OBJECTIVE: To determine whether there are differences in the etiologies of two of the most common pelvic floor disorders (PFD), pelvic organ prolapse (POP) and stress urinary incontinence (SUI).
STUDY DESIGN: This cross-sectional descriptive study included 1042 women, referred to a pelvic floor unit in a tertiary Spanish hospital, between 2008 and 2012. Subjects at their fist visit were interviewed and examined generally and specifically (medical and urogynecological history). Collected parameters included: age, weight, height, medical and surgical background (including in-depth obstetrical and gynecological characteristics). The participants were classified into 3 different groups (POP, SUI, and mixed pathology). Descriptive analyses of each variable and multinomial logistic regression were performed to determine factors associated with POP and SUI.
RESULTS: Patients with POP were older, thinner, with greater parity and their newborns tended to be heavier. Furthermore, forceps, vaginal tears and vaginal surgeries were more common in the POP group. In contrast, family history was an important factor for the development of SUI, with a 6.45-fold increase (95% CI: 3.69-11.24). Two protective factors were identified for POP, cesarean section reduces the risk by 3 fold (OR=0.33) (95% CI: 0.13-0.85) whereas pelvic floor rehabilitation produces a 2 fold reduction (OR=0.49) (95% CI: 0.31-0.76).
CONCLUSIONS: Our data study demonstrates differences in potential triggers and risk factors for POP and SUI. Cesarean section and pelvic floor rehabilitation have a protective effect on preventing the development of POP. Bringing up that a personal medical care and a specific urogynecological follow-up should be developed for those who are more susceptible or at risk of PFD.
Written by:
Rodríguez-Mias NL, Martínez-Franco E, Aguado J, Sánchez E, Amat-Tardiu L. Are you the author?
Department of Obstetrics and Gynaecology, Hospital Sant Joan de Déu, University of Barcelona, Spain; Department of Obstetrics and Gynaecology, Parc Sanitari Sant Joan de Déu, Sant Boi del Llobregat, Spain; Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi del Llobregat, Spain; Blanquerna School of Health Sciences, Universitat Ramon Llull, Barcelona, Spain.
Reference: Eur J Obstet Gynecol Reprod Biol. 2015 Jul;190:52-7.
doi: 10.1016/j.ejogrb.2015.04.015
PubMed Abstract
PMID: 25984809