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Introduction and Hypothesis: The purpose of this study was to determine pelvic floor muscle (PFM) function in hospitalized elderly women with urinary incontinence (UI)., Methods: A cross-sectional study was performed using data of 704 patients, routinely collected by means of a clinical UI assessment., Results: Only 25.5% of the patients were able to perform normal PFM contractions (Oxford grading scale score ≥3); 74.5% were unable to contract their PFM or showed weak PFM activity without circular contraction or elevation of the vagina. Vulvovaginal mucosal dystrophy was noted in 84% of the patients. A significant positive correlation of PFM function was found to cognitive status (MMSE score), mobility (Tinetti performance score), and history of previous PFM training; a negative correlation of PFM function was found to patients' age and vulvovaginal mucosal dystrophy, and no significant correlation to body mass index, parity, or history of hysterectomy., Conclusions: Targeted clinical UI assessment including digital vaginal palpation should be performed in all incontinent elderly women in order to detect PFM dysfunction and to optimize therapeutic measures.

Introduction and Hypothesis: the aim of this pilot study was to demonstrate physiological movements of the muscular walls surrounding the abdominal cavity during breathing and coughing in healthy nulliparous women by means of real-time dynamic magnetic resonance imaging (MRI)., Methods: eight volunteers underwent MRI measurements in a 1.5-T whole body MR-scanner. Coronal and sagittal slices were acquired simultaneously to assess respiratory-related cranio-caudal movement of diaphragm and pelvic floor (PF) and concomitant changes in horizontal abdominal diameter., Results: respective mean amplitudes of cranio-caudal movement of the right and left diaphragmatic cupolae were 15 ± 6 and 9 ± 7 mm during quiet breathing; 32 ± 15 and 28 ± 16 mm during forceful breathing; and 32 ± 13 and 28 ± 7 mm during coughing. Both diaphragm and PF moved caudally during inspiration and cranially during expiration. Abdominal diameter decreased in all eight women consistently during the expiration phase of breathing, and in five women during coughing., Conclusions: in healthy women, real-time dynamic MRI demonstrates parallel cranio-caudal movement of the diaphragm and the PF during breathing and coughing and synchronous changes in abdominal wall diameter.

Introduction and Hypothesis: The aim of this cross-sectional study was to determine correlations between pelvic floor muscle (PFM) function and expiratory function in healthy young nulliparous women., Methods: In 40 volunteers, PFM function was assessed by vaginal palpation. Forced expiration patterns were evaluated visually and by palpation of the suprapubic insertion region of the anterolateral abdominal muscles. Forced vital capacity (FVC) and forced expiratory flows (FEF) were determined by spirometry., Results: Incremental positive correlation was found between voluntary PFM contraction strength and forced expiratory flow at 25%, 50% and 75% (FEF(25%), FEF(50%), FEF(75%)) of the FVC, respectively. Positive correlation was also found between PFM contraction strength and forced expired volume in 1 s (FEV(1)). No correlation was found between PFM contraction strength and FVC or peak expiratory flow (PEF)., Conclusions: Despite some limitations of this study, the observed correlation between PFM contraction strength and forced expiratory flows may serve as theoretical background for a potential role of coordinated abdominal and PFM training in diseases with expiratory flow limitations.