Skip to main content

Advertisement

SpringerLink
Log in

Pelvic floor dysfunction distress is correlated with quality of life, but not with muscle function

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To analyze the relationship between the symptoms of pelvic floor dysfunction (PFD) and quality of life (QoL), as well as the function of the pelvic floor muscle (PFM) in women with urinary incontinence (UI).

Methods

A cross-sectional study conducted in two centers in Brazil (Northeast and Southeast regions) with women with stress urinary incontinence (SUI) and mixed urinary incontinence (MUI). Data on pelvic floor symptoms, discomfort and impact on QoL were collected using the Pelvic Floor Distress Inventory-short form (PFDI-SF-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7) instruments. PFM function was assessed by palpation (PERFECT scale) and manometry. Pearson’s correlation test, analysis of variance (ANOVA) and the Student’s t test were used to discriminate the differences, adopting a significance level of 5%.

Results

A total of 72 women participated in the study (mean age 51.7 ± 11.9 years). The presence and discomfort of pelvic floor symptoms (PFDI-SF-20) were correlated with QoL (PFIQ-7) (r = 0.52, p < 0.001). Deficits in PFM function (power and pressure) were observed, however, there was no correlation between these with the presence and discomfort of the pelvic floor symptoms (PFDI-SF-20).

Conclusion

Greater discomfort due to PFD symptoms were correlated with a worse QoL. However, the relationship between symptoms and PFM function was not significant. These results reinforce the need to assess the aspects of activity and participation which compose functionality and QoL, and not only the PFM functions in women with UI.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

The corresponding author and co-authors declare the data in this manuscript to be completely transparent.

Code availability

Not applicable.

References

  1. Haylen BT, de Ridder D, Freeman RM et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21:5–26. https://doi.org/10.1007/s00192-009-0976-9

    Article  PubMed  Google Scholar 

  2. Abrams P, Andersson KE, Birder L et al (2010) Fourth international consultation on incontinence recommendations of the international scientific committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn 29:213–240. https://doi.org/10.1002/nau.20870

    Article  CAS  PubMed  Google Scholar 

  3. Abrams P, Cardozo L, Khoury S, Wein A (2013) Incontinence. 5a. Paris: ICUD-EAU

  4. Schimpf MO, Patel M, O’Sullivan DM, Tulikangas PK (2009) Difference in quality of life in women with urge urinary incontinence compared to women with stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 20:781–786. https://doi.org/10.1007/s00192-009-0855-4

    Article  PubMed  Google Scholar 

  5. Firdolas F, Onur R, Deveci SE, Rahman S, Sevindik F, Acik Y (2012) Effect of urinary incontinence and its subtypes on quality of life of women in eastern Turkey. Urology 80:1221–1226. https://doi.org/10.1016/j.urology.2012.08.023

    Article  PubMed  Google Scholar 

  6. Fornell EU, Wingren G, KjOlhede P (2004) Factors associated with pelvic floor dysfunction with emphasis on urinary and fecal incontinence and genital prolapse: an epidemiological study. Acta Obstet Gynecol Scand 83:383–389. https://doi.org/10.1111/j.0001-6349.2004.00367.x

    Article  Google Scholar 

  7. Svihrova V, Svihra J, Luptak J, Swift S, Digesu GA (2014) Disability-adjusted life years (DALYs) in general population with pelvic organ prolapse: a study based on the prolapse quality-of-life questionnaire (P-QOL). Eur J Obstet Gynecol Reprod Biol 182:22–26. https://doi.org/10.1016/j.ejogrb.2014.08.024

    Article  PubMed  Google Scholar 

  8. Koloski NA, Jones M, Wai R, Gill RS, Byles J, Talley NJ (2013) Impact of persistent constipation on health-related quality of life and mortality in older community-dwelling women. Am J Gastroenterol 108:1152–1158. https://doi.org/10.1038/ajg.2013.137

    Article  CAS  PubMed  Google Scholar 

  9. Boreham MK, Richter HE, Kenton KS et al (2005) Anal incontinence in women presenting for gynecologic care: Prevalence, risk factors, and impact upon quality of life. Am J Obstet Gynecol 192:1637–1642. https://doi.org/10.1016/j.ajog.2004.11.030

    Article  PubMed  Google Scholar 

  10. Bezerra LRPS, Vasconcelos Neto JA, Vasconcelos CTM et al (2014) Prevalence of unreported bowel symptoms in women with pelvic floor dysfunction and the impact on their quality of life. Int Urogynecol J. https://doi.org/10.1007/s00192-013-2317-2

    Article  PubMed  Google Scholar 

  11. Portella PM, Feldner PC Jr, da Conceição JC, Castro RA, Sartori MG, Girão MJ (2012) Prevalence of and quality of life related to anal incontinence in women with urinary incontinence and pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol 160:228–231. https://doi.org/10.1016/j.ejogrb.2011.11.009

    Article  Google Scholar 

  12. Bordeianou L, Hicks CW, Olariu A et al (2015) Effect of coexisting pelvic floor disorders on fecal incontinence quality of life scores. Dis Colon Rectum 58:1091–1097. https://doi.org/10.1097/DCR.0000000000000459

    Article  PubMed  Google Scholar 

  13. Tamanini JTN, Dambros M, D’Ancona CAL, Palma PCR, Netto NR Jr (2004) Validação para o português do “International Consultation on Incontinence Questionnaire—Short Form” (ICIQ-SF). Rev Saúde Pública 38:438–444. https://doi.org/10.1590/S0034-89102004000300015

    Article  PubMed  Google Scholar 

  14. Barber MD, Kuchibhatla MN, Pieper CF, Bump RC (2001) Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders. Am J Obstet Gynecol 185:1388–1395. https://doi.org/10.1067/mob.2001.118659

    Article  CAS  PubMed  Google Scholar 

  15. Arouca MAF, Duarte TB, Lott DAM et al (2016) Validation and cultural translation for Brazilian Portuguese version of the Pelvic Floor Impact Questionnaire (PFIQ-7) and Pelvic Floor Distress Inventory (PFDI-20). Int Urogynecol J 27:1097–1106. https://doi.org/10.1007/s00192-015-2938-8

    Article  PubMed  Google Scholar 

  16. Rohr G, Christensen K, Ulstrup K, Kragstrup J (2004) Reproducibility and validity of simple questions to identify urinary incontinence in elderly women. Acta Obstet Gynecol Scand 83:969–972. https://doi.org/10.1111/j.0001-6349.2004.00557.x

    Article  PubMed  Google Scholar 

  17. Laycock J, Jerwood D (2001) Pelvic floor muscle assessment: the PERFECT scheme. Physiotherapy 87:631–642. https://doi.org/10.1016/S0031-9406(05)61108-X

    Article  Google Scholar 

  18. Messelink B, Benson T, Berghmans B et al (2005) Standardization of terminology of pelvic floor muscle function and dysfunction: report from the pelvic floor clinical assessment group of the International Continence Society. Neurourol Urodyn 24:374–380. https://doi.org/10.1002/nau.20144

    Article  PubMed  Google Scholar 

  19. Bo K, Talseth T, Holme I (1999) Single blind, randomised controlled trial of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in management of genuine stress incontinence in women. BMJ 318:487–493. https://doi.org/10.1136/bmj.318.7182.487

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Figueiredo VB, Nascimento SL, Martínez RFL, Lima CTS, Ferreira CHJ, Driusso P (2020) Effects of individual pelvic floor muscle training vs individual training progressing to group training vs group training alone in women with stress urinary incontinence: a randomized clinical trial. Neurourol Urodyn 39(5):1447–1455. https://doi.org/10.1002/nau.24370

    Article  PubMed  Google Scholar 

  21. Reigota RB, Pedro AO, Souza SMV, Costa-Paiva L, Pinto-Neto AM (2016) Prevalence of urinary incontinence and its association with multimorbidity in women aged 50 years or older: a population-based study. Neurourol Urodyn 35:62–68. https://doi.org/10.1002/nau.22679

    Article  PubMed  Google Scholar 

  22. Nygaard I, Barber MD, Burgio KL et al (2008) Prevalence of symptomatic pelvic floor disorders in US women. JAMA 300:1311–1316. https://doi.org/10.1001/jama.300.11.1311

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Hannestad YS, Rortveit G, Sandvik H, Hunskaar S (2000) A community-based epidemiological survey of female urinary incontinence. J Clin Epidemiol 53:1150–1157. https://doi.org/10.1016/S0895-4356(00)00232-8

    Article  CAS  PubMed  Google Scholar 

  24. Minassian VA, Bazi T, Stewart WF (2017) Clinical epidemiological insights into urinary incontinence. Int Urogynecol J 28:687–696. https://doi.org/10.1007/s00192-017-3314-7

    Article  PubMed  Google Scholar 

  25. Rodrigues MP, Barbosa LJF, Ramos JGL et al (2016) Perfil das pacientes do ambulatório de uroginecologia de um Hospital Público de Porto Alegre com relação à incontinência urinária e à qualidade de vida. Clin Biomed Res 36:131–135. https://doi.org/10.4322/2357-9730.64817

    Article  Google Scholar 

  26. Harvie HS, Arya LA, Saks EK, Sammel MD, Schwartz JS, Shea JA (2011) Utility preference score measurement in women with fecal incontinence. Am J Obstet Gynecol 204:72.e1–72.e6. https://doi.org/10.1016/j.ajog.2010.08.018

    Article  Google Scholar 

  27. da Cunha RM, Leite LC, de Oliveira GND, Brito AG, de Figueiredo VB, do Nascimento SL (2016) Perfil epidemiológico e sintomas urinários de mulheres com disfunções do assoalho pélvico atendidas em ambulatório. Rev Fisioter S Fun 5(1):2–49

    Google Scholar 

  28. Barentsen JA, Visser E, Hofstetter H, Maris AM, Dekker JH, da Bock GH (2012) Severity, not type, is the main predictor of decreased quality of life in elderly women with urinary incontinence: a population-based study as part of a randomized controlled trial in primary care. Health Qual Life Outcomes 10:153. https://doi.org/10.1186/1477-7525-10-153

    Article  PubMed  PubMed Central  Google Scholar 

  29. Frota IPR, Rocha ABO, Neto JAV et al (2018) Pelvic floor muscle function and quality of life in postmenopausal women with and without pelvic floor dysfunction. Acta Obstet Gynecol Scand 97:552–559. https://doi.org/10.1111/aogs.13305

    Article  PubMed  Google Scholar 

  30. Chevalier F, Fernandez-Lao C, Cuesta-Vargas AI (2014) Normal reference values of strength in pelvic floor muscle of women: a descriptive and inferential study. BMC Womens Health 14:143. https://doi.org/10.1186/s12905-014-0143-4

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We are grateful for the contribution of physiotherapists from the Pelvic Physiotherapy Service/Rehabilitation Unit of the Maternidade Escola Assis Chateuabriand (MEAC) and contribution from the Physiotherapy Project in Women's Health (PROFISM).

Funding

This study was supported by the Foundation for Support in Scientific and Technological Development of Ceará (FUNCAP, Fortaleza, CE, Brazil), through doctoral fellowship, funder approval number: nº BDS‐0017‐00071.01.11/15 and São Paulo Research Foundation(FAPESP), Project Number 2016/0638‐4. This study was supported in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001.

Author information

Authors and Affiliations

  1. Physical Therapy Department, Faculty of Medicine, Federal University of Ceará (UFC), Major Weyne Street, 1440 - Rodolfo Teófilo, Fortaleza, Ceará, 60430-450, Brazil

    Marta Quézia Silva Fontenele, Mayle Andrade Moreira, Anna Caroline Ribeiro de Moura, Vilena Barros de Figueiredo & Simony Lira Nascimento

  2. Physical Therapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil

    Vilena Barros de Figueiredo & Patricia Driusso

Authors
  1. Marta Quézia Silva Fontenele
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mayle Andrade Moreira
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anna Caroline Ribeiro de Moura
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Vilena Barros de Figueiredo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Patricia Driusso
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Simony Lira Nascimento
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

MQSF: Protocol/project development, data collection or management, data analysis, manuscript writing/editing. MAM: Protocol/project development, data analysis, manuscript writing/editing. ACRM: data collection or management, manuscript writing/editing. VBF: Protocol/project development, data collection or management, data analysis, manuscript writing/editing. PD: Protocol/project development, manuscript writing/editing. SLN: Protocol/project development, data analysis, manuscript writing/editing.

Corresponding author

Correspondence to Simony Lira Nascimento.

Ethics declarations

Conflict of interest

The authors declare that there are no conflict of interest.

Ethical approval

The study refers to a secondary analysis of an intervention study on pelvic floor muscle training in women with UI, approved by the Research Ethics Committee (CEP) of the Federal University of São Carlos (CAAE: 42677115.5.0000.5504, report 2.579.162), with the consent of the CEP of MEAC, on April 4, 2018.

Consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent for publication

All participants were informed of the procedures, risks and benefits of participating in the study, and their data were included in the research after signing the Free and Informed Consent Form (ICF). The corresponding author and co-authors agree with the publication of the manuscript.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fontenele, M.Q.S., Moreira, M.A., de Moura, A.C.R. et al. Pelvic floor dysfunction distress is correlated with quality of life, but not with muscle function. Arch Gynecol Obstet 303, 143–149 (2021). https://doi.org/10.1007/s00404-020-05770-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-020-05770-5

Keywords

Search

Navigation