Marijke C. Ph. Slieker-ten Hove

Symptomatic pelvic organ prolapse and possible risk factors in a general population.

OBJECTIVE We sought to examine the prevalence of pelvic organ prolapse (POP) symptoms and risk factors in a general white population. STUDY DESIGN This was a cross-sectional study. All female residents aged 45-85 years in a small Dutch city received validated questionnaires. Women were classified as symptomatic if they reported feeling and/or seeing vaginal bulge. RESULTS Response rate was 62.7% (1869/2979). Prevalence of POP was 11.4%. Multivariate analysis revealed POP symptoms during pregnancy, a maternal history of POP, and heavy physical work, with a total population-attributable risk of 46%. CONCLUSION There is high prevalence of symptomatic POP in a general white population of which independent risk factors are POP symptoms during pregnancy, a maternal history of POP, and heavy physical work. Clinicians should focus on risk factors in counseling of (pregnant) women to inform women to be aware of further exposures for themselves and their daughters.

Relations between pregnancy-related low back pain, pelvic floor activity and pelvic floor dysfunction.

To assess the occurrence of pelvic floor dysfunction (PFD) in pregnancy- related low back and pelvic pain (PLBP) patients, a cross-sectional study was performed, comprising 77 subjects. Each subject underwent physical assessment, and filled in the Urogenital Distress Inventory completed with gynaecological questions. Differences in the presence of PFD between PLBP patients and healthy controls as well as differences in pelvic floor muscle activity were tested for significance. Interaction by age and vaginal delivery were tested. PFD occurred in 52% of all PLBP patients, significantly more than in the healthy control group. In PLBP patients a significantly increased activity of the pelvic floor muscles could be demonstrated with respect to healthy controls. The occurrence of PFD and PLBP was influenced by a confounding effect of age. Clinicians should be aware of the relation between PLBP and PFD and hence address both problems at the same time.

Prevalence of double incontinence, risks and influence on quality of life in a general female population

Urinary incontinence (UI) and anal incontinence (AI) are complaints with impact on quality of life (QOL). Few data are available on prevalence of double incontinence (DI) in the general female population.

Dutch guidelines for physiotherapy in patients with stress urinary incontinence: an update

Introduction and hypothesisStress urinary incontinence (SUI) is the most common form of incontinence impacting on quality of life (QOL) and is associated with high financial, social, and emotional costs. The purpose of this study was to provide an update existing Dutch evidence-based clinical practice guidelines (CPGs) for physiotherapy management of patients with stress urinary incontinence (SUI) in order to support physiotherapists in decision making and improving efficacy and uniformity of care.Materials and methods A computerized literature search of relevant databases was performed to search for information regarding etiology, prognosis, and physiotherapy assessment and management in patients with SUI. Where no evidence was available, recommendations were based on consensus. Clinical application of CPGs and feasibility were reviewed. The diagnostic process consists of systematic history taking and physical examination supported by reliable and valid assessment tools to determine physiological potential for recovery. Therapy is related to different problem categories. SUI treatment is generally based on pelvic floor muscle exercises combined with patient education and counseling. An important strategy is to reduce prevalent SUI by reducing influencing risk factors.ResultsScientific evidence supporting assessment and management of SUI is strong. ConclusionsThe CPGs reflect the current state of knowledge of effective and tailor-made intervention in SUI patients.

The impact of a mobile application-based treatment for urinary incontinence in adult women: Design of a mixed-methods randomized controlled trial in a primary care setting

We aim to assess whether a purpose‐developed mobile application (app) is non‐inferior regarding effectiveness and cost‐effective when used to treat women with urinary incontinence (UI), as compared to care as usual in Dutch primary care. Additionally, we will explore the expectations and experiences of patients and care providers regarding app usage.