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Introduction: Genitourinary Syndrome of Menopause (GSM) defines a set of symptoms associated with an estrogen deficit involving alterations in organs genitourinary and that results in several urinary, genital, and sexual alterations. Brazilian women live about a third of their life after menopause, where hormonal changes occur along with clinical manifestations, characterized by vaginal and vulvar dryness, burning sensation, discomfort, vulvovaginal irritation, lack of lubrication, dyspareunia and urinary incontinence. Fractionated photothermolysis and radiofrequency systems, alone or in combination were tested to improve GSM. Objective: The goal of this study is to elaborate a protocol to evaluate the clinical response of patients with symptoms of GSM after the application of photobiomodulation in the vulvar region. Method: In this randomized, double-blind, placebo-controlled study protocol, women over 50 years of age who are in the postmenopausal period (amenorrhea for at least 12 months, with no pathology involved) with one or more symptoms of GSM will be randomly divided into two groups. The treatment group (n = 30) will receive four consecutive applications, weekly, using DMC laser diode (λ = 808 nm), 4J per point, 100mW of power, 1,016W/cm2, 8 sites in the vulvar region, The Placebo Group (n = 30) will be handled as treated, but with the laser turned off. The quality of life will be assessed using female sexual functioning index (FSFI-6), urinary incontinence questionnaire (ICIQ-SF), Quality of life will be analyzed using the female sexual functioning index (FSFI-6). The intensity of menopausal symptoms will be evaluated using a visual analogue scale (VAS), the vulvo vaginal atrophy will be measured by the Vaginal Health Index (VHI). Also, the vaginal temperature will be measured using a thermal camera, the pressure of the pelvic floor force (vaginal dynamometer) and a 1-hour Pad Test will be performed to quantify the urinary loss. With this procedure, we intend to obtain an overall better life quality and diminished symptoms in women with GSM. All assessments will be performed prior to the first irradiation and after the last one. Trial registration: This protocol is registered at ClinicalTrials.gov under the number NCT05557799. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) is a prevalent pregnancy complication with well-established adverse effects on maternal and fetal health. However, research on its impact on sexual health is inconsistent. Currently, there is no comprehensive review on sexual function in pregnant women with GDM. The purpose of this study is to systematically gather and synthesize the available evidence, addressing this important research gap. Methods: This systematic review and meta-analysis utilized a comprehensive literature search strategy and incorporated the following databases: the Cochrane Library, Scopus, PubMed, Web of Science, SID, and Google Scholar. The search was conducted until February 21, 2024. The quality of the cross-sectional and case‒control studies included in the current study was evaluated via the modified and standard Newcastle‒Ottawa scale. The certainty of the evidence was evaluated via the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. A meta-regression was conducted to examine the variables that influence total sexual function. Additionally, sequential analysis was performed to determine the required information size for the meta-analysis. Results: The systematic search process yielded a total of 370 studies. The final analysis included six studies. The meta-analysis findings revealed that compared with controls, women with GDM had significantly lower total scores for sexual function (SMD − 1.80, 95% CI -3.44 to -0.15, p = 0.03), sexual desire (SMD − 5.14, 95% CI -8.14 to -2.14, p < 0.001), arousal (SMD − 0.58, 95% CI -0.95 to -0.21, p = 0.002), lubrication (MD -0.41, 95% CI -0.59 to -0.22, p < 0.001) and satisfaction (SMD − 3.82, 95% CI -6.08 to -1.57, p < 0.001). However, the analysis did not reveal statistically significant differences in sexual pain, or orgasm between the GDM and control groups. The meta-regression analysis revealed that older age in the control group was associated with poorer sexual function. Conclusion: Compared with control women, pregnant women diagnosed with GDM have lower sexual function. Further research with larger sample sizes is necessary to enhance the robustness of the evidence, given the low level of certainty. Healthcare providers should focus on the sexual well-being of women with GDM and create tailored interventions to address their specific needs. [ABSTRACT FROM AUTHOR]

Introduction: Female sexual dysfunction is a frequent problem that may be caused by several factors, such as pregnancy and diabetes, and that can affect the woman's quality of life., Aim: The aim of this study was to assess the sexual function of pregnant women with gestational diabetes., Methods: This is a cross-sectional clinical study involving 88 women, among which 33 were pregnant with gestational diabetes mellitus (GDM) and 55 were with low-risk pregnancy (LRP)., Main Outcome Measures: Sexual function was assessed using the Female Sexual Function Index (FSFI), a self-applicable questionnaire validated in Portuguese. All the pregnant women answered the questionnaire between the 20th and 25th week of gestation. Data were submitted to descriptive analysis by using the SAS version 9.2 procedure PROC MEANS (SAS Institute Inc., Cary, NC, USA), whereas Student's t-test was applied by using the procedure PROC TTEST (SAS Institute Inc.) at a significance level of ≤5% for all analyses., Results: The percentage of women presenting sexual dysfunction in each group was the following: 66.7% in Group GDM and 38.9% in the Group LRP, with significant difference between the groups (P = 0.03). However, no significant differences were found between the groups regarding sexual desire, excitement, lubrication, and pain. On the total score of FSFI, Group GDM had a score ≤26.55 (P = 0.03)., Conclusion: Diabetic pregnant women were found to have a higher incidence of sexual dysfunction as their scores were lower for all FSFI domains compared with LRP females., (© 2013 International Society for Sexual Medicine.)

Objective: To analyze the results obtained in the evaluation of intra-vaginal pressure using three different brands of perineometers in nulliparous volunteers., Materials and Methods: Twenty nulliparous women with no anatomical alterations and/or dysfunction of the pelvic floor were enrolled in our study. All the women had the ability to voluntarily contract their PFM (Pelvic Floor Muscles), as assessed by digital palpation. The intra-vaginal pressure was assessed using three different brands of perineometer (Neurodyn Evolution, SensuPower and Peritron). Each volunteer was evaluated on three alternate days by a single examiner using a single brand of perineometer on each day. In the assessment, the volunteers were required to pull (contract) their PFM in and up as strongly as possible 3 times and to sustain the contraction for 5 seconds, with an interval of 30 seconds between each pull. For the statistical analysis, a concordance correlation coefficient was used to compare the values that were obtained with each brand of perineometer., Results: A moderate concordance (0.51) was found between the results from the Peritron and Neurodyn perineometers, a fair concordance (0.21) between the Peritron and SensuPower brands and a poor concordance (0.19) between the Neurodyn and SensuPower brands., Conclusion: The concordance of the measurements of the intra-vaginal pressure ranged from poor to moderate, suggesting that perineometers of different brands generate different results.

Objective: To evaluate the effectiveness of pelvic floor muscle training (PFMT) on pelvic floor muscle (PFM) function and quality of life (QoL) in women with stress urinary incontinence (SUI) and pelvic organ prolapse (POP). Methods: This study will be a randomized, controlled, parallel, and blinded clinical trial. The final sample will consist of 32 women diagnosed with SUI and cystocele (stage I and II). All volunteers will be assessed and reassessed using the same protocol: assessment form, gynecological examination, functional evaluation of PFM, and questionnaires to assess quality of life, urinary function, and sexual function. All volunteers will be evaluated for satisfaction levels post-treatment. The intervention will be PFMT, totaling 16 sessions to be conducted twice a week. Reevaluation will take place at the end of treatment and 1 month after completion of PFMT. Descriptive analysis and repeated measures ANOVA will be used for result analysis. A significance level of p<0.05 will be considered for all statistical tests. Ethics and dissemination: This study has been submitted to the Ethics in Research Committee of the Federal University of Rio Grande do Norte and approved under protocol number 5.826.563. It has been registered with the Brazilian Clinical Trials Registry ReBec (RBR-49p6g3t). It is expected that these studies will provide a deeper understanding of the efficacy of PFMT in women with SUI and cystocele. Additionally, it aims to provide more insights into the efficacy of PFMT prior to surgery. [ABSTRACT FROM AUTHOR]

Objective: Gestational diabetes during pregnancy causes many adverse effects in mothers and affects them in various aspects. The aim is to investigate the impact of gestational diabetes during the course of pregnancy on patients' quality of life, depression and anxiety levels, and sexual functions. Material and Methods: The study was conducted on 131 third-trimester pregnant women (healthy pregnant women: 79, patients with GDM: 52) by using the WHO Quality of Life-BREF (WHOQOL-BREF), Female Sexual Function Index (FSFI), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) between September 2020 and August 2021. The patients with GDM were then divided according to their treatment strategies (Lifestyle Modification: 43 and Insulin Therapy: 9) for further evaluations. Results: Healthy pregnant women have a higher score (69.30±14.68) on the general health domain of WHOQOL-BREF than patients with GDM (63.22±18.25) with statistical significance (p=0.037). The Insulin Therapy Group has a significantly (p=0.008) lower psychological health score (60.18±18.05) on the psychological health domain of WHOQOL-BREF than the Lifestyle Modification Group (76.06±15.05). There was no significant difference in FSFI, BAI, BDI, and other domains of WHOQOL-BREF scores between the two groups and treatment strategies. Conclusion: Suffering from GDM or using different treatment options has no impact on patients' quality of life, levels of depression or anxiety, or sexual function. [ABSTRACT FROM AUTHOR]

There had been various methods employed for the evaluation of pelvic floor muscle (PFM) strength. The aim of the study was to do a systemic review of these methods for a better understanding of these techniques and to find the best appropriate method. A systemic review of the literature was done using three databases that included: PubMed, Scopus and Web of Science using the keywords "pelvic floor anatomy" and "functional anatomy of pelvic floor muscles" from 1985 to 2022. All the studies involved were analyzed for the methodologies used by the researcher, advantages, disadvantages, and the conclusion of the study. A total of 1,876 studies were found, out of which only 64 met the criteria of inclusion. In these studies, seven methods were used for the determination of PFM strength. These methods included: clinical palpation, perineometer, electromyography, dynamometer, ultrasonography, magnetic resonance imaging, and vaginal cones. The PFM cannot be calculated accurately using any one measuring technique. There is therefore no "gold standard" approach to PFM assessment. However, combining these methods will result in the best outcomes. According to the literature review, the most often employed procedures were digital palpation, perineometry, and Ultrasonography (USG). [ABSTRACT FROM AUTHOR]

Introduction: Functional intestinal constipation (FIC) has a high prevalence worldwide. It is higher in adult and elderly women, and in those with alterations in the pelvic floor muscle (PFM) structure and function. Objective: The primary aim of this study was to characterize PFM function, including tone, of women with and without FIC. The secondary aim was to assess and compare the general and symptom‐related quality of life (QoL) between participants with and without FIC and its correlation with the assessed PFM function. Methods: This was a cross‐sectional observational study, the outcomes were assessed using vaginal palpation, vaginal manometry and validated questionnaires: the Pelvic Floor Impact Questionnaire Short Form 7 (PFIQ‐7), the Pelvic Floor Distress inventory (PFDI‐20), and the Short‐Form Health Survey (SF‐36). This study included 60 women, 30 with FIC and 30 without FIC. The mean age of women with FIC was 48.2 years (standard deviation [SD] 12.22) and 51 years (SD 13.47) for those without FIC. Both groups were overweight. There was a significant difference between groups in the bowel domain of the PFIQ‐7 (p = 0.016) and in the anal dysfunction domain of the PFDI‐20 (p < 0.001), being higher in those women with FIC. Women with FIC presented a significantly worse ability to voluntarily relax their PFM (38.3%) than those without FIC (11.7%; p = 0.008). participants without FIC presented higher values of maximum voluntary contraction (MVC) assessed by vaginal manometry compared to participants without FIC (p = 0.008). PFM tone was not different between groups. Conclusion: Women with FIC have more difficulty in relaxing their PFM and lower MVC values than women without FIC. FIC negatively impacts women's symptom‐related QoL. The main contribution of this study was to reavel the difficulty of the participants with FIC to relax their PFM. This finding is important to guide clinical decision making for an adequate treatment program direct to women with FIC. [ABSTRACT FROM AUTHOR]

Introduction: The terminology for female and male pelvic floor muscle (PFM) assessment has expanded considerably since the first PFM function and dysfunction standardization of terminology document in 2005. New terms have entered assessment reports, and new investigations to measure PFM function and dysfunction have been developed. An update of this terminology was required to comprehensively document the terms and their definitions, and to describe the assessment method and interpretation of the finding, to standardize assessment procedures and aid diagnostic decision making. Methods: This report combines the input of members of the Standardisation Committee of the International Continence Society (ICS) Working Group 16, with contributions from recognized experts in the field and external referees. A logical, sequential, clinically directed assessment framework was created against which the assessment process was mapped. Within categories and subclassifications, each term was assigned a numeric coding. A transparent process of 12 rounds of full working group and external review was undertaken to exhaustively examine each definition, plus additional extensive internal development, with decision making by collective opinion (consensus). Results: A Terminology Report for the symptoms, signs, investigations, and diagnoses associated with PFM function and dysfunction, encompassing 185 separate definitions/descriptors, has been developed. It is clinically based with the most common assessment processes defined. Clarity and user‐friendliness have been key aims to make it interpretable by clinicians and researchers of different disciplines. Conclusion: A consensus‐based Terminology Report for assessment of PFM function and dysfunction has been produced to aid clinical practice and be a stimulus for research. [ABSTRACT FROM AUTHOR]

Background: Urinary incontinence is any involuntary leakage of urine. It has serious negative health impacts on quality of life in pregnant women. According to the scientific committee of the International Continence Society report, worldwide prevalence of urinary incontinence estimated ranges between 32% and 64% among pregnant women. However, there is scarcity of evidence on prevalence and associated factors of urinary incontinence in Ethiopia. Objective: The aims of this study were to assess prevalence and associated factors of urinary incontinence among pregnant women attending antenatal care in public health facilities of Mekelle city, Tigray, Ethiopia. Methodology: Institution-based cross-sectional study design was conducted. Data were collected using an interviewer-administered structured questionnaire. Physical examination was done to assess the strength of pelvic floor muscles. The data were entered to EPI Info version 7 and analyzed using SPSS version 23. Bivariate and multivariate logistic regression analyses were done to investigate the factors associated with urinary incontinence. Results: Among 317 respondents, the prevalence of urinary incontinence was 23%. The contributing factors that had statistically significant association with urinary incontinence were gestational age (adjusted odds ratio: 9.6 (1.87–49.39, 95%), parity (adjusted odds ratio: 6.32 (1.48–27.05), 95% confidence interval), prior miscarriage (adjusted odds ratio: 6.28 (2.15–18.28), 95% confidence interval), constipation (adjusted odds ratio: 8.25 (3.12–21.84), 95% confidence interval), respiratory problem (adjusted odds ratio: 6.31 (2.05–19.43), 95% confidence interval), and weak pelvic floor muscle (adjusted odds ratio: 7.55 (2.51–22.67), 95% confidence interval). Conclusion: The prevalence of urinary incontinence is moderate compared to other studies. Gestational age, parity, prior miscarriage, having constipation, having respiratory problem, and weak pelvic floor muscle had significant association with urinary incontinence. This finding will help to increase the awareness of health care professionals involved in the care of pregnant women about urinary incontinence. [ABSTRACT FROM AUTHOR]

Aim There is poor consensus in the literature about measuring perineal descent. We aimed to assess symptoms and quality of life in constipated patients with abnormal perineal descent. Method Constipated patients were categorized into those with obstructed defaecation, colonic inertia, mixed disorders and irritable bowel syndrome constipation types. Anal physiology was performed. KESS score, Irritable Bowel Syndrome Quality of Life and SF-12 questionnaires were completed. The position of the perineum was measured by defaecography. Patients were divided into two groups according to the position of the perineal descent at rest: group 1 (normal < 3.5 cm) and group 2 (abnormal > 3.5 cm). Results Fifty-eight patients were identified, 23 (40%) in group 1 and 35 (60%) in group 2. Patients in group 2 were older ( P = 0.007), had a higher body mass index (BMI; P = 0.003), a higher rate of hysterectomy ( P = 0.04) and more vaginal deliveries ( P = 0.001). Obstructed defaecation was the predominant subtype of constipation. Group 1 had more difficulty in initiating defaecation and group 2 presented more cases with intussusception and enterocele ( P = 0.03 for both). Group 2 had a lesser degree of perineal descent between rest and straining. Rectal compliance was greater in group 2 ( P = 0.03). Symptoms and quality of life scores were similar between the groups. Conclusion Radiologically determined excessive perineal descent is not indicative of worse symptoms or quality of life. This radiological finding does not warrant further investigation. [ABSTRACT FROM AUTHOR]

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Copyright of Pelvi-Perineologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The purpose of this study was to clarify the reliability and validity of pelvic floor muscle (PFM) strength assessment using the MizCure perineometer in healthy women.Methods: Twenty healthy women (age 20-45 years) participated in this study. The vaginal pressure measured using the MizCure and validated Peritron perineometers were repeated during PFM contraction in the supine and standing positions. All women were evaluated twice by examiners 1 and 2. Following the measurements in the first session (Test 1), they were repeated after an interval of between 2 and 6 weeks (Test 2). Within- and between-session intra- and inter-rater reliabilities in vaginal pressure were analyzed using intraclass correlation coefficients (ICC) (1, 1) and (2, 1), respectively. Validity was assessed by Pearson's product-moment correlation coefficient and Spearman's rank correlation analysis.Results: Within-session intra-rater reliabilities for both examiners 1 and 2 for all vaginal pressures in Tests 1 and 2 were 0.90-0.96 for both perineometers. Between-session intra-rater reliability for the MizCure was 0.72-0.79 for both positions for examiner 1, and 0.63 in the supine position and 0.80 in the standing position for examiner 2. Inter-rater reliability for Test 1 was 0.91 in the supine position and 0.87 in the standing position for the MizCure. The vaginal pressures using the MizCure and Peritron were significantly associated with the supine position (r = 0.68, P < .001) and the standing position (rs = 0.82, P < .001).Conclusion: MizCure perineometer is a validated tool to measure PFM strength in both supine and standing positions in healthy nulliparous women. [ABSTRACT FROM AUTHOR]