Stefanie N Foster1, Theresa M Spitznagle1,2, Lori J Tuttle3, Jerry L Lowder2,4, Siobhan Sutcliffe5,2, Karen Steger-May6, Chiara Ghetti2,4, Jinli Wang6, Taylor Burlis1, Melanie R Meister2,4, Michael J Mueller1,7, Marcie Harris-Hayes1,8. 1. Program in Physical Therapy, Washington University in St. Louis, St Louis, MO. 2. Department Obstetrics and Gynecology, Washington University in St. Louis, St Louis, MO. 3. Doctor of Physical Therapy Program, San Diego State University, San Diego, CA. 4. Division of Female Pelvic Medicine & Reconstructive Surgery, Washington University in St. Louis, St Louis, MO. 5. Department of Surgery, Washington University in St. Louis, St Louis, MO. 6. Division of Biostatistics, Washington University in St. Louis, St Louis, MO. 7. Department of Radiology, Washington University in St. Louis, St Louis, MO. 8. Department Orthopedic Surgery, Washington University in St. Louis, St Louis, MO.
Abstract
Background: Women with urgency/frequency predominant lower urinary tract symptoms (UF-LUTS) may have elevated pelvic floor muscle (PFM) position at rest and limited mobility with PFM contraction and bearing down, but this has not been quantified. Objectives: To compare PFM position and mobility using transperineal ultrasound (TPUS) at rest, maximal PFM contraction (perineal elevation), and bearing down (perineal descent) in women with and without UF-LUTS. We hypothesized that women with UF-LUTS would demonstrate elevated resting position and decreased excursion of pelvic landmarks during contraction and bearing down as compared to women without UF-LUTS. Study Design: Case-control study. Methods: Women with UF-LUTS were matched 1:1 on age, body mass index and vaginal parity to women without UF-LUTS. TPUS videos were obtained during 3 conditions: rest, PFM contraction, and bearing down. Levator plate angle (LPA) and puborectalis length (PR length), were measured for each condition. Paired t-tests or Wilcoxon signed rank tests compared LPA and PR length between cases and controls. Results: 21 case-control pairs (42 women): Women with UF-LUTS demonstrated greater LPA at rest (66.8 ± 13.2 degrees vs 54.9 ± 9.8 degrees; P=0.006), and less PR lengthening from rest to bearing down (0.2 ± 3.1 mm vs 2.1 ± 2.9 mm; P=.03). Conclusion: Women with UF-LUTS demonstrated more elevated (cranioventral) position of the PFM at rest and less PR muscle lengthening with bearing down. These findings highlight the importance of a comprehensive PFM examination and possible treatment for women with UF-LUTS to include PFM position and mobility.
Background: Women with urgency/frequency predominant lower urinary tract symptoms (UF-LUTS) may have elevated pelvic floor muscle (PFM) position at rest and limited mobility with PFM contraction and bearing down, but this has not been quantified. Objectives: To compare PFM position and mobility using transperineal ultrasound (TPUS) at rest, maximal PFM contraction (perineal elevation), and bearing down (perineal descent) in women with and without UF-LUTS. We hypothesized that women with UF-LUTS would demonstrate elevated resting position and decreased excursion of pelvic landmarks during contraction and bearing down as compared to women without UF-LUTS. Study Design: Case-control study. Methods: Women with UF-LUTS were matched 1:1 on age, body mass index and vaginal parity to women without UF-LUTS. TPUS videos were obtained during 3 conditions: rest, PFM contraction, and bearing down. Levator plate angle (LPA) and puborectalis length (PR length), were measured for each condition. Paired t-tests or Wilcoxon signed rank tests compared LPA and PR length between cases and controls. Results: 21 case-control pairs (42 women): Women with UF-LUTS demonstrated greater LPA at rest (66.8 ± 13.2 degrees vs 54.9 ± 9.8 degrees; P=0.006), and less PR lengthening from rest to bearing down (0.2 ± 3.1 mm vs 2.1 ± 2.9 mm; P=.03). Conclusion: Women with UF-LUTS demonstrated more elevated (cranioventral) position of the PFM at rest and less PR muscle lengthening with bearing down. These findings highlight the importance of a comprehensive PFM examination and possible treatment for women with UF-LUTS to include PFM position and mobility.
Authors: S M Armstrong; J M Miller; K Benson; S Jain; K Panagopoulos; J O L DeLancey; C M Sampselle Journal: Neurourol Urodyn Date: 2006 Impact factor: 2.696
Authors: Tiago Antunes-Lopes; Alice Vasconcelos; Daniel Costa; Ana Charrua; João Neves; João Silva; Francisco Cruz; Carlos Silva Journal: Urology Date: 2018-09-13 Impact factor: 2.649
Authors: Johannes Schindelin; Ignacio Arganda-Carreras; Erwin Frise; Verena Kaynig; Mark Longair; Tobias Pietzsch; Stephan Preibisch; Curtis Rueden; Stephan Saalfeld; Benjamin Schmid; Jean-Yves Tinevez; Daniel James White; Volker Hartenstein; Kevin Eliceiri; Pavel Tomancak; Albert Cardona Journal: Nat Methods Date: 2012-06-28 Impact factor: 28.547
Authors: Marc Beer-Gabel; Mark Teshler; Naphtali Barzilai; Yoav Lurie; Stephen Malnick; David Bass; Andrew Zbar Journal: Dis Colon Rectum Date: 2002-02 Impact factor: 4.585