Childbirth-Related Pelvic Floor Dysfunction pp 171-184 | Cite as
A Practical Approach to Pelvic Floor Dysfunctions After Childbirth: Diagnostic and Therapeutic Flowcharts
Abstract
Pregnancy and childbirth are well-known risk factors for pelvic dysfunction. Great attention was paid in the later years to urinary incontinence, as many women report this distressing condition in the first year after delivery. So, many studies were published in the attempt of correlating urinary incontinence with risk factors either inherent maternal or fetal or delivery factors. Despite its frequency, urinary incontinence is not the only possible unwished consequence of delivery. Other dysfunctions can affect women, but they are often less investigated by professionals and reported by women. Minor prevalence, or greater shame in complaining of these other symptoms, and moreover no knowledge about available treatment could account for this disparity of approach.
References
- 1.van Brummen HJ, Bruinse HW, van de Pol G et al (2006) Bothersome lower urinary tract symptoms 1 year after first delivery: prevalence and the effect of childbirth. BJU Int 98(1):89–95CrossRefPubMedGoogle Scholar
- 2.Chang SR, Chen KH, Lin HH et al (2014) Association of mode of delivery with urinary incontinence and changes in urinary incontinence over the first year postpartum. Obstet Gynecol 123(3):568–577CrossRefPubMedGoogle Scholar
- 3.Torrisi G, Minini G, Bernasconi F (2012) A prospective study of pelvic floor dysfunctions related to delivery. Eur J Obstet Gynecol Reprod Biol 160(1):110–115CrossRefPubMedGoogle Scholar
- 4.Thom DH, Rortveit G (2010) Prevalence of postpartum urinary incontinence: a systematic review. Acta Obstet Gynecol Scand 89(12):1511–1522CrossRefPubMedGoogle Scholar
- 5.Johannessen HH, Wibe A, Stordahl A et al (2014) Prevalence and predictors of anal incontinence during pregnancy and 1 year after delivery: a prospective cohort study. BJOG 121(3):269–279CrossRefPubMedGoogle Scholar
- 6.Fritel X, Khoshnood B, Fauconnier A (2013) Specific obstetrical risk factors for urinary versus anal incontinence 4 years after first delivery. Prog Urol 23(11):911–916CrossRefPubMedGoogle Scholar
- 7.King VG, Boyles SH, Worstell TR (2010) Using the Brink score to predict postpartum anal incontinence. Am J Obstet Gynecol 203(5):486CrossRefPubMedGoogle Scholar
- 8.Glazener C, Elders A, Macarthur C (2013) Childbirth and prolapse: long-term associations with the symptoms and objective measurement of pelvic organ prolapse. BJOG 120(2):161–168CrossRefPubMedGoogle Scholar
- 9.O’Boyle AL, O’Boyle JD, Calhoun B et al (2005) Pelvic organ support in pregnancy and postpartum. Int Urogynecol J Pelvic Floor Dysfunct 16(1):69–72CrossRefPubMedGoogle Scholar
- 10.Sze EH, Sherard GB 3rd, Dolezal JM et al (2002) Pregnancy, labor, delivery, and pelvic organ prolapse. Obstet Gynecol 100(5 Pt 1):981–986CrossRefPubMedGoogle Scholar
- 11.Chen Y, Li FY, Lin X et al (2013) The recovery of pelvic organ support during the first year postpartum. BJOG 120(11):1430–1437CrossRefPubMedGoogle Scholar
- 12.Handa VL, Nygaard I, Kenton K et al (2009) Pelvic organ support among primiparous women in the first year after childbirth. Int Urogynecol J Pelvic Floor Dysfunct 20(12):1407–1411PubMedCentralCrossRefPubMedGoogle Scholar
- 13.Tennfjord MK, Hilde G, Stær-Jensen J, Ellström Engh M et al (2014) Dyspareunia and pelvic floor muscle function before and during pregnancy and after childbirth. Int Urogynecol J 25(9):1227–1235CrossRefPubMedGoogle Scholar
- 14.Serati M, Salvatore S, Khullar V et al (2008) Prospective study to assess risk factors for pelvic floor dysfunction after delivery. Acta Obstet Gynecol Scand 87(3):313–318CrossRefPubMedGoogle Scholar
- 15.Connolly A, Thorp J, Pahel L (2005) Effects of pregnancy and childbirth on postpartum sexual function: a longitudinal prospective study. Int Urogynecol J Pelvic Floor Dysfunct 16:263–267CrossRefPubMedGoogle Scholar
- 16.Tunn R, DeLancey JO, Howard D (1999) MR imaging of levator ani muscle recovery following vaginal delivery. Int Urogynecol J Pelvic Floor Dysfunct 10(5):300–307CrossRefPubMedGoogle Scholar
- 17.Peschers UM, Schaer GN, DeLancey JO et al (1997) Levator ani function before and after childbirth. Br J Obstet Gynaecol 104(9):1004–1008CrossRefPubMedGoogle Scholar
- 18.Abrams P, Cardozo L, Khoury S, Wein A (ed) (2012) Incontinence. 5th international consultation on incontinence, ParisGoogle Scholar
- 19.Braekken IH, Majida M, Engh ME (2010) Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial. Am J Obstet Gynecol 203(2):170CrossRefPubMedGoogle Scholar
- 20.Hagen S, Stark D, Glazener C (2014) Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. Lancet 383(9919):796–806CrossRefPubMedGoogle Scholar
- 21.Norton C, Cody JD (2012) Biofeedback and/or sphincter exercises for the treatment of faecal incontinence in adults. Cochrane Database Syst Rev (7). doi: 10.1002/14651858.CD002111.pub3
- 22.Montorsi F, Basson R, Adaikan G et al (eds) (2010) Sexual medicine: sexual dysfunctions in men and women. Health Publication Ltd, ParisGoogle Scholar
- 23.Bergeron S, Khalifé S, Glazer HI (2008) Surgical and behavioral treatments for vestibulodynia: two-and-one-half year follow-up and predictors of outcome. Obstet Gynecol 111(1):159–166CrossRefPubMedGoogle Scholar
- 24.Glazer HI, Rodke G, Swencionis C (1995) Treatment of vulvar vestibulitis syndrome with electromyographic biofeedback of pelvic floor musculature. J Reprod Med 40(4):283–290PubMedGoogle Scholar
- 25.Boyle R, Hay-Smith EJC, Cody JD et al (2014) Pelvic floor muscle training for prevention and treatment of urinary and fecal incontinence in antenatal and postnatal women: a short version Cochrane Review. Neurourol Urodyn 33(3):269–276CrossRefPubMedGoogle Scholar
- 26.Hilde G, Stær-Jensen J, Siafarikas F et al (2013) Postpartum pelvic floor muscle training and urinary incontinence: a randomized controlled trial. Obstet Gynecol 122(6):1231–1238CrossRefPubMedGoogle Scholar
- 27.Dumoulin C, Martin C, Elliott V et al (2013) Randomized controlled trial of Physiotherapy for postpartum stress incontinence: 7-year follow-up. Neurourol Urodyn 32:449–454CrossRefPubMedGoogle Scholar
- 28.Glazener CM, MacArthur C, Hagen S (2014) Twelve-year follow-up of conservative management of postnatal urinary and faecal incontinence and prolapse outcomes: randomised controlled trial. BJOG 121(1):112–120CrossRefPubMedGoogle Scholar
- 29.Bø K, Hilde G, Stær-Jensen J, Siafarikas F et al (2015) Postpartum pelvic floor muscle training and pelvic organ prolapse-a randomized trial of primiparous women. Am J Obstet Gynecol 212(1):38.e1–7CrossRefPubMedGoogle Scholar
- 30.Biroli A, Soligo M, Bernasconi F et al (2013) The “Italian Society of Urodynamics’ (SIUD) delivery & pelvic dysfunctions card”: an Italian language screening tool. Pelviperineology 32:81–85Google Scholar
- 31.Zanelli S, Minini GF, Gatti D (2002) Perineal care program (PCP): un progetto di tutela della salute perineale nelle varie fasi del percorso biologico della donna. Urogynaecologia Int J 1(Suppl 16):178–82Google Scholar
- 32.Chiarelli P, Cockburn J (2002) Promoting urinary continence in women after delivery: randomised controlled trial. BMJ 324(7348):1241PubMedCentralCrossRefPubMedGoogle Scholar
- 33.Biroli A, Castellino C, Bellora MG et al (2004) Post-partum pelvic floor dysfunctions: prevalence and management. Urodinamica 14:274–277Google Scholar