Nuriye Özengin

The effect of parity on pelvic floor muscle strength and quality of life in women with urinary incontinence: a cross sectional study.

[Purpose] The purpose of this study was to analyze the pelvic floor muscle (PFM) activity after vaginal birth, and the effect of parity on PFM strength and quality of life (QoL) in women with urinary incontinence. [Subjects and Methods] Patients (n=241) who gave birth vaginally and experienced urinary incontinence were divided into three groups: group 1 consisted of women having 1–3 children, group 2 consisted of women having 4–6 children, and group 3 consisted of women having more than 6 children. All patients underwent detailed examination of the PFM. The Turkish version of the self-administered Incontinence Quality of Life Instrument (I-QoL) questionnaire was used to evaluate the effects of stress urinary incontinence on participants’ QoL. [Results] Comparison of PFM strengths showed a significant intergroup difference. Group 1 showed significantly higher PFM strength scores than those of groups 2 and 3. I-QoL scores related to stress incontinence showed a significant intergroup difference. As number of deliveries increased, quality of life decreased. Comparison of PFM strengths and I-QoL scores related to stress incontinence showed a significant intergroup difference. [Conclusion] Increasing the awareness of PFM training in women will reduce potential postpartum incontinence due to a weak PFM strength; and will increase quality of life.

The effect of pelvic organ prolapse type on sexual function, muscle strength, and pelvic floor symptoms in women: A retrospective study

Objective: This retrospective research was planned to investigate the effect of pelvic organ prolapse (POP) type on sexual function, muscle strength, and pelvic floor symptoms in symptomatic women. Materials and Methods: Data on POP type and stages as assessed using the Pelvic Organ Prolapse-Quantification system of 721 women who presented to the women’s health unit between 2009 and 2016 were collected retrospectively. POP types were recorded as asymptomatic, anterior, apical, and posterior compartment prolapses. Sexual function was assessed using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short-form (PISQ-12), pelvic floor muscle strength was assessed through vaginal pressure measurement, and pelvic floor symptoms and quality of life were assessed using the Pelvic Floor Distress Inventory-20 (PFDI-20). Results: Among 168 women who met the inclusion criteria, 96 had anterior compartment prolapses, 20 had apical compartment prolapses, 16 had posterior compartment prolapses, and 36 women were asymptomatic. There was no difference between the groups in their PISQ-12 total and subscales scores, PFDI-20 total and two subscale (colorectal/anal, urinary) scores, and muscle strength (p>0.05). In the Pelvic Organ Prolapse Distress Inventory-6, another subscale of PFDI-20, it was determined that there was a difference between asymptomatic women and those with anterior compartment prolapses (p=0.044) and apical compartment prolapses (p=0.011). Conclusion: This research found that POP type did not affect sexual function, muscle strength, and colorectal and urinary symptoms in our cohort. There were more prolapse symptoms and complaints in women with anterior and apical compartment prolapses.

Turkish adaptation of the Pelvic Organ Prolapse Symptom Score and its validity and reliability

Introduction and hypothesisThe purpose of this study was to adapt the Pelvic Organ Prolapse Symptom Score (POP-SS) into Turkish and evaluate its reliability and validity.MethodsThe POP-SS was adapted into Turkish by following the steps of the intercultural adaptation process. One hundred and three women with symptomatic or asymptomatic pelvic organ prolapse (POP) completed the Turkish POP-SS and other valid and reliable Turkish tools for POP: Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6), Colorectal–Anal Distress Inventory 8 (CRADI-8), Urinary Distress Inventory 6 (UDI-6), Pelvic Floor Distress Inventory 20 (PFDI-20), and Pelvic Organ Prolapse Impact Questionnaire 7 (POPIQ-7). Pelvic Organ Prolapse Quantification (POP-Q) system was also used to assess pelvic support, and patients were divided into three groups based on POP-Q scores. Cronbach’s alpha was used to determine internal consistency, and intraclass correlation coefficient (ICC) was estimated for test–retest reliability. POP-SS validity was assessed by using the Spearman rank correlation and Kruskal–Wallis analyses. The underlying scale structure was determined by exploratory factor analysis.ResultsThe POP-SS scale had high internal consistency (Cronbach’s alpha = 0.705) and test–retest reliability (ICC = 0.981; p < 0.001). Among groups, there was statistically significant differences in POP-SS scores. POP-SS scores were also significantly correlated with POPDI-6 (r = 0.830), CRADI-8 (r = 0.525), UDI-6 (r = 0.385), PFDI-20 (r = 0.752), and POPIQ-7 (r = 0.690) (p < 0.001). Two factors were identified by exploratory factor analysis.ConclusionsThe Turkish version of POP-SS is a valid and reliable tool for Turkish women with POP.

Does Stage of Pelvic Organ Prolapse Affect Female Sexual Functions? A Retrospective Study

ABSTRACT Objectives: The objective of this study was to investigate the effect of pelvic organ prolapse stage on sexual function in women. Methods: Prolapse stages, muscle strength, sexual function, and pelvic floor symptoms were assessed by Pelvic Organ Prolapse Quantification, by vaginal pressure measurement, by the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12), and the Pelvic Floor Distress Inventory-20 (PFDI-20), respectively. Results: There was no difference between pelvic floor muscle strength, PISQ-12 subscales and PISQ-12 total scores based on prolapse stages (p > 0.05). When the Pelvic Organ Prolapse Distress Inventory and PFDI-20 scores of the women with stage 3/4 prolapse were compared with Stage 1 and Stage 2, there was a difference found between them (p < 0.001). Conclusions: Sexual function and muscular strength were not affected by prolapse stages.

Stres Üriner İnkontinanslı Kadınlarda Pelvik Taban Kas Eğitimine Ek Olarak Uygulanan Elektromyografik Biofeedback Eğitiminin Etkinliğinin İncelenmesi

Amac: Stres uriner inkontinansli kadinlarda pelvik taban kas egitimine ek olarak uygulanan elektromyografik biofeedback egitiminin yasam kalitesi, idrar kacirma miktari ve pelvik taban kas kuvveti uzerine etkisinin arastirilmasi amaclandi. Gerec ve Yontemler: Calismaya stres uriner inkontinansli 52 kadin hasta dâhil edildi. Hastalar pelvik taban kas egitimi (n=27) ve pelvik taban kas egitimiyle birlikte elektromyografik biofeedback egitimi (n=25) alanlar olarak iki gruba ayrildi. Hastalarin algilanan yasam kalitesi ve algilanan kuruluk hissi icin bir vizuel analog skala kullanildi. Pelvik taban kas kuvveti, vajinal basinc manometresi ile; idrar kacirma miktari ise 1 saatlik ped testi ile degerlendirildi. Degerlendirmeler, tedavi oncesi ve 8 haftalik tedavi sonrasinda yapildi. Bulgular: Pelvik taban kas egitimi ve pelvik taban kas egitimine ek olarak uygulanan elektromyografik biofeedback egitimleri grup ici analizlerinde, tedavi oncesi ve sonrasi algilanan kuruluk hissi, algilanan yasam kalitesi, pelvik taban kas kuvveti ve idrar kacirma miktarinda iyilesme oldugu saptandi (p 0.05). Tartisma ve Sonuc: Stres uriner inkontinansli kadinlarin tedavisinde pelvik taban kas egitimine ek olarak uygulanan elektromyografik biofeedback egitiminin ilave bir iyilestirici etkisi olmadigi saptandi. nce.

Authors' reply to the letter from Mohadeseh Sani and Erfan Ayubi on: "Reliability and validity of a Turkish version of the Global Pelvic Floor Bother Questionnaire".

Sir, We thank Drs. Sani and Ayubi for their interest in our article [1]. The Global Pelvic Floor Bother Questionnaire (GPFBQ) is a survey instrument for assessing the presence of pelvic floor dysfunction and bother severity. We frequently use the GPFBQ in our academic studies and clinic. We have found that the GPFBQ is a practical and global survey instrument because it consists of a low number of questions, and its application is quick and not time consuming. The statistical analysis of the validity and reliability of the GPFBQ was conducted by Prof. Dr. Handan Ankarali of Düzce University Biostatistics and Medical Informatics Department. First, confirmatory factor analysis was applied in this study seeking to determine whether the GPFBQ scale, that consists of nine items and is described as singledimensional in the literature, is also single-dimensional in the analysis of research data. As a result of this analysis, the root mean square of residuals (RMSR) value was found to be 0.1008, and an expected mean value of the RMSR for an acceptable model of 0.0877 (Kelley’s criterion) was estimated for a single dimension. The RMSR value was greater than Kelley’s criterion and therefore it was decided that the model is not appropriate for a single dimension. Explanatory factor analysis was applied following this stage and four dimensions appropriate for the analysis of research data were obtained. In our manuscript and the printed article the term Bconfirmatory factor analysis^ was used four times instead of the correct term Bexplanatory factor analysis^. Moreover, although we performed confirmatory factor analysis, the result was not reported in the article. We regret these errors and hope that we have been able to clarify the statistical methods used in our study.

A comparison between stabilization exercises and pelvic floor muscle training in women with pelvic organ prolapse

Objective: This study aimed to compare the effectiveness of stabilization exercises and pelvic floor muscle training in women with stage 1 and 2 pelvic organ prolapse. Materials and Methods: In a total 38 women with pelvic organ prolapse whose average age was 45.60 years, pelvic floor muscles were evaluated with electromyography, and prolapse with pelvic organ prolapse quantification system, and the quality of life with prolapse quality of life questionnaire. Afterwards, the subjects were divided into two groups; stabilization exercise group (n=19) and pelvic floor muscle training group (n=19). Stabilization exercise group were given training for 8 weeks, 3 times a week. Pelvic floor muscle training group were given eight-week home exercises. Each group was assessed before training and after eight weeks. Results: An increase was found in the pelvic muscle activation response in the 2 groups (p≤0.05). There was no difference in EMG activity values between the groups (p>0.05). A difference was found in the values Aa, Ba and C in subjects of each group (p≤0.05), and the TVL, Ap, Bp and D values of subjects in pelvic floor muscle training group (p≤0.05) in the before and after pelvic organ prolapse quantification system assessment, however, no difference was found between the groups (p≤0.05). A positive difference was found in the effect of prolapse sub parameter in each of the two groups, and in general health perception sub parameter in subjects of stabilization exercise group (p<0.05) in the prolapse quality of life questionnaire. Conclusions: It was concluded that both training programs increased the pelvic floor muscle strength, provided a decline in prolapse stages. Stabilization exercise has increased general health perception unlike home training, thus, these exercises can be added to the treatment of women with prolapse.