011; 5: 30-2. [Karayeva K.Yu., Vladimirov V.G., Kappusheva L.M., Kurtser M.A. The dynamics of clinical manifestations of pelvic floor prolapse from the first symptoms to the development of the complete symptom complex. Vestnik Rossiyskogo gosudarstvennogo meditsinskogo universiteta. 2011; 5: 30-2. (in Russian)]

10. Аполихина И.А., Дикке Г.Б., Кочев Д.М. Современная лечебно-профилактическая тактика при опущении и выпадении половых органов у женщин. Знания и практические навыки врачей. Акушерство и гинекология. 2014; 10: 104-10. [Apolikhina I.A., Dikke G.B., Kochev D.M. Current therapeutic and prophylactic tactics for women with genital descent and prolapse. Physicians’ knowledge and practical skills. Akusherstvo i ginekologiya/Obstetrics and Gynecology. 2014; 10: 104-110. (in Russian)]

11. Солуянов М.Ю., Любарский М.С., Королева Е.Г., Ракитин Ф.А. Ошибки и осложнения хирургического лечения пролапса тазовых органов с использованием синтетических материалов. Успехи современного естествознания. 2012; 10: 48-52. [Soluyanov M.YU., Lyubarskiy M.S., Koroleva Ye.G., Rakitin F.A. Errors and complications of surgical treatment of prolapse of pelvic organs with the use of synthetic materials. Uspekhi sovremennogo yestestvoznaniya. 2012; 10: 48-52. (in Russian)]

12. Vorvick L.J., Storck S., Zieve D. Uterine prolapse (online). Available at: www.nlm.nih.gov/ medlineplus/ ency/article 001508

13. Nygaard I., Barber M.D., Burgio K.L., Kenton K., Meikle S., Schaffer J. et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008; 300(11): 1311-6.

14. Дубинская Е.Д., Бабичева И.А., Колесникова С.Н., Дорфман М.Ф., Лаптева Н.В. Клинические особенности и сексуальная функция у пациенток с ранними формами пролапса тазовых органов. Вопросы гинекологии, акушерства и перинатологии. 2015; 14(6): 5-11. [Dubinskaya Ye.D., Babicheva I.A., Kolesnikova S.N., Dorfman M.F., Lapteva N.V. Clinical features and sexual function in patients with early forms of prolapse of pelvic organs.Vopr. ginekologii, akusherstva i perinatologii. 2015; 14(6): 5–11. (in Russian)]

15. Ваde Araujo C.C., Coelho S.A., Stahlschmidt P., Juliato C.R.T. Does vaginal delivery cause more damage to the pelvic floor than cesarean section as determined by 3D ultrasound evaluation? A systematic review. Int. Urogynecol. J. 2018; 29(5): 639-45.

16. Živković K., Živković N., Župić T., Hodžić D., Mandić V., Orešković S. Effect of delivery and episiotomy on the emergence of urinary incontinence in women: review of literature. Acta Clin. Croat. 2016; 55(4): 615-24.

17. Wai C.Y., McIntire D.D., Atnip S.D., Schaffer J.I., Bloom S.L., Leveno K.J. Urodynamic indices and pelvic organ prolapse quantification 3 months after vaginal delivery in primiparous women. Int. Urogynecol. J. 2011; 22(10):1293-8.

18. Chen Y., Li F.Y., Lin X., Chen J., Chen C., Guess M.K. The recovery of pelvic organ support during the first year postpartum. BJOG. 2013; 120(11): 1430-7.

19. Sangsawang B., Sangsawang N. Stress urinary incontinence in pregnant women: a review of prevalence, pathophysiology, and treatment. Int. Urogynecol. J. 2013; 24(6): 901-12.

20. Дикке Г.Б., Аполихина И.А., Кочев Д.М., Щербатых Е.Ю. Распространенность дисфункции тазового дна среди акушеров-гинекологов и факторы, влияющие на выбор терапевтических подходов. Акушерство и гинекология. 2017; 10: 111-9. [Dikke G.B., Apolikhina I.A., Kochev D.M., Shcherbatykh E.Yu. Prevalence of pelvic floor dysfunction among obstetricians/gynecologists and factors influencing the choice of therapeutic approaches. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (10): 111-9. (in Russian)] https://dx.doi.org/10.18565/aig.2017.10.111-119

21. Keag O.E., Norman J.E., Stock S.J. Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: systematic review and meta-analysis. PLoS Med. 2018; 15(1): e1002494.

22. Komeilifar R., Javadifar N., Afshari P., Haghighizade H.M., Honarmandpour A. The prevalence, subtypes and obstetric risk factors of urinary incontinence in reproductive age women referred to community health care centers of Dezful, Iran-2015. Int. J. Community Based Nurs. Midwifery. 2017; 5(3): 275-83.

23. Brown S., Gartland D., Perlen S., McDonald E., MacArthur C. Consultation about urinary and faecal incontinence in the year after childbirth: a cohort study. BJOG. 2015; 122(7): 954-62.

24. Arnouk A., De E., Rehfuss A., Cappadocia C., Dickson S., Lian F. Physical, complementary, and alternative medicine in the treatment of pelvic floor disorders. Curr. Urol. Rep. 2017; 18(6): 47.

25. Parés D., Martinez-Franco E., Lorente N., Viguer J., Lopez-Negre J.L., Mendez Z.R. Prevalence of fecal incontinence in women during pregnancy: a large cross-sectional study. Dis. Colon Rectum. 2015;58(11): 1098-103.

26. Dabiri F., Yabandeh A.P., Shahi A., Kamjoo A., Teshnizi S.H. The effect of mode of delivery on postpartum sexual functioning in primiparous women. Oman Med. J. 2014; 29(4): 276-9.

27. Andreucci C.B., Bussadori J.C., Pacagnella R.C., Chou D., Filippi V., Say L., Cecatti J.G. Sexual life and dysfunction after maternal morbidity: a systematic review. BMC Pregnancy Childbirth. 2015; 15: 307.

28. Schaffer J.I., Bloom S.L. A randomized trial of the effects of coached vs uncoached maternal pushing during the second stage of labor on postpartum pelvic floor structure and function. Am. J. Obstet. Gynecol. 2005; 192(5): 1692-6.

29. Hagen S., Stark D. Conservative management of pelvic organ prolapse in women. Cochrane Database Syst. Rev. 2006; (4): CD003882. Available at: http://summaries.cochrane.org/

30. Серов В.Н., Аполихина И.А., Кубицкая Ю.В., Железнякова А.И. Электростимуляция мышц тазового дна в лечении недержания мочи у женщин. Акушерство и гинекология. 2011; 7-2: 51-5. [Serov V.N., Apolikhina I.A., Kubitskaya Yu.V., Zheleznyakova A.I. Pelvic floor myoelectrostimulation in the treatment of female urinary incontinence. Akusherstvo i ginekologiya/Obstetrics and Gynecology. 2011; 7-2: 51-5. (in Russian)]

Received 08.06.2018

Accepted 22.06.2018

About the Authors

Artymuk, Natalia V, Doctor of Medical Sciences, Professor, Head of the Department of Obstetrics and Gynecology № 2, Kemerovo State Medical University.
650056, Russia, Kemerovo, Voroshilov str. 22а. Tel.: +79609233355. E-mail: artymuk@gmail.com
Khapacheva, Svetlana Yu., Post-graduate student of the Department of Obstetrics and Gynecology № 2, Kemerovo State Medical University.
650056, Russia, Kemerovo, Voroshilov str. 22а. Tel.: +79235321222. E-mail: lanahapacheva@mail.ru

For citations: Artymuk N.V., Khapacheva S.Yu. The prevalence of pelvic floor dysfunction symptoms in reproductive-aged women. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (9): 99-105. (in Russian)
https://dx.doi.org/10.18565/aig.2018.9.99-105

Similar Articles

By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.