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Prevention of pelvic floor disorders: international urogynecological association research and development committee opinion

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Abstract

Introduction and hypothesis

Pelvic floor disorders (PFD), including urinary incontinence, anal incontinence, and pelvic organ prolapse, are common and have a negative effect on the quality of life of women. Treatment is associated with morbidity and may not be totally satisfactory. Prevention of PFDs, when possible, should be a primary goal. The purpose of this paper is to summarise the current literature and give an evidence-based review of the prevention of PFDs

Methods

A working subcommittee from the International Urogynecological Association (IUGA) Research and Development (R&D) Committee was formed. An initial document addressing the prevention of PFDs was drafted, based on a review of the English-language literature. After evaluation by the entire IUGA R&D Committee, revisions were made. The final document represents the IUGA R&D Committee Opinion on the prevention of PFDs.

Results

This R&D Committee Opinion reviews the literature on the prevention of PFDs and summarises the findings with evidence-based recommendations.

Conclusions

Pelvic floor disorders have a long latency, and may go through periods of remission, thus making causality difficult to confirm. Nevertheless, prevention strategies targeting modifiable risk factors should be incorporated into clinical practice before the absence of symptomatology.

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Abbreviations

AI:

Anal incontinence

CD:

Caesarean delivery

LA:

Levator avulsion

OAB:

Overactive bladder

OASIS:

Obstetric anal sphincter injuries

PFD:

Pelvic floor disorder

PFM:

Pelvic floor muscle

PFMT:

Pelvic floor muscle training

POP:

Pelvic organ prolapse

SUI:

Stress urinary incontinence

UI:

Urinary incontinence

VD:

Vaginal delivery

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Medicine, American University of Beirut Medical Center, PO Box 11–0236, Riad El-Solh, Beirut, 1107 2020, Lebanon

    Tony Bazi

  2. Department of Urology, Nihon University School of Medicine, Tokyo, Japan

    Satoru Takahashi

  3. Brighton and Sussex Medical School, Brighton and Sussex University Hospitals NHS Trust, Brighton, England, UK

    Sharif Ismail

  4. Norwegian School of Sport Sciences, Oslo, Norway

    Kari Bø

  5. Department of Obstetrics and Gynecology, Department of Urology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands

    Alejandra M. Ruiz-Zapata

  6. Directorate of Women’s Health, Medway NHS Foundation Trust, Gillingham, UK

    Jonathan Duckett

  7. Women’s Pelvic Specialty Care of New Mexico, University of New Mexico Hospital, Albuquerque, NM, USA

    Dorothy Kammerer-Doak

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Correspondence to Tony Bazi.

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Tony Bazi: none; Satoru Takahashi: research funding from Astellas; Sharif Ismail: none; Kari Bø: none; Alejandra M. Ruiz-Zapata: none; Jonathan Duckett: paid travel expenses, honoraria, research funding by AMS, Astellas, Ethicon, Pfizer, EliLilly and was a consultant for Astellas and Ethicon; Dorothy Kammerer-Doak: none.

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Bazi, T., Takahashi, S., Ismail, S. et al. Prevention of pelvic floor disorders: international urogynecological association research and development committee opinion. Int Urogynecol J 27, 1785–1795 (2016). https://doi.org/10.1007/s00192-016-2993-9

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