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Dos Santos GB, Sato TDO, Miwa-Cerqueira T, Bifani BE, Rocha APR, Carvalho C. Pelvic floor dysfunctions in women with fibromyalgia: A cross-sectional study. Eur J Obstet Gynecol Reprod Biol 2023; 282:1-6. [PMID: 36603313 DOI: 10.1016/j.ejogrb.2022.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 10/17/2022] [Accepted: 12/29/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Fibromyalgia (FM) is a rheumatic syndrome that causes musculoskeletal disorders and is associated with several problems that affect quality of life. As the musculoskeletal system is affected, it can have an impact on the pelvic floor muscles, leading to pelvic floor dysfunction (PFD). OBJECTIVE Investigate the occurrence of PFD, such as urinary incontinence (UI) and anal incontinence (AI), sexual problems, and pelvic organ prolapse (POP), in women with FM compared to a control group composed of women without FM; and investigate the association between FM and PFD. STUDY DESIGN This was an online cross-sectional survey. Demographic and anthropometric data, the description of PFD (UI, nocturia, AI, genital-pelvic pain/penetration disorder, and POP), and previous obstetric history were collected through a web-based questionnaire. The groups were compared using the independent t-test for quantitative variables and the chi-square test for categorical variables. The association between FM and PFD was tested using logistic regression analysis. RESULTS A total of 175 women answered the questionnaire (97 with FM and 78 healthy controls). The women with FM reported significantly more UI, mixed urinary incontinence, AI, POP, and vaginismus than the healthy controls (p ≤ 0.05). FM was associated with mixed urinary incontinence (OR: 2.6; 95 % CI: 1.1-6.4; p = 0.04), anal incontinence (OR: 2.9; 95 % CI: 1.3-6.1; p = 0.01), and flatus incontinence (OR: 2.6; 95 % CI: 1.2-5.4; p = 0.01). CONCLUSION The prevalence of PFD was significantly higher in women with FM compared to healthy women. Indeed, the women with FM were 2.6-fold to 2.9-fold more likely to report mixed urinary incontinence, anal and flatus incontinence than those in the control group. The present findings show possible impairment of the pelvic floor musculature in women with FM.
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Affiliation(s)
- Gabriel Bernardi Dos Santos
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil; Physical Therapy Post-Graduate Program, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Tatiana de Oliveira Sato
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil; Physical Therapy Post-Graduate Program, Federal University of São Carlos, São Carlos, SP, Brazil.
| | - Tsugui Miwa-Cerqueira
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Bianca Escuer Bifani
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Ana Paula Rodrigues Rocha
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil; Physical Therapy Post-Graduate Program, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Cristiano Carvalho
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil; Physical Therapy Post-Graduate Program, Federal University of São Carlos, São Carlos, SP, Brazil.
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Goldberg N, Tamam S, Weintraub AY. The association between overactive bladder and fibromyalgia: A systematic review and meta-analysis. Int J Gynaecol Obstet 2022; 159:630-641. [PMID: 35641437 DOI: 10.1002/ijgo.14290] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/09/2022] [Accepted: 05/10/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Overactive bladder is a common syndrome that significantly affects the quality of life. Fibromyalgia is characterized by widespread pain, impacting patients' lives. The exact mechanisms of the two syndromes remain unknown, but there is an overlap between the suspected pathophysiologies. OBJECTIVE To present an overview of the current research on the association between overactive bladder (OAB) and fibromyalgia. SEARCH STRATEGY A systematic search of four electronic databases was conducted. SEARCH STRATEGY Studies examining the correlation between OAB and fibromyalgia with female patients aged over 18 years were included. DATA COLLECTION AND ANALYSIS Two reviewers screened the studies for eligibility. Eligible studies were screened for quality. A meta-analysis was performed for eligible studies. MAIN RESULTS Seven studies were included in the final review, of which six presented a positive association between the syndromes. The studies demonstrated a positive association between fibromyalgia and the severity of OAB and an adverse effect on the quality of life related to OAB. A mean effect size of 1.96 (95% confidence interval 0.85-3.06) was calculated. CONCLUSION OAB and fibromyalgia are both complex and multifactorial syndromes. The study presents an association between them, but additional studies on the topic should be conducted for a more precise conclusion.
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Affiliation(s)
- Nitzan Goldberg
- Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Shai Tamam
- Library of Life Sciences and Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adi Y Weintraub
- Faculty of Health Sciences, Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Zanetti MRD, Dourado VZ, Scudeller TT, Vieira ER, Amaral MTPD. Pelvic Floor Muscle Strength and the Postural Balance in Middle-Aged Women: A Pilot Study. Physical & Occupational Therapy In Geriatrics 2022. [DOI: 10.1080/02703181.2022.2044968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Victor Zuniga Dourado
- Department of Human Movement Sciences, Federal University of São Paulo, Santos, Brazil
| | | | - Edgar Ramos Vieira
- Department of Physical Therapy, Florida International University, Miami, Florida, USA
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Leila R, Alia F, Khereddine MD, Ben Rhouma S, Saoussen M, Kmar O, Leila S, Selma K, Selma C, Kawther BA, Yassine N, Ahmed L. Lower urinary tract symptoms in rheumatoid arthritis and spondyloarthritis male patients versus controls. Romanian Journal of Internal Medicine 2021; 59:134-140. [DOI: 10.2478/rjim-2020-0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Indexed: 11/20/2022] Open
Abstract
Abstract
Background. We aimed to evaluate the severity of lower urinary tract symptoms (LUTS) in rheumatoid arthritis (RA) and spondyloarthritis (SpA) male patient versus control, then to determine the relation of LUTS with rheumatic diseases (RD) characteristics and with erectile dysfunction (ED).
Methods. We conducted a cross-sectional case control study including 50 men with RA or SpA and 50 healthy controls. LUTS were evaluated by the International Prostate Symptom Score (IPSS). LUTS bother was evaluated by the Quality of life (QoL) score, which ranges from 0 to 6. LUTS bother was considered if QoL score exceeded 2. Moreover, erectile function was assessed by the International Index of Erectile Function-5 (IIEF5) (ED if score < 21).
Results. LUTS were significantly more severe in RD patients than controls (p = 0.03). However, there was no difference between the two groups in LUTS bother (QoL) (p = 0.2). Comparing RA and SpA showed no difference as to the severity of LUTS or effect of bother on QoL (p = 0.13, p = 0.5). The prevalence of ED in RD patients was not significantly higher than controls (80% versus 70%; p = 0.2).There were also no differences either between RA and SpA groups (p = 0.74).
The severity of LUTS for patients with RD (RA and SpA) was significantly associated with age (p = 0.001), age at disease onset (p = 0.002) and ED (p = 0.008).
Conclusion. According to our study, men with RD seem to be exposed to more severe LUTS than controls. Also, the severity of LUTS was associated with ED, age of patients and the age of disease onset.
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de Carvalho Fusco HCS, Filho MAP, Consolo RT, Lunardi AC, Ferreira EAG. Sexual performance and pelvic floor muscle strength in patients with fibromyalgia: a controlled cross-sectional study. Rheumatol Int 2020; 41:415-421. [PMID: 32377958 DOI: 10.1007/s00296-020-04595-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 04/24/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Fibromyalgia (FM) is characterized by chronic and widespread pain, sleep disturbances, fatigue, psychological distress and morning stiffness. These patients also present symptoms such as depression, sexual dysfunctions and reproductive problems. Sexuality involves several aspects, including pelvic floor functionality, and one question is whether the sexual performance of women with fibromyalgia is associated with pelvic floor function or other characteristics of the disease. OBJECTIVE The aim of this study was to gauge the association between perineal function and sexual performance in women with and without fibromyalgia. METHODS We performed a cross-sectional study with 109 sexually active women from 19 to 65 years of age, either suffering from fibromyalgia (FM group, n = 51) or free from fibromyalgia (non-FM group, n = 58). Perineal function was measured with the use of perineometry and digital vaginal palpation (PERFECT Scheme), while sexual performance was assessed by the Sexual Quotient Female questionnaire (QS-F). RESULTS Patients with fibromyalgia presented poor sexual performance compared to those without fibromyalgia (QS-F score 58 (32-66) vs. 66 (56-70); p = 0.002) as well as lower pelvic floor muscle strength measured by perineometry (32.5 (18.2-40.5) vs. 37.9 (23.4- 57.3); p = 0.03). Patients without fibromyalgia presented a positive correlation between perineometry and QS-F (r = 0.22; p = 0.038), while those with fibromyalgia presented no correlation between those two variables (r = 0.22; p = 0.12). The regression model showed an association between sexual performance and the presence of fibromyalgia, pelvic floor muscle strength (perineometry) and age, according to the following equation: sexual performance = 48.52 + (9.5 * non-FM group) + (0.23 * perineometry)-(0.4 * age), with adjusted R2 = 0.19. CONCLUSION Women with FM present poor sexual performance and lower pelvic floor muscle strength compared to those without FM. However, the correlation between these variables among women without FM was not observed in women with FM. Sexual performance showed a positive association with absence of fibromyalgia and higher pelvic floor muscle strength, and a negative association with age.
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Affiliation(s)
- Hellen Cristina Souza de Carvalho Fusco
- Department of Physiotherapy, Speech Therapy and Occupational Therapy, School of Medicine, Faculty of Medicine, University of São Paulo, Cipotanea Street, 51, São Paulo, SP, Brazil.
| | - Marco Antônio Pontes Filho
- Department of Rheumatology, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Rafael Treitero Consolo
- Department of Physiotherapy, Speech Therapy and Occupational Therapy, School of Medicine, Faculty of Medicine, University of São Paulo, Cipotanea Street, 51, São Paulo, SP, Brazil
| | - Adriana Claudia Lunardi
- Department of Physiotherapy, Speech Therapy and Occupational Therapy, School of Medicine, Faculty of Medicine, University of São Paulo, Cipotanea Street, 51, São Paulo, SP, Brazil
| | - Elizabeth Alves Gonçalves Ferreira
- Department of Physiotherapy, Speech Therapy and Occupational Therapy, School of Medicine, Faculty of Medicine, University of São Paulo, Cipotanea Street, 51, São Paulo, SP, Brazil
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Hulens M, Bruyninckx F, Rasschaert R, Vansant G, De Mulder P, Stalmans I, Bervoets C, Dankaerts W. Electrodiagnostic Abnormalities Associated with Fibromyalgia. J Pain Res 2020; 13:737-744. [PMID: 32308473 PMCID: PMC7154040 DOI: 10.2147/jpr.s234475] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 03/24/2020] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Increasing evidence suggests that fibromyalgia most likely represents a neurological dysfunction. We previously hypothesized that at least some fibromyalgia cases may be caused by irritation of nerve root fibers and sensory neurons due to moderately increased cerebrospinal pressure. Because of the rostro-caudal hydrostatic pressure gradient, neurogenic abnormalities are expected to be most pronounced in sacral nerve roots. The purpose was to review electrodiagnostic tests of patients with fibromyalgia. METHODS A retrospective review of electrodiagnostic test results, including the lumbar and sacral nerve root myotomes of patients diagnosed with fibromyalgia according to the 1990 criteria of the American College of Rheumatology was done. RESULTS All 17 patients were female. Sural nerve responses could not be elicited in 12% and S1-Hoffmann reflex latencies were increased in 41%. In 12% of the patients, fibular motor nerve distal latency and conduction velocity were outside normal limits. Needle-EMG revealed neurogenic motor unit potentials in 0% of L2, 6% of L3, 29% of L4, 71% of L5, 47% of S1, 94% of S2, and 76% of S3-S4 myotomes. S3-S4 nerve-supplied anal reflexes were delayed in 94%. CONCLUSION This is the first time that electrodiagnostic data of both lumbar and sacral nerve root myotomes in fibromyalgia patients are presented. All patients showed neurogenic abnormalities that were more pronounced in the sacral than in the lumbar myotomes with a rather patchy distribution pattern. We propose that, in addition to skin punch biopsies to assess small fiber neuropathy, assessment of the anal reflex may be a useful part of the diagnostic pathway in patients with fibromyalgia.
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Affiliation(s)
- Mieke Hulens
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Unit, Faculty of Kinesiology and Rehabilitation Sciences, University of Leuven, Leuven, Belgium
| | - Frans Bruyninckx
- Clinical Electromyography Laboratory, University Hospitals UZ Leuven, Leuven, Belgium
| | | | - Greet Vansant
- Department of Social and Primary Health Care, Public Health Nutrition, University of Leuven, Leuven, Belgium
| | - Peter De Mulder
- Department of Anesthesiology and Pain Therapy, Imelda Hospital, Bonheiden, Belgium
| | - Ingeborg Stalmans
- Department of Neurosciences, Ophthalmology Research Group, University of Leuven, Leuven, Belgium
- Department of Ophthalmology, University Hospitals UZ Leuven, Leuven, Belgium
| | - Chris Bervoets
- Department of Neurosciences, Adult Psychiatry, University of Leuven, Leuven, Belgium
- Department of Adult Psychiatry, University Psychiatric Center UPC KULEUVEN, Leuven, Belgium
| | - Wim Dankaerts
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Unit, Faculty of Kinesiology and Rehabilitation Sciences, University of Leuven, Leuven, Belgium
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Hamed N, Rida MA, Uthman I, El Taha L, Assad M, Mikhael E, Bazi T. The Fibromyalgia Bladder Index in 100 consecutive women with fibromyalgia. Int Urogynecol J 2020; 31:1883-1889. [PMID: 31919557 DOI: 10.1007/s00192-019-04199-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 11/21/2019] [Indexed: 12/30/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The Fibromyalgia Bladder Index (FBI) is a validated instrument to quantify bothersome bladder symptoms specifically in women with fibromyalgia syndrome (FMS). The FBI includes two sub-scales: one addressing urinary urgency and bladder pain (UP), the other addressing urinary frequency and nocturia (FN). The objectives of this study are to evaluate the FBI in a cohort of patients with FMS, to correlate it with certain characteristics in this cohort, and to compare it with controls. METHODS We performed a case-control study of 100 women with FMS and 155 controls. Demographic data, comorbidities, and other characteristics were registered. Comparison between FBI scores of participants with and without FMS, as well as correlation of FBI scores with the characteristics of FMS patients, were undertaken using independent two-sample t test for continuous outcomes and Pearson's Chi-squared test for categorical outcomes. RESULTS The mean UP subscale score of the FBI was significantly higher in the FMS group (10.29 ± 5.61) compared with the controls (1.65 ± 2.65; (p = 0.001). The mean FN subscale score was significantly higher in the FMS group (9.93 ± 5.37) compared with the controls (2.95 ± 3.27; p = 0.001). FMS patients diagnosed >3 years ago had a higher UP subscale score and a higher FN subscale score compared with FMS patients diagnosed <3 years ago (p = 0.020 and p = 0.024 respectively). Menopause and parity significantly increased the FBI scores. Smoking and a history of depression did not significantly affect any of the FBI subscale scores in the FMS group. CONCLUSION Women with FMS suffer from bothersome bladder symptoms that can be readily identified and quantified.
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Affiliation(s)
- Nouran Hamed
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El-Solh, Beirut, 110-72020, Lebanon
| | - Mohamad Ali Rida
- Department of Internal Medicine, Division of Rheumatology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Imad Uthman
- Department of Internal Medicine, Division of Rheumatology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Lina El Taha
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El-Solh, Beirut, 110-72020, Lebanon
| | - Mariam Assad
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Elie Mikhael
- Department of Obstetrics and Gynecology, Hôpital Simone Veil, 14 rue de Saint Prix, Eaubonne, France
| | - Tony Bazi
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El-Solh, Beirut, 110-72020, Lebanon.
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