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Frigerio M, Barba M, Palmieri S, Ruffolo AF, Gallo P, Magoga G, Manodoro S, Vergani P. Prevalence and severity of sexual disorders in the third trimester of pregnancy. Minerva Obstet Gynecol 2024; 76:21-26. [PMID: 35686638 DOI: 10.23736/s2724-606x.22.05118-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Female sexual function in pregnancy is an under-investigated topic by care providers. This study aimed to investigate the sexual function and the impact of traditional risk factors for pelvic floor disorders (PFDs) during the third trimester of pregnancy. METHODS This is a secondary analysis of a multicenter cross-sectional study conducted in eight hospitals in Italy and Italian-speaking Switzerland. Women at the third trimester of pregnancy aged 18 years and over completed the Italian-PFQPP questionnaire anonymously. RESULTS Overall, 927 patients in the third trimester of pregnancy answered the questionnaire. About 29.5% of women reported reduced or absent sexual activity. The less reported symptom was coital incontinence (1.3%), while painful intercourses was the most frequent one (50.3%). Nicotine abuse was associated with traumatic sexual intercourses, impaired vaginal sensibility, and negative impact on sexual life and well-being. Familiarity for pelvic floor disorder resulted as a risk factor for coital incontinence (OR=3.61). CONCLUSIONS Sexual symptoms, with pain during intercourses being the most widely reported, are extremely common in the third trimester of pregnancy and can greatly affect quality of life. Familiarity for pelvic floor disorders and nicotine abuse resulted as significant risk factors for at least one sexual symptom.
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Affiliation(s)
- Matteo Frigerio
- ASST Monza, San Gerardo Hospital, Monza, Monza-Brianza, Italy
| | - Marta Barba
- Milano-Bicocca University, Monza, Monza-Brianza, Italy -
| | | | | | | | - Giulia Magoga
- ULSS2 Marca Trevigiana, Oderzo Hospital, Oderzo, Treviso, Italy
| | | | - Patrizia Vergani
- Obstetrics Division, Monza and Brianza Mother and Child Foundation, Monza, Monza-Brianza, Italy
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Geoffrion R. Pelvic Floor Health Index: Initial validation of a practical postpartum tool for busy clinicians. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2023; 69:e229-e235. [PMID: 37963795 PMCID: PMC10645455 DOI: 10.46747/cfp.6911e229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
OBJECTIVE To design a primary care clinical tool (Pelvic Floor Health Index [PFHI]) to screen for postpartum pelvic floor disorders, as well as complete its psychometric validation. DESIGN Prospective cohort study. SETTING Two tertiary care obstetric centres in Vancouver, BC. PARTICIPANTS Primiparous women older than 19 years of age who were in the immediate postpartum period. MAIN OUTCOME MEASURES The PFHI was administered to 74 primiparous women immediately postpartum and at 2, 4, and 6 months postpartum. For evaluation of convergent and divergent construct validity, participants also completed several validated questionnaires, including the Female Sexual Functioning Index, the Pelvic Floor Distress Inventory, the 36-Item Short Form Health Survey, and the Edinburgh Postnatal Depression Scale. Fifteen women repeated their 6-month questionnaires 2 weeks later in order to determine test-retest reliability. Responsiveness was assessed by measuring the PFHI score change from baseline to 6 months postpartum. RESULTS Pelvic Floor Health Index score was inversely correlated with subscale scores on the Pelvic Floor Distress Inventory at all time points. There were moderate correlations between PFHI score and the Female Sexual Functioning Index and 36-Item Short Form Health Survey scores at several time points. There were weak correlations with postpartum depression scores. The intraclass correlation coefficient for test-retest reliability was 0.78 (95% CI 0.47 to 0.92). The PFHI mean total score significantly improved by 1.8 (95% CI 1.0 to 2.6) at 6 months postpartum. CONCLUSION The PFHI is a 10-item, newly validated, and psychometrically robust questionnaire that can be administered to patients in the postpartum period to screen for pelvic floor dysfunction.
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Affiliation(s)
- Roxana Geoffrion
- Associate Professor, Director of the Fellowship in Female Pelvic Medicine and Reconstructive Surgery, and Chair of the Obstetrics and Gynaecology Residency Research Committee, all at the University of British Columbia (UBC) in Vancouver
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Bosio S, Frigerio M, Barba M, Ruffolo AF, Gallo P, Magoga G, Manodoro S. Prevalence and severity of lower urinary tract symptoms in the third trimester of pregnancy. Int Urogynecol J 2023; 34:2155-2161. [PMID: 37014397 DOI: 10.1007/s00192-023-05515-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/19/2023] [Indexed: 04/05/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Pregnancy is a risk factor for urinary disorders, mainly in the third trimester. Lower urinary tract symptoms (LUTS) are often underreported by health care professionals and significantly impact the quality of life of pregnant women. Our objective is to analyse lower urinary tract function during the third trimester of pregnancy and assess the impact of traditional risk factors for pelvic floor dysfunctions on bladder health in pregnant women. METHODS This is a secondary analysis of a multicentre cross-sectional study. Third-trimester pregnant women aged 18 years or older anonymously filled in the "Italian Pelvic Floor Questionnaire for pregnant and postpartum women" questionnaire, validated for pelvic floor disorders in pregnancy and postpartum. RESULTS A total of 927 pregnant patients completed the questionnaire. Among them, 97.3% complained of at least one urinary disorder. Frequency was the symptom reported most often (77.3%), whereas nocturnal enuresis was the least reported (17%). Despite the high prevalence of LUTS in our sample, only 13.4% reported that they negatively impact their quality of life. Overweight and obesity, advanced maternal age, smoking, family history of pelvic floor disorders and poor pelvic floor contraction capacity were confirmed to be risk factors for the onset of LUTS, even in our population. CONCLUSIONS Urinary symptoms are extremely common in the third trimester and significantly affect the quality of life of pregnant women. Since overweight, obesity, smoking and reduced pelvic floor contractility emerged as modifiable risk factors for the development of these symptoms, prevention and adequate counselling are cornerstones of pregnancy care.
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Affiliation(s)
- Sara Bosio
- ASST Santi Paolo e Carlo, San Paolo Hospital, Via Antonio di Rudinì 8, 20142, Milan, MI, Italy
- University of Milano, Milan, Italy
| | - Matteo Frigerio
- ASST Monza, San Gerardo Hospital, Monza, Italy
- Urogynecology-Pelvic Floor Working Group (GLUP), Monza, MB, Italy
| | | | | | - Pasquale Gallo
- Urogynecology-Pelvic Floor Working Group (GLUP), Monza, MB, Italy
- San Giovanni di Dio Hospital, ASL Napoli 2 Nord, Frattamaggiore, Na, Italy
| | - Giulia Magoga
- ULSS2 Marca Trevigiana, Oderzo Hospital, Oderzo, Italy
| | - Stefano Manodoro
- ASST Santi Paolo e Carlo, San Paolo Hospital, Via Antonio di Rudinì 8, 20142, Milan, MI, Italy.
- University of Milano, Milan, Italy.
- Urogynecology-Pelvic Floor Working Group (GLUP), Monza, MB, Italy.
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Frigerio M, Marino G, Barba M, Palmieri S, Ruffolo AF, Degliuomini R, Gallo P, Magoga G, Manodoro S, Vergani P. Prevalence and severity of bowel disorders in the third trimester of pregnancy. AJOG GLOBAL REPORTS 2023; 3:100218. [PMID: 37645654 PMCID: PMC10461240 DOI: 10.1016/j.xagr.2023.100218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Bowel-related disorders are common conditions associated with pregnancy and are a cause of significant distress and healthcare burden. However, there is a lack of data in the literature about these disorders. OBJECTIVE This study aimed to investigate bowel dysfunctions during the third trimester of pregnancy in a large cohort of women using the validated bowel domain of the Italian version of the Pelvic Floor Questionnaire for Pregnant and Postpartum Women. STUDY DESIGN This was a secondary analysis of a multicenter cross-sectional study conducted in hospitals in Italy and Italian-speaking Switzerland. Women in the third trimester of pregnancy were asked to complete the Italian Pelvic Floor Questionnaire for Pregnant and Postpartum Women. RESULTS During the study period, 927 pregnant women in the third trimester of pregnancy responded to the questionnaire and were included in the analysis. Overall bowel dysfunctions were reported by 29.6% of patients. Constipation was reported by 66.6% of pregnant women, whereas symptoms of obstructed defecation were reported by 49.9% of patients. In contrast, urgency was reported by 41.1% of patients. Incontinence to flatus and incontinence to stool were reported by 45.1% and 2.8% of patients, respectively. Moreover, age >35 years, familiarity with pelvic floor disorders, nicotine abuse, and pelvic floor contraction inability were identified as independent risk factors for at least 1 bowel symptom. CONCLUSION Bowel symptoms are extremely common in the third trimester of pregnancy and can greatly affect a patient's quality of life; therefore, bowel symptoms deserve to be investigated and managed properly. The use of validated questionnaires represents a precious tool to investigate functional symptoms that could be very frequent and disabling in this particular period of life for women.
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Affiliation(s)
- Matteo Frigerio
- ASST Monza, San Gerardo Hospital, Monza, Italy (Dr Frigerio)
- Urogynecology-Pelvic Floor Working Group, Monza, Italy (Drs Frigerio, Gallo, and Manodoro)
| | - Giuseppe Marino
- Department of Obstetrics and Gynecology, University of Milano-Bicocca, Milano, Italy (Drs Marino, Barba, and Palmieri)
| | - Marta Barba
- Department of Obstetrics and Gynecology, University of Milano-Bicocca, Milano, Italy (Drs Marino, Barba, and Palmieri)
| | - Stefania Palmieri
- Department of Obstetrics and Gynecology, University of Milano-Bicocca, Milano, Italy (Drs Marino, Barba, and Palmieri)
| | | | | | - Pasquale Gallo
- Urogynecology-Pelvic Floor Working Group, Monza, Italy (Drs Frigerio, Gallo, and Manodoro)
- San Giovanni di Dio Hospital, ASL Napoli 2 Nord, Frattamaggiore, Italy (Dr Gallo)
| | - Giulia Magoga
- ULSS2 Marca Trevigiana, Oderzo Hospital, Oderzo, Italy (Dr Magoga)
| | - Stefano Manodoro
- Urogynecology-Pelvic Floor Working Group, Monza, Italy (Drs Frigerio, Gallo, and Manodoro)
- ASST Santi Paolo e Carlo, San Paolo Hospital, Milano, Italy (Dr Manodoro)
| | - Patrizia Vergani
- Obstetric Division, Monza and Brianza Mother and Child Foundation, Monza, Italy (Dr Vergani)
| | - Urogynecology-Pelvic Floor Working Group
- ASST Monza, San Gerardo Hospital, Monza, Italy (Dr Frigerio)
- Urogynecology-Pelvic Floor Working Group, Monza, Italy (Drs Frigerio, Gallo, and Manodoro)
- Department of Obstetrics and Gynecology, University of Milano-Bicocca, Milano, Italy (Drs Marino, Barba, and Palmieri)
- San Raffaele University, Milano, Italy (Drs Ruffolo and Degliuomini)
- San Giovanni di Dio Hospital, ASL Napoli 2 Nord, Frattamaggiore, Italy (Dr Gallo)
- ULSS2 Marca Trevigiana, Oderzo Hospital, Oderzo, Italy (Dr Magoga)
- ASST Santi Paolo e Carlo, San Paolo Hospital, Milano, Italy (Dr Manodoro)
- Obstetric Division, Monza and Brianza Mother and Child Foundation, Monza, Italy (Dr Vergani)
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Baruch Y, Manodoro S, Barba M, Cola A, Re I, Frigerio M. Prevalence and Severity of Pelvic Floor Disorders during Pregnancy: Does the Trimester Make a Difference? Healthcare (Basel) 2023; 11:healthcare11081096. [PMID: 37107930 PMCID: PMC10137441 DOI: 10.3390/healthcare11081096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/05/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
(1) Background: Women experience pelvic floor dysfunction symptoms during pregnancy. This study is the first to investigate and compare variances in the prevalence and severity of pelvic floor symptoms between trimesters using a valid pregnancy-targeted questionnaire. (2) Methods: A retrospective cohort study was conducted between August 2020 to January 2021 at two university-affiliated tertiary medical centers. Pregnant women (n = 306) anonymously completed the Pelvic Floor Questionnaire for Pregnancy and Postpartum with its four domains (bladder, bowel, prolapse, and sexual). (3) Results: Thirty-six women (11.7%) were in the 1st trimester, eighty-three (27.1%) were in the 2nd trimester, and one hundred and eighty-seven (61.1%) were in the 3rd trimester. The groups were similar in age, pregestational weight, and smoking habits. A total of 104 (34%) had bladder dysfunction, 112 (36.3%) had bowel dysfunction, and 132 (40.4%) reported sexual inactivity and/or sexual dysfunction. Least prevalent (33/306; 10.8%) were prolapse symptoms. Increased awareness of prolapse and significantly higher rates of nocturia and the need to use pads due to incontinence were recorded in the 3rd trimester. Sexual dysfunction or abstinence were equally distributed in all three trimesters. (4) Conclusions: Bladder and prolapse symptoms, equally frequent throughout pregnancy, significantly intensified in the 3rd trimester. Bowel and sexual symptoms, equally frequent throughout pregnancy, did not intensify in the third trimester.
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Affiliation(s)
- Yoav Baruch
- Urogynecology and Pelvic Floor Unit, Department of Obstetrics and Gynecology, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Stefano Manodoro
- Department of Obstetrics and Gynecology, ASST Santi Paolo e Carlo, San Paolo Hospital, 20132 Milano, Italy
| | - Marta Barba
- Department of Obstetrics and Gynecology, Fondazione IRCCS San Gerardo dei Tintori, University Milano Bicocca, 20900 Monza, Italy
| | - Alice Cola
- Department of Obstetrics and Gynecology, Fondazione IRCCS San Gerardo dei Tintori, University Milano Bicocca, 20900 Monza, Italy
| | - Ilaria Re
- Department of Obstetrics and Gynecology, Fondazione IRCCS San Gerardo dei Tintori, University Milano Bicocca, 20900 Monza, Italy
| | - Matteo Frigerio
- Department of Obstetrics and Gynecology, Fondazione IRCCS San Gerardo dei Tintori, University Milano Bicocca, 20900 Monza, Italy
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Schütze S, Landenberger M, Heinloth M, Schütze J, Andres S, Janni W, Deniz M. Effect of the Delivery Mode on Pelvic Floor Function and Coping With Birth-Related Pain and Fear: A Prospective Survey Six Months Postpartum. Cureus 2023; 15:e35065. [PMID: 36942173 PMCID: PMC10024571 DOI: 10.7759/cureus.35065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2023] [Indexed: 02/18/2023] Open
Abstract
Background and objective Delivering a baby is one of the most decisive events in a woman`s life and brings along psychological and physical challenges. Therefore, the question arises: which mode of delivery is the best for the woman's health and her future life? The aim of this study was to evaluate the influence of the delivery mode on pelvic floor function and coping with birth-related pain and fear six months postpartum. Materials and methods A total of 200 primiparous women, who delivered during 2018-2019, were included in this prospective case-control study and were asked to fill out the "Pelvic floor questionnaire for pregnant women and women after childbirth" six months after delivery. The women were separated into the following groups: spontaneous vaginal delivery (n = 113), operative vaginal delivery (n = 44), and cesarean section (n = 41). The pelvic floor function as well as coping with birth-related pain and fear six months after delivery was compared. Results A significantly higher body mass index was found in the cesarean section group. A significantly worse bladder score was shown in the group with an operative vaginal delivery (p = 0.006). The total score of the questionnaire as well as the anal, prolapse, and sexual subscores showed no difference between the delivery modes. Concerning coping with birth-related pain and fear postpartum, significant differences could be seen between the modes of delivery (pain: p < 0.001; fear: p < 0.001). Women with spontaneous vaginal delivery showed better coping with pain and fear postpartum. Conclusion It must be highlighted that women who have had a surgical delivery, including the operative vaginal delivery and cesarean section, stated a lower coping with birth-related pain and fear. This study showed that an operative vaginal delivery has a negative influence on bladder function and the use should be well-indicated. Obstetricians should always be aware of this, as they can contribute to better coping. It is essential to give women the opportunity to talk about the delivery and individual experiences both in pre- and postnatal situations.
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Affiliation(s)
- Sabine Schütze
- Obstetrics and Gynaecology, University Hospital Ulm, Ulm, DEU
| | | | - Marlen Heinloth
- Obstetrics and Gynaecology, University Hospital Ulm, Ulm, DEU
| | - Juliane Schütze
- Fundamental Sciences, University of Applied Science, Jena, DEU
| | - Sophia Andres
- Obstetrics and Gynaecology, University Hospital Ulm, Ulm, DEU
| | - Wolfgang Janni
- Obstetrics and Gynaecology, University Hospital Ulm, Ulm, DEU
| | - Miriam Deniz
- Obstetrics and Gynaecology, University Hospital Ulm, Ulm, DEU
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Hock M, Tiringer I, Ambrus E, Németh Z, Farkas B. Validation and translation of the Hungarian version of the Australian Pelvic Floor Questionnaire (APFQ-H). Int Urogynecol J 2022:10.1007/s00192-022-05322-2. [PMID: 35972523 DOI: 10.1007/s00192-022-05322-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/18/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION AND HYPOTHESIS The aims of the study were the translation, cultural adaptation, and validation of self-administered Australian Pelvic Floor Questionnaire (APFQ) on a Hungarian population. METHODS The validation was performed in 294 women over 18 who agreed to answer the Hungarian version of the APFQ. The validation of the questionnaire included evaluation of content/face validity, internal consistency, construct validity, test-retest reproducibility, discriminant validity and convergent validity. RESULTS Acceptable and good internal consistency was observed in all four dimensions [McDonald's ω (95% confidence interval) coefficients were > 0.7 for each dimension: bladder 0.888, bowel 0.790, prolapse 0.895 and sexual function 0.738]. Test-retest analyses revealed high reproducibility with intraclass correlation coefficients (bladder 0.83, bowel 0.92, prolapse 0.96 and sexual function 0.87). Prolapse symptom score correlated significantly with Pelvic Organ Prolapse Quantification (POP-Q), and bladder score correlated significantly with the results of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ UI SF) (convergent validity). Scores distinguished between patients with pelvic floor disorders and controls (high discriminant validity). CONCLUSIONS Hungarian version of the self-administered APFQ is a reliable and valid instrument for evaluating symptom severity and impact of pelvic floor dysfunction on the quality of life of Hungarian women.
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Affiliation(s)
- Márta Hock
- Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, University of Pécs, 3 Vörösmarty str., Pécs, 7621, Hungary
| | - István Tiringer
- Institute, of Behavioural Sciences, Medical School, University of Pécs, 12 Szigeti str., Pécs, 7623, Hungary
| | - Eszter Ambrus
- Harkány Thermal Rehabilitation Center, 1 Zsigmondy str., Harkány, 7815, Hungary
| | - Zoltán Németh
- Department of Gynecology, Hospital St. John of God, 1 Johannes von Gott-Platz, 1020, Vienna, Austria
| | - Bálint Farkas
- Department of Obstetrics and Gynecology, University of Pécs, Pécs, Hungary.
- Member of the MTA-PTE Human Reproduction Scientific Research Group, Hungarian Academy of Sciences, 17 Édesanyák str., Pécs, Budapest, 7624, Hungary.
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Swedish validation of the Pelvic Floor Questionnaire for pregnant and postpartum women. Int Urogynecol J 2022; 33:3013-3024. [PMID: 35767025 PMCID: PMC9569317 DOI: 10.1007/s00192-022-05264-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/22/2022] [Indexed: 12/03/2022]
Abstract
Introduction and hypothesis The German “Pelvic Floor Questionnaire for pregnant and postpartum women” is a self-administered questionnaire customized for pregnancy and the postpartum period that assesses four domains of pelvic floor function regarding perceived symptoms, suffering, and impact on quality of life: bladder, bowel, prolapse, and sexual function. No similar questionnaire is available in Swedish, despite a high prevalence of pregnancy and postpartum pelvic floor dysfunction. Thus, we aimed to translate the validated German questionnaire into Swedish and test its validity and reliability in a Swedish population. Methods Translation and cultural adaptation were performed according to guidelines. Of the 248 women who answered the Swedish questionnaire, 57 filled out the questionnaire twice to evaluate test-retest reliability. We also assessed internal consistency and discriminant validity. Results The Swedish version of the questionnaire showed good face and content validity. Cronbach’s alpha was in the acceptable to excellent range (bladder 0.82, bowel 0.78, prolapse 0.91, and sexual 0.83), showing adequate internal consistency. A comparison of means (≥ 1 point) showed that the questionnaire significantly (p < 0.05) distinguished between women who reported suffering and those who did not. Cohen's kappa for all individual items showed fair to almost perfect agreement (0.24–0.87) between test and retest scores. The intraclass correlation coefficients for domain scores (0.92–0.97) were all in an optimal range. Conclusions The Swedish version of the questionnaire is a reliable and valid instrument for assessing pelvic floor disorders, symptom severity, and impact on quality of life during pregnancy and the postpartum period.
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Volonte' S, Barba M, Cola A, Marino G, Frigerio M. Italian validation of the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Int Urogynecol J 2022; 33:3171-3175. [PMID: 35648181 PMCID: PMC9569287 DOI: 10.1007/s00192-022-05235-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 05/10/2022] [Indexed: 10/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The aim of this study was to translate the English short form of Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and evaluate its validity, internal consistency, and test-retest reliability. METHODS The questionnaire was translated into Italian by standardized procedural steps, and the final version was submitted to women referred to urogynecological outpatient care for genital prolapse or urinary incontinence reporting sexual disorders (cases) or not (controls). For the test-retest evaluation, cases received the questionnaire 2 weeks later. The Wilcoxon test (non-parametric) was used to assess differences between cases and controls. Convergent validity was tested with the Italian version of the FSFI-19. The internal consistency was tested using Cronbach's alpha. The degree of concordance/agreement was measured with Cohen's kappa. The absolute agreement of test-retest results was tested with the intraclass correlation coefficient (ICC). RESULTS Sixty women were recruited for the study and answered the questionnaire. The overall rate of missing items was 1.3%. Construct validity was demonstrated, as the questionnaire discriminated significantly between patients with and without symptoms. Convergent validity with FSFI-19 was tested, and a linear correlation between scores was demonstrated (F < 0.001). Internal consistency reliability evaluated with Cronbach's alpha was satisfactory (0.54-0.81). Cohen's kappa values as absolute agreement coefficients were between 0.59 and 0.80 (good agreement). Intraclass correlation coefficients ranged between 0.88 and 0.94 (very satisfactory agreement) for each functional domain. CONCLUSIONS The Italian version of the PISQ-12 is reliable, valid, and consistent.
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Affiliation(s)
- Silvia Volonte'
- ASST Monza, Ospedale San Gerardo, Via Pergolesi 33, Monza, Italy.
| | - Marta Barba
- ASST Monza, Ospedale San Gerardo, Via Pergolesi 33, Monza, Italy
| | - Alice Cola
- ASST Monza, Ospedale San Gerardo, Via Pergolesi 33, Monza, Italy
| | - Giuseppe Marino
- ASST Monza, Ospedale San Gerardo, Via Pergolesi 33, Monza, Italy
| | - Matteo Frigerio
- ASST Monza, Ospedale San Gerardo, Via Pergolesi 33, Monza, Italy
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Validation and cross-cultural adaptation of the Brazilian Portuguese version of the questionnaire for the assessment of pelvic floor disorders and their risk factors during pregnancy and postpartum. Int Urogynecol J 2022; 33:3155-3161. [PMID: 35467137 DOI: 10.1007/s00192-022-05101-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 01/14/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Pelvic floor dysfunction may be treated and prevented during pregnancy and postpartum, as it decreases women's quality of life. The aim of the present study was to translate and validate the Brazilian Portuguese questionnaire for the assessment of pelvic floor disorders and their risk factors during pregnancy and postpartum. METHODS This is a cross-sectional study. Two translators fluent in German translated the German version of the questionnaire into English. The back translation was performed by two other translators. The final version was tested on Brazilian pregnant/puerperal women. The participants answered the questionnaire twice, with an interval of 7-10 days between sessions. They also completed the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). To evaluate the test-retest reliability, we used the intraclass correlation coefficient (ICC), Cronbach's alpha coefficient, to test the internal consistency, and Pearson's linear correlation to assess construct validity. RESULTS Sixty-six women were included (77% pregnant; 23% puerperal women), with a mean age of 26.5 ± 5.8 years and a body mass index of 26.4 ± 5.7 kg/cm2. There were no missing ceiling or floor effects. The construct validity presented a moderate correlation with the role physical domain of the SF-36 (r = -0.48), the ICC test-retest showed good reliability of 0.72, and the internal consistency was 0.71. CONCLUSIONS These results provide evidence that the questionnaire for the assessment of pelvic floor disorders and their risk factors during pregnancy and postpartum is a valid and reliable instrument when utilized in Brazilian pregnant and postpartum women.
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Schütze S, Heinloth M, Uhde M, Schütze J, Hüner B, Janni W, Deniz M. The effect of pelvic floor muscle training on pelvic floor function and sexuality postpartum. A randomized study including 300 primiparous. Arch Gynecol Obstet 2022; 306:785-793. [PMID: 35377043 PMCID: PMC8977567 DOI: 10.1007/s00404-022-06542-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/16/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE Although pregnancy and childbirth are physiological processes they may be associated with pelvic floor disorders. The aim of this study was to evaluate the influence of pelvic floor muscle training on postpartum pelvic floor and sexual function of primiparous. METHODS This is a randomized prospective study including 300 primiparous women. Due to the dropout 200 women were analyzed. Inclusion criteria were the delivery of the first, mature baby, the ability to speak and understand German. The participants were evaluated by clinical examinations and questionnaires after 6 and 12 months postpartum. After 6 months, the women were randomized in two groups. Compared to the control group the intervention groups participated in 45-min pelvic floor muscle training and pelvic floor perception once a week over 6 weeks. RESULTS The results of the questionnaires showed no significant differences between the groups after 12 months. A significant stronger pelvic floor muscle strength was found for the intervention group after 12 months. The improvement of the pelvic floor and sexual function over the time showed a significant improvement in both groups. CONCLUSION Supervised pelvic floor muscle training did not improve both the pelvic floor and the female sexual function in comparison to the control group. After 12 months, the pelvic floor and sexual function improved significant in all women. TRIAL REGISTRATION German Clinical Trials Register (DRKS00024725), retrospectively registrated.
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Affiliation(s)
- Sabine Schütze
- Department of Obstetrics and Gynecology, University Hospital of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
| | - Marlen Heinloth
- Department of Obstetrics and Gynecology, University Hospital of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany
| | - Miriam Uhde
- Department of Obstetrics and Gynecology, University Hospital of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany
| | - Juliane Schütze
- Department of Basic Science, University of Applied Sciences Jena, Jena, Germany
| | - Beate Hüner
- Department of Obstetrics and Gynecology, University Hospital of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany
| | - Wolfgang Janni
- Department of Obstetrics and Gynecology, University Hospital of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany
| | - Miriam Deniz
- Department of Obstetrics and Gynecology, University Hospital of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany
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12
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Hübner M, Rothe C, Plappert C, Baeßler K. Aspects of Pelvic Floor Protection in Spontaneous Delivery - a Review. Geburtshilfe Frauenheilkd 2022; 82:400-409. [PMID: 35392067 PMCID: PMC8983111 DOI: 10.1055/a-1515-2622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/17/2021] [Indexed: 11/17/2022] Open
Abstract
The necessity of increasingly addressing aspects of pelvic floor protection, i.e., prevention of the most frequent female pelvic floor disorders, such as urinary incontinence, faecal incontinence and pelvic organ prolapse, is the result of the steadily improving understanding of the association of pregnancy and delivery with the prevalence of these disorders. About a quarter of all women experience one or more such symptoms during their life. Apart from age and weight, pregnancies and births play an important part. While initial discussion of pelvic floor protection often focused very rapidly on the mode of delivery and elective caesarean section as a possible protective intervention, it has become apparent in the last few decades how varied and wide-ranging the options are that can be used to protect against pelvic floor disorders. The mode of delivery as such is "only" one element among numerous other considerations and has diminished markedly in importance. Interprofessionality and interdisciplinarity undoubtedly represent an important development as resulting recommendations must always be incorporated in an overall context that considers mother and child at the same time. Considering the pelvic floor only certainly does not make sense. This review article will analyze in greater detail important pre-, intra- and postpartum aspects that in their entirety can provide insight into the various aspects of pelvic floor protection. The authors regard the following article as an additional basis for discussion on achieving a sustained reduction in the incidence and prevalence of female pelvic floor disorders.
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Affiliation(s)
- Markus Hübner
- Klinik für Frauenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany
- Medizinische Fakultät der Universität Tübingen, Tübingen, Germany
| | | | - Claudia Plappert
- Institut für Gesundheitswissenschaften, Abt. Hebammenwissenschaft, Universität Tübingen, Tübingen, Germany
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Gard E, Lyman A, Garg H. Perinatal Incontinence Assessment Tools: A Psychometric Evaluation and Scoping Review. J Womens Health (Larchmt) 2022; 31:1208-1218. [DOI: 10.1089/jwh.2021.0353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Emily Gard
- Department of Physical Therapy, Rocky Mountain University of Health Professions, Provo, Utah, USA
| | - Alyssa Lyman
- Department of Physical Therapy, Rocky Mountain University of Health Professions, Provo, Utah, USA
| | - Hina Garg
- Department of Physical Therapy, Rocky Mountain University of Health Professions, Provo, Utah, USA
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Liu Z, Zhou C, Munoz A, Zhang Y, Li X. Validation of a Chinese version for the global Pelvic Floor Bother Questionnaire. Arch Gynecol Obstet 2022; 305:1353-1357. [PMID: 35079874 DOI: 10.1007/s00404-021-06370-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/13/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE The Pelvic Floor Bother Questionnaire (PFBQ) is a self-administered instrument for determining pelvic floor dysfunction (PFD). The PFBQ was validated in English, but lately in other languages. However, a Chinese version has not been established. Thus, we aimed at validating a Chinese PFBQ version. METHODS We used a translation-back method to develop a PFBQ Chinese version and validated in 102 women, 51 with at least one PFD symptom participated in the patient group, and 51 without PFD in the control group. Construct validity was assessed by comparing groups and a content validity index (CVI) determined. For test-retest reliability, participants completed the questionnaire twice within 1-week interval and the interclass correlation coefficient (ICC) was determined. Internal consistency was calculated using Cronbach's statistics. RESULTS Missing information after applying the translated PFBQ did not exceed 4% of any questions. Total scores between control and PFD women were significantly different (2.94 ± 1.84 vs. 10.29 ± 6.64; P < 0.001). The CVI for all items ranged from 0.800 to 1.000, and a good reliability was corroborated (α = 0.677, ICC = 0.938). CONCLUSION The Chinese PFBQ version is a valid and reliable tool to identify the existence and severity of bothersome symptoms in Chinese women with PFD.
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Affiliation(s)
- Zhaoxue Liu
- Department of Rehabilitation Medicine, Central South University, The 3rd Xiangya Hospital, Tongzipo Road 138#, 410013, Changsha, Hunan, China
| | - Chengyu Zhou
- Department of Rehabilitation Medicine, Central South University, The 3rd Xiangya Hospital, Tongzipo Road 138#, 410013, Changsha, Hunan, China
| | - Alvaro Munoz
- Centro Universitario del Norte, Universidad de Guadalajara, Guadalajara, Mexico
| | - Yingchun Zhang
- Department of Biomedical Engineering, University of Houston, Houston, USA
| | - Xuhong Li
- Department of Rehabilitation Medicine, Central South University, The 3rd Xiangya Hospital, Tongzipo Road 138#, 410013, Changsha, Hunan, China.
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Hou Y, Tong B. Three-year follow-up of a self-administered Australian pelvic floor questionnaire validated in Chinese pregnant and postpartum women. Int Urogynecol J 2022; 33:3077-3084. [PMID: 35037976 PMCID: PMC9569312 DOI: 10.1007/s00192-022-05077-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 12/23/2021] [Indexed: 10/27/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The aim of this study was to verify whether the Chinese version of the self-administered Australian Pelvic Floor Questionnaire (APFQ) can assess the changes in symptoms over a long time period (responsiveness) and to verify the reliability and validity of the questionnaire after 3 years of follow-up. METHODS The questionnaire was completed by 146 women using the WeChat platform after 3 years of follow-up. Reliability was assessed through internal consistency (Cronbach's alpha). Construct validity was evaluated by significantly distinguished differences in symptom scores between women who did and did not subjectively suffer bothersome symptoms. Responsiveness was evaluated in 146 women. The effect size (ES) and standardized response mean (SRM) were used to assess the degree of responsiveness. RESULTS Of the 146 women, all completed the questionnaire through the WeChat platform without missing any items. Reliability, Cronbach's alpha for the four domains and total APFQ were: bladder function 0.78, bowel function 0.71, pelvic organ prolapse 0.78, sexual function 0.68 and total APFQ 0.84. Concerning construct validity, the APFQ significantly distinguished the symptom scores between women who did and did not subjectively suffer from bothersome symptoms, and the score difference was 1.1-1.6 points, 1.2 points, 2.0-3.7 points and 1.4 points, respectively. For responsiveness, three domains showed slight (bowel domain) to moderate (bladder domain, sex domain) sensitivity to change. ES and SRM ranged from 0.21 to 0.75 and 0.16 to 0.60, respectively. CONCLUSIONS The Chinese version of the self-administered APFQ is reliable and valid and can monitor the changes in symptoms over time.
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Affiliation(s)
- Yuqing Hou
- Gynecology Department, Women's Hospital School of Medicine Zhejiang University, No.1 Xueshi RoadZhejiang Province, Hangzhou, 310006, China.
| | - Baoqin Tong
- Gynecology Department, Women's Hospital School of Medicine Zhejiang University, No.1 Xueshi RoadZhejiang Province, Hangzhou, 310006, China
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16
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Palmieri S, De Bastiani SS, Degliuomini R, Ruffolo AF, Casiraghi A, Vergani P, Gallo P, Magoga G, Cicuti M, Parma M, Frigerio M. Prevalence and severity of pelvic floor disorders in pregnant and postpartum women. Int J Gynaecol Obstet 2021; 158:346-351. [PMID: 34778951 DOI: 10.1002/ijgo.14019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/31/2021] [Accepted: 11/10/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This multicenter study aimed to evaluate risk factors, prevalence and severity of pelvic floor disorders (PFDs) as well as their consequences on women's emotional well-being, using a questionnaire validated specifically for pregnancy and postpartum. METHODS Prospective study conducted in eight teaching hospitals in Italy and Italian-speaking Switzerland. Pregnant and postpartum women completed the Italian Pelvic Floor Questionnaire for Pregnancy and Postpartum anonymously. Prevalence of, severity of, and risk factors for PFDs were evaluated for all the four domains considered: bladder, bowel, prolapse, and sexual function. RESULTS A total of 2007 women were included: 983 of the patients were bothered by at least one kind of PFD: bladder, bowel, and sexual dysfunction were more frequently reported. There were no significant differences in PFD prevalence between pregnancy and postpartum, except for bladder disorders, which were more prevalent in pregnancy. Familiarity for PFDs, pelvic floor contraction inability, cigarette smoking, body mass index more than 25 (calculated as weight in kilograms divided by the square of height in meters), and age more than 35 years were confirmed risk factors for the development of PFDs during pregnancy and postpartum. CONCLUSION Almost half of the women included in the study suffered from PFD-related symptoms with important consequences on quality of life. Validated questionnaires are fundamental in early diagnosis and treatment of PFDs.
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Affiliation(s)
| | | | | | | | - Arianna Casiraghi
- Gynecology Division, Vita-Salute San Raffaele University, Milan, Italy
| | - Patrizia Vergani
- Gynaecology Division, Milano-Bicocca University, Milan, Italy
- Obstetric Division, Monza and Brianza Mother and Child Foundation, Monza, Italy
| | | | - Giulia Magoga
- ULSS2 Marca Trevigiana, Oderzo Hospital, Oderzo, Italy
| | - Marta Cicuti
- ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy
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17
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Baessler K, Kempkensteffen C. Urogynäkologie meets Koloproktologie. COLOPROCTOLOGY 2021. [DOI: 10.1007/s00053-021-00544-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Baessler K, Windemut S, Chiantera V, Köhler C, Sehouli J. Sexual, bladder and bowel function following different minimally invasive techniques of radical hysterectomy in patients with early-stage cervical cancer. Clin Transl Oncol 2021; 23:2335-2343. [PMID: 34003456 PMCID: PMC8455389 DOI: 10.1007/s12094-021-02632-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/26/2021] [Indexed: 12/17/2022]
Abstract
Purpose Despite the establishment of radical surgery for therapy of cervical cancer, data on quality of life and patient-reported outcomes are scarce. The aim of this retrospective cohort study was to evaluate bladder, bowel and sexual function in women who underwent minimally invasive surgery for early-stage cervical cancer. Methods From 2007–2013, 261 women underwent laparoscopically assisted radical vaginal hysterectomy (LARVH = 45), vaginally assisted laparoscopic or robotic radical hysterectomy (VALRRH = 61) or laparoscopic total mesometrial resection (TMMR = 25) and 131 of them completed the validated German version of the Australian Pelvic Floor Questionnaire (PFQ). Results were compared with controls recruited from gynecological clinics (n = 24) and with urogynecological patients (n = 63). Results Groups were similar regarding age, BMI and parity. The TMMR group had significantly shorter median follow-up (16 months versus 70 and 36 months). Postoperatively, deterioration of bladder function was reported by 70%, 57% and 44% in the LARVH, VARRVH and TMMR groups, respectively (p = 0.734). Bowel function was significantly worse after TMMR with a higher deterioration rate in 72 versus 43% (LARVH) and 47% (VARRVH) with a correspondingly higher bowel dysfunction score of 2.9 versus 1.5 and 1.8, respectively and 1.8 in urogynaecological patients. Sexual dysfunction was common in all surgical groups. 38% considered their vagina too short which was significantly associated with deep dyspareunia. Compared with controls, surgical groups had significantly increased PFQ scores. Conclusion Pelvic floor dysfunction commonly deteriorates and negatively impacts on quality of life after minimally invasive radical hysterectomy, especially bowel function after TMMR. Pelvic floor symptoms should routinely be addressed pre- and postoperatively.
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Affiliation(s)
- K Baessler
- Department of Gynecology with Center for Oncological Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany. .,Pelvic Floor Centre Franziskus and St Joseph Hospital Berlin, Budapester Str. 15-19, 10787, Berlin, Germany.
| | - S Windemut
- Department of Gynecology, Vivantes Hospital Am Urban, Berlin, Germany
| | - V Chiantera
- Department of Gynecologic Oncology, University of Palermo, Palermo, Sicilia, Italy
| | - C Köhler
- Department of Gynecology, Medical Faculty, University of Cologne, Cologne, Germany
| | - J Sehouli
- Department of Gynecology with Center for Oncological Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Graf J, Abele H, Kagan KO, Jakubowski P. Vaginale Geburt und Inkontinenz – ist eine Aufklärung über dieses Risiko vor Geburt zielführend? Geburtshilfe Frauenheilkd 2021. [DOI: 10.1055/a-1109-2237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Palmieri S, Cola A, Ceccherelli A, Manodoro S, Frigerio M, Vergani P. Italian validation of the German Pelvic Floor Questionnaire for pregnant and postpartum women. Eur J Obstet Gynecol Reprod Biol 2020; 248:133-136. [PMID: 32203824 DOI: 10.1016/j.ejogrb.2020.03.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/11/2020] [Accepted: 03/16/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The only available validated questionnaire for pelvic floor disorders in pregnant and postpartum women is in German. The aim of this study was to translate and validate the German Pelvic Floor Questionnaire for pregnant and postpartum women into Italian. STUDY DESIGN The questionnaire was translated into Italian by standardized procedural steps. The final version of the questionnaire was submitted to women in the third trimester of pregnancy or within 6 weeks post partum. Construct validity was tested using the Wilcoxon test, and internal consistency was tested using Cronbach's alpha. Test-retest reliability was measured with Cohen's kappa and intraclass correlation coefficient. RESULTS Fifty women answered the questionnaire. Construct validity was demonstrated, as the questionnaire discriminated significantly between patients with and without symptoms for four domains of pelvic floor disorders. Internal consistency was satisfactory (0.62-0.93). Cohen's kappa values for test-retest reliability were between 0.46 (moderate agreement) and 1.00 (complete agreement). Intraclass correlation coefficients ranged between 0.93 and 0.96, indicating very satisfactory overall agreement for each functional domain. CONCLUSIONS The Italian version of the German Pelvic Floor Questionnaire for pregnant and postpartum women is reliable, valid and consistent.
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Affiliation(s)
| | - Alice Cola
- ASST Monza, Ospedale San Gerardo, Monza, Italy
| | | | - Stefano Manodoro
- ASST Santi Paolo e Carlo, San Paolo University Hospital, Via A. di Rudinì 8, Milano, Milano, Italy.
| | | | - Patrizia Vergani
- Fondazione Monza e Brianza per il Bambino e la sua Mamma, Monza, Italy
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Hou Y, Hou D. Validation of the Australian Pelvic Floor Questionnaire in Chinese pregnant and postpartum women. Eur J Obstet Gynecol Reprod Biol 2020; 245:102-106. [PMID: 31891892 DOI: 10.1016/j.ejogrb.2019.12.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 12/17/2019] [Accepted: 12/23/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To test the psychometric properties of the culturally adapted Chinese version of the self-administered Australian Pelvic Floor Questionnaire (APFQ) in pregnant and postpartum women. STUDY DESIGN Between November 2018 and December 2018, a total of 316 pregnant women who met the inclusion criteria in an outpatient setting were enrolled. The participants completed the questionnaire during the third trimester and twice after delivery. The test for validity was composed of face/content validity and construct validity. Reliability testing included internal consistency and test-retest reliability. The degree of responsiveness was assessed using effect size (ES) and standardized response mean (SRM). RESULTS Two hundred and seventy-four women completed all questionnaires. Content validity, missing data did not exceed 4 % for any questions in the Chinese version of the self-administered APFQ. Construct validity, there was statistically significant difference in the symptoms scores of women with and without subjective suffering bothersome symptoms in bladder function, bowel function, prolapse and sexual function during pregnancy and postpartum periods. Reliability, the total Cronbach's alpha coefficients of the questionnaire in pregnancy and postpartum periods were 0.8, 0.9 and 0.9, respectively, and the intraclass correlation coefficient (ICC) of the total questionnaire was 0.8 during the test-retest. Responsiveness, the Chinese version of APFQ can track changes in bladder function domain and bowel function domain for the women with standardized response mean equal to 0.6 and 0.2, respectively. CONCLUSIONS The Chinese version of the self-administered APFQ had satisfactory reliability and validity, and can longitudinally monitor changes in pelvic floor symptoms during pregnancy and postpartum periods.
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Affiliation(s)
- Yuqing Hou
- School of Nursing, China Medical University, Shenyang 110122, China.
| | - Dan Hou
- Health Management Center, General Hospital of Northern Theater Command, Shenyang 110003, China.
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Prevalence and risk factors for pelvic floor disorders during early and late pregnancy in a cohort of Austrian women. Arch Gynecol Obstet 2019; 300:1325-1330. [PMID: 31599348 PMCID: PMC6814848 DOI: 10.1007/s00404-019-05311-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 09/14/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To investigate the prevalence of pelvic floor disorders (PFDs) in a cohort of Austrian women either during their early or late pregnancy and to search for clinical risk factors which correlate with pelvic floor symptoms during pregnancy. METHODS A prospective study was conducted and 200 pregnant women answered the validated German pelvic floor questionnaire during their first or third trimenon of gestation. Furthermore, a multivariate logistic regression model was used to determine independent risk factors for PFDs after adjusting for confounders. RESULTS 96/200 (48%) women reported psychological strain in at least 1 of the 4 pelvic floor domains while the remaining 104 women (52%) were asymptomatic. Affected women showed a significant higher BMI, a more frequent positive family history and a higher rate of multiple pregnancies was noted compared to asymptomatic women (p < 0.05). Furthermore, a statistically significant positive correlation could be observed between BMI, smoking and mean bladder score as well as mean prolapse score, signifying more symptom bother from bladder and prolapse in smokers with high BMI. A significant positive correlation was also detected between mean bowel score and parity. In the multivariate model, high BMI (CI 1.013-1.143), positive family history (CI 0.044-0.260) and multiple pregnancies (CI 0.011-0.244) remained independently associated with pelvic floor symptoms (p < 0.05). CONCLUSION Our results demonstrate that pelvic floor-related quality of life during pregnancy is a prevalent condition which is strongly affected by the expectant mother's weight as well as her family history. In addition, women with multiple pregnancies seem to be at increased risk.
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Zuchelo LTS, Bezerra IMP, Da Silva ATM, Gomes JM, Soares Júnior JM, Chada Baracat E, de Abreu LC, Sorpreso ICE. Questionnaires to evaluate pelvic floor dysfunction in the postpartum period: a systematic review. Int J Womens Health 2018; 10:409-424. [PMID: 30123009 PMCID: PMC6087030 DOI: 10.2147/ijwh.s164266] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Pelvic floor dysfunctions (PFDs) affect the female population, and the postpartum period can be related to the onset or aggravation of the disease. Early identification of the symptoms and the impact on quality of life can be achieved through assessment instruments. Objective The purpose of this systematic review is to evaluate questionnaires used to assess PFD in the postpartum period. Methods A systematic review study was conducted, following Preferred Reporting Items for the Systematic Reviews and Meta-Analyses (PRISMA) criteria, using the databases: PubMed, Biblioteca Virtual de Saúde (BVS), Web of Science, and Scopus, and the keywords PFD or pelvic floor disorders, postpartum or puerperium, and questionnaire. Articles published up till May 2018 were included, searching for articles using validated questionnaires for the evaluation of PFDs in postpartum women. The articles included were evaluated according to a checklist, and the validation studies and translated versions of the questionnaires were identified. Results The search of the databases resulted in 359 papers, and 33 were selected to compose this systematic review, using nine validated questionnaires to assess PFDs in the postpartum period: International Consultation on Incontinence Questionnaire – Vaginal Symptoms (ICIQ-VS), Pelvic Floor Distress Inventory 20 (PFDI-20), Pelvic Floor Impact Questionnaire (PFIQ-7), PFDI-46, Pelvic Floor Impact Questionnaire (PFIQ-31), Pelvic Floor Bother Questionnaire (PFBQ), Female Pelvic Floor Questionnaire, electronic Personal Assessment Questionnaire – Pelvic Floor, and PFD questionnaire specific for pregnancy and postpartum. The most frequently reported questionnaires included PFDI-20, PFIQ-7, and ICIQ-VS and are recommended by ICI. In addition, the review identified a specific questionnaire, recently developed, to access PFD during pregnancy and postpartum. Conclusion The questionnaires used to evaluate PFD during postpartum period are developed for general population or urology/gynecology patients with incontinence and reinforce the paucity of highly recommended questionnaires designed for postpartum, in order to improve early and specific approach for this period of life.
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Affiliation(s)
- Lea Tami Suzuki Zuchelo
- Study Design and Scientific Writing Laboratory at ABC Medical School, Santo André, Brazil, .,Research Laboratory of Uninorte (Barão do Rio Branco Faculty), Rio Branco, Brazil
| | - Italla Maria Pinheiro Bezerra
- Study Design and Scientific Writing Laboratory at ABC Medical School, Santo André, Brazil, .,School of Sciences of Santa Casa de Misericórdia de Vitoria, Vitória, Brazil
| | - Adna Thaysa Marcial Da Silva
- Study Design and Scientific Writing Laboratory at ABC Medical School, Santo André, Brazil, .,Faculty of Medicine, University of São Paulo, São Paulo, Brazil,
| | - Jéssica Menezes Gomes
- Study Design and Scientific Writing Laboratory at ABC Medical School, Santo André, Brazil, .,Faculty of Medicine, University of São Paulo, São Paulo, Brazil,
| | | | | | - Luiz Carlos de Abreu
- Study Design and Scientific Writing Laboratory at ABC Medical School, Santo André, Brazil, .,School of Sciences of Santa Casa de Misericórdia de Vitoria, Vitória, Brazil
| | - Isabel Cristina Esposito Sorpreso
- Study Design and Scientific Writing Laboratory at ABC Medical School, Santo André, Brazil, .,Faculty of Medicine, University of São Paulo, São Paulo, Brazil,
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