Pub Date : 2024-07-01DOI: 10.1097/jwh.0000000000000304
Elizabeth Levay, Dawn Hall-Bibb
As holistic, autonomous health care providers, physical therapists must be confident in discussing all aspects of health with patients, including sexual health. Lack of attention to patients’ sexual issues may result in aspects of health going unaddressed, leading to poor patient care. The purpose of this study was to investigate the relationship between exposure to pelvic health content in physical therapy school curricula and Doctor of Physical Therapy (DPT) students’ comfort levels discussing sexual health issues with future patients. Survey research report. A cluster sample of DPT students in the United States (n = 167) completed a novel tool, titled the Pelvic Health Curricular Exposure Scale (PHCES), as well as an adapted version of the Students’ Attitudes Towards Addressing Sexual Health (SA-SH) questionnaire. Exposure to and comfort with pelvic floor dysfunction (p< .001; p< .001), obstetrical issues (p= .051; p< .001), colorectal health (p= .007; p< .001), and incontinence (p= .009; p< .001), as well as participating in a pelvic health elective (r pb = 0.05) or clinical experience (r pb < 0.003), positively correlated with comfort discussing sexual health with future patients. DPT programs should make a dedicated effort to implement pelvic health into the curriculum with an emphasis on topics such as pelvic floor dysfunction, obstetrical issues, colorectal health, and incontinence, as well as to provide students with pelvic health electives and clinical experiences. The Supplemental Digital Content video abstract for this article is available at: http://links.lww.com/JWHPT/A131
{"title":"The Pelvic Health Curricular Exposure Scale (PHCES): A Survey of Physical Therapy Students’ Comfort Discussing Sexual Health","authors":"Elizabeth Levay, Dawn Hall-Bibb","doi":"10.1097/jwh.0000000000000304","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000304","url":null,"abstract":"\u0000 \u0000 As holistic, autonomous health care providers, physical therapists must be confident in discussing all aspects of health with patients, including sexual health. Lack of attention to patients’ sexual issues may result in aspects of health going unaddressed, leading to poor patient care.\u0000 \u0000 \u0000 \u0000 The purpose of this study was to investigate the relationship between exposure to pelvic health content in physical therapy school curricula and Doctor of Physical Therapy (DPT) students’ comfort levels discussing sexual health issues with future patients.\u0000 \u0000 \u0000 \u0000 Survey research report.\u0000 \u0000 \u0000 \u0000 A cluster sample of DPT students in the United States (n = 167) completed a novel tool, titled the Pelvic Health Curricular Exposure Scale (PHCES), as well as an adapted version of the Students’ Attitudes Towards Addressing Sexual Health (SA-SH) questionnaire.\u0000 \u0000 \u0000 \u0000 Exposure to and comfort with pelvic floor dysfunction (p< .001; p< .001), obstetrical issues (p= .051; p< .001), colorectal health (p= .007; p< .001), and incontinence (p= .009; p< .001), as well as participating in a pelvic health elective (r\u0000 pb = 0.05) or clinical experience (r\u0000 pb < 0.003), positively correlated with comfort discussing sexual health with future patients.\u0000 \u0000 \u0000 \u0000 DPT programs should make a dedicated effort to implement pelvic health into the curriculum with an emphasis on topics such as pelvic floor dysfunction, obstetrical issues, colorectal health, and incontinence, as well as to provide students with pelvic health electives and clinical experiences.\u0000 The Supplemental Digital Content video abstract for this article is available at: http://links.lww.com/JWHPT/A131\u0000","PeriodicalId":518889,"journal":{"name":"Journal of Women's & Pelvic Health Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141852525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1097/jwh.0000000000000309
Laurel Proulx, Kelli J Brizzolara, Mary Thompson, S. Wang-Price, Patricia Rodriguez, Shane Koppenhaver
The purpose of this cross-sectional study was to assess the association of extrapelvic muscular stiffness measures with pelvic floor symptoms and clinical impairments in women with chronic pelvic pain (CPP). In addition to bivariate correlations, exploratory factor analysis (EFA) was used to identify multivariate clinical presentation patterns of CPP. Muscle stiffness measurements of 11 extrapelvic muscles were taken in 149 women with CPP. Associations between muscle stiffness and clinical measures such as pelvic floor function, pain, psychosocial status, and urogynecology history were calculated. In addition, variables were assessed using EFA to identify patterns of CPP. There were small but significant correlations between muscle stiffness measurements and clinical measures. Three categorizations of CPP symptoms and impairments emerged from the 25 continuous variables chosen for EFA. These could be classified as follows: (1) pelvic floor dysfunction and psychosocial involvement; (2) muscle stiffness of the hips and thighs; and (3) muscle stiffness of the low back and abdomen, collectively making up 49.1% of the variance. Stiffness of commonly treated extrapelvic muscles was not strongly correlated to pain level or health history of women with CPP. The first EFA component is consistent with patients routinely seen by pelvic health physical therapists, and the latter components are consistent with those who may benefit initially from orthopedic physical therapy. Further research looking at the relationship of muscle stiffness, pelvic floor function, and movement impairments is needed. EFA may be a starting point to better understand who may be appropriate for orthopedic physical therapy treatment versus specialized pelvic health physical therapy care.
{"title":"Characterizing Chronic Pelvic Pain: The Relationship Between Extrapelvic Muscle Stiffness, Pain Level, Health History, and Pelvic Floor Symptoms in Women With Chronic Pelvic Pain","authors":"Laurel Proulx, Kelli J Brizzolara, Mary Thompson, S. Wang-Price, Patricia Rodriguez, Shane Koppenhaver","doi":"10.1097/jwh.0000000000000309","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000309","url":null,"abstract":"\u0000 \u0000 The purpose of this cross-sectional study was to assess the association of extrapelvic muscular stiffness measures with pelvic floor symptoms and clinical impairments in women with chronic pelvic pain (CPP). In addition to bivariate correlations, exploratory factor analysis (EFA) was used to identify multivariate clinical presentation patterns of CPP.\u0000 \u0000 \u0000 \u0000 Muscle stiffness measurements of 11 extrapelvic muscles were taken in 149 women with CPP. Associations between muscle stiffness and clinical measures such as pelvic floor function, pain, psychosocial status, and urogynecology history were calculated. In addition, variables were assessed using EFA to identify patterns of CPP.\u0000 \u0000 \u0000 \u0000 There were small but significant correlations between muscle stiffness measurements and clinical measures. Three categorizations of CPP symptoms and impairments emerged from the 25 continuous variables chosen for EFA. These could be classified as follows: (1) pelvic floor dysfunction and psychosocial involvement; (2) muscle stiffness of the hips and thighs; and (3) muscle stiffness of the low back and abdomen, collectively making up 49.1% of the variance.\u0000 \u0000 \u0000 \u0000 Stiffness of commonly treated extrapelvic muscles was not strongly correlated to pain level or health history of women with CPP. The first EFA component is consistent with patients routinely seen by pelvic health physical therapists, and the latter components are consistent with those who may benefit initially from orthopedic physical therapy. Further research looking at the relationship of muscle stiffness, pelvic floor function, and movement impairments is needed. EFA may be a starting point to better understand who may be appropriate for orthopedic physical therapy treatment versus specialized pelvic health physical therapy care.\u0000","PeriodicalId":518889,"journal":{"name":"Journal of Women's & Pelvic Health Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1097/jwh.0000000000000307
Amanda Hardy, Leigh Campbell, Carol Jones, Carolyn Vandyken, Jilly Bond, Penny Moss, Anne Smith, Benedict Wand, Judith Thompson
Altered body awareness and perception comprise a common feature of persistent pain. The Fremantle Back Awareness Questionnaire (FreBAQ) was developed to assess body awareness and perception in people with back pain. There is no tool to measure these changes in people with persistent perineal pain. To develop the Fremantle Perineal Awareness Questionnaire (FrePAQ) to assess body awareness and perception in people with persistent perineal pain. To evaluate content validity using a qualitative survey. Modified electronic Delphi and cross-sectional qualitative online survey. A focus group developed a draft questionnaire from the preexisting FreBAQ. A preliminary FrePAQ was developed through 3 Delphi rounds of anonymous voting by a panel of 14 experts. A qualitative survey was completed by individuals with persistent perineal pain to evaluate the comprehensiveness, comprehensibility, and relevance of the preliminary questionnaire. Responses were thematically analyzed, and demographic data were summarized descriptively. Fourteen panel participants completed the Delphi study, with consensus achieved on a 9-item questionnaire after 3 rounds. One hundred thirty-five participants with persistent perineal pain completed the round 1 validation survey. Changes were made to the introduction and 7 items. A new group of 53 participants completed round 2, resulting in final changes to the introduction and 2 of the 9 items. An expert consensus was achieved in the wording of a new questionnaire aimed at assessing body awareness and perception in people with persistent perineal pain, which demonstrated acceptable content validity.
{"title":"The Development and Content Validity of the Fremantle Perineal Awareness Questionnaire (FrePAQ) for Use in People With Persistent Perineal Pain","authors":"Amanda Hardy, Leigh Campbell, Carol Jones, Carolyn Vandyken, Jilly Bond, Penny Moss, Anne Smith, Benedict Wand, Judith Thompson","doi":"10.1097/jwh.0000000000000307","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000307","url":null,"abstract":"\u0000 \u0000 Altered body awareness and perception comprise a common feature of persistent pain. The Fremantle Back Awareness Questionnaire (FreBAQ) was developed to assess body awareness and perception in people with back pain. There is no tool to measure these changes in people with persistent perineal pain.\u0000 \u0000 \u0000 \u0000 To develop the Fremantle Perineal Awareness Questionnaire (FrePAQ) to assess body awareness and perception in people with persistent perineal pain. To evaluate content validity using a qualitative survey.\u0000 \u0000 \u0000 \u0000 Modified electronic Delphi and cross-sectional qualitative online survey.\u0000 \u0000 \u0000 \u0000 A focus group developed a draft questionnaire from the preexisting FreBAQ. A preliminary FrePAQ was developed through 3 Delphi rounds of anonymous voting by a panel of 14 experts. A qualitative survey was completed by individuals with persistent perineal pain to evaluate the comprehensiveness, comprehensibility, and relevance of the preliminary questionnaire. Responses were thematically analyzed, and demographic data were summarized descriptively.\u0000 \u0000 \u0000 \u0000 Fourteen panel participants completed the Delphi study, with consensus achieved on a 9-item questionnaire after 3 rounds. One hundred thirty-five participants with persistent perineal pain completed the round 1 validation survey. Changes were made to the introduction and 7 items. A new group of 53 participants completed round 2, resulting in final changes to the introduction and 2 of the 9 items.\u0000 \u0000 \u0000 \u0000 An expert consensus was achieved in the wording of a new questionnaire aimed at assessing body awareness and perception in people with persistent perineal pain, which demonstrated acceptable content validity.\u0000","PeriodicalId":518889,"journal":{"name":"Journal of Women's & Pelvic Health Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1097/jwh.0000000000000308
Gülbala Gülören, Gamze Nalan Çinar, E. Baran, Ceren Gürşen, Esra Uzelpasaci, S. Özgül, K. Beksaç, E. Fadıloğlu, Emine Aydın, A. Tanaçan, T. Akbayrak, M. Sinan Beksaç
To investigate the presence of hemorrhoids and anorectal signs/symptoms and to identify various risk factors including anthropometric/musculoskeletal contributors associated with hemorrhoids in pregnancy and the postpartum period. Pregnancy and the postpartum period may predispose women to develop hemorrhoids and anorectal symptoms because of hormonal and musculoskeletal changes. Fifty-one pregnant women with no history of anorectal disease were included in the study. The occurrence of hemorrhoids and other anorectal signs/symptoms was examined at 4 different times: first, second, and third trimesters, and postpartum 6th week. The Rome III criteria and the Bristol Stool Scale were used to confirm the presence of constipation and to determine stool type, respectively. Waist and hip circumference (as anthropometric contributors), bi-iliac and bitrochanteric width (as diameter measurements), diastasis recti abdominis, joint hypermobility, and lumbar lordosis (as musculoskeletal contributors) were evaluated. Personal, demographic, and clinical characteristics of the patients as well as postpartum period information were also recorded. Hemorrhoids, perianal discomfort, perianal pain, and protrusion were significantly more frequent at postpartum than at the first trimester (P < .008). According to the multivariate analysis, body mass index, the presence of constipation, joint hypermobility, and birth weight were significant determinants of hemorrhoids at the third trimester and postpartum (odds ratio = 1.25-2.67). Body mass index, constipation, joint hypermobility, and increased birth weight of the newborn were potential risk factors for the development of hemorrhoids during pregnancy and postpartum. Hemorrhoids and anorectal complaints should be kept in mind and managed to increase the quality of life during pregnancy and the postpartum period.
{"title":"Hemorrhoids, Anorectal Symptoms, and Related Risk Factors in Pregnancy and the Postpartum Period: A Follow-up Study","authors":"Gülbala Gülören, Gamze Nalan Çinar, E. Baran, Ceren Gürşen, Esra Uzelpasaci, S. Özgül, K. Beksaç, E. Fadıloğlu, Emine Aydın, A. Tanaçan, T. Akbayrak, M. Sinan Beksaç","doi":"10.1097/jwh.0000000000000308","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000308","url":null,"abstract":"\u0000 \u0000 To investigate the presence of hemorrhoids and anorectal signs/symptoms and to identify various risk factors including anthropometric/musculoskeletal contributors associated with hemorrhoids in pregnancy and the postpartum period.\u0000 \u0000 \u0000 \u0000 Pregnancy and the postpartum period may predispose women to develop hemorrhoids and anorectal symptoms because of hormonal and musculoskeletal changes.\u0000 \u0000 \u0000 \u0000 Fifty-one pregnant women with no history of anorectal disease were included in the study. The occurrence of hemorrhoids and other anorectal signs/symptoms was examined at 4 different times: first, second, and third trimesters, and postpartum 6th week. The Rome III criteria and the Bristol Stool Scale were used to confirm the presence of constipation and to determine stool type, respectively. Waist and hip circumference (as anthropometric contributors), bi-iliac and bitrochanteric width (as diameter measurements), diastasis recti abdominis, joint hypermobility, and lumbar lordosis (as musculoskeletal contributors) were evaluated. Personal, demographic, and clinical characteristics of the patients as well as postpartum period information were also recorded.\u0000 \u0000 \u0000 \u0000 Hemorrhoids, perianal discomfort, perianal pain, and protrusion were significantly more frequent at postpartum than at the first trimester (P < .008). According to the multivariate analysis, body mass index, the presence of constipation, joint hypermobility, and birth weight were significant determinants of hemorrhoids at the third trimester and postpartum (odds ratio = 1.25-2.67).\u0000 \u0000 \u0000 \u0000 Body mass index, constipation, joint hypermobility, and increased birth weight of the newborn were potential risk factors for the development of hemorrhoids during pregnancy and postpartum. Hemorrhoids and anorectal complaints should be kept in mind and managed to increase the quality of life during pregnancy and the postpartum period.\u0000","PeriodicalId":518889,"journal":{"name":"Journal of Women's & Pelvic Health Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1097/jwh.0000000000000302
Nicole J. Ron, Sarah C. Dolbinski, Elizabeth G. Hodonicky, Darby O. Middlebrook, Sally R. Olmstead, Sandra L. Olsen, Eyal D. Ron, John H Hollman
Women with stress urinary incontinence (SUI) may have altered running mechanics and reduced hip muscle strength compared with women without SUI. Little research has examined running metrics and functional lower extremity strength of parous runners. To determine whether SUI severity correlates with running metrics and lower extremity muscle strength among parous women. This was a cross-sectional observational study of 22 parous participants (mean age 39.8 years, with a mean of 3.4 pregnancies and 8.1-year interval since last delivery). Participants completed the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI), Urinary Distress Inventory-6 (UDI-6), Colorectal-Anal Distress (CRAD) Inventory-8, and Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6), and Questionnaire for Urinary Incontinence Diagnosis (QUID) and provided demographic, relevant running, and obstetric/gynecologic history information. After a brief warm-up, participants completed 30-second single-leg sit-to-stand tests bilaterally and a standardized 10-minute treadmill run with pod cadence assessment. Pearson-product moment correlation coefficients were calculated (α = .05). Prolonged ground contact times were associated with higher ICIQ-UI SF (r= 0.523, P= .015), POPDI-6 (r= 0.694, P< .001), and UDI-6 scores (r= 0.577, P= .006), while lower cadences were associated with higher POPDI-6 (r=−0.550, P= .010) and UDI-6 scores (r=−0.444, P= .044). Parous female runners with more severe SUI and prolapse symptoms demonstrate altered running mechanics characterized by prolonged ground contact times and slower cadences.
{"title":"Associations Between Running Mechanics, Functional Lower Extremity Strength, and Stress Urinary Incontinence in Parous Female Runners","authors":"Nicole J. Ron, Sarah C. Dolbinski, Elizabeth G. Hodonicky, Darby O. Middlebrook, Sally R. Olmstead, Sandra L. Olsen, Eyal D. Ron, John H Hollman","doi":"10.1097/jwh.0000000000000302","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000302","url":null,"abstract":"\u0000 \u0000 Women with stress urinary incontinence (SUI) may have altered running mechanics and reduced hip muscle strength compared with women without SUI. Little research has examined running metrics and functional lower extremity strength of parous runners.\u0000 \u0000 \u0000 \u0000 To determine whether SUI severity correlates with running metrics and lower extremity muscle strength among parous women.\u0000 \u0000 \u0000 \u0000 This was a cross-sectional observational study of 22 parous participants (mean age 39.8 years, with a mean of 3.4 pregnancies and 8.1-year interval since last delivery).\u0000 \u0000 \u0000 \u0000 Participants completed the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI), Urinary Distress Inventory-6 (UDI-6), Colorectal-Anal Distress (CRAD) Inventory-8, and Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6), and Questionnaire for Urinary Incontinence Diagnosis (QUID) and provided demographic, relevant running, and obstetric/gynecologic history information. After a brief warm-up, participants completed 30-second single-leg sit-to-stand tests bilaterally and a standardized 10-minute treadmill run with pod cadence assessment. Pearson-product moment correlation coefficients were calculated (α = .05).\u0000 \u0000 \u0000 \u0000 Prolonged ground contact times were associated with higher ICIQ-UI SF (r= 0.523, P= .015), POPDI-6 (r= 0.694, P< .001), and UDI-6 scores (r= 0.577, P= .006), while lower cadences were associated with higher POPDI-6 (r=−0.550, P= .010) and UDI-6 scores (r=−0.444, P= .044).\u0000 \u0000 \u0000 \u0000 Parous female runners with more severe SUI and prolapse symptoms demonstrate altered running mechanics characterized by prolonged ground contact times and slower cadences.\u0000","PeriodicalId":518889,"journal":{"name":"Journal of Women's & Pelvic Health Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1097/jwh.0000000000000303
Elizabeth Kvach, Ryan O’Connell, S. Sairafi, Krystyna Holland, Nancy Wittmer
The study purpose was to report neovaginal dilation outcomes and identify factors associated with pain, dilation discontinuation, and sexual function for transgender individuals who underwent gender-affirming vaginoplasty. A retrospective cohort study design was employed of transgender patients 18 years or older undergoing full-depth vaginoplasty and pelvic floor physical therapy (PFPT) between May 2018 and April 2021 at a safety-net hospital through medical record review and an online survey developed with a patient advisory board. Exclusion criterion was minimal-depth vaginoplasty or loss to follow-up. In total, 137 patients included underwent full-depth vaginoplasty (46.7% survey response rate) 796.2 days (mean) postoperatively. Patients received 4.3 PFPT visits, with the last visit 12.4 weeks postoperatively (mean). Ninety patients (64.3%) achieved the 2 widest dilators, and 68 patients dilated to a depth of 5.5 inches or more (49.6%). The mean progression time between dilators was 5 weeks. Twenty-nine patients (21.2%) had pain preventing dilation, associated with minor or any surgical complication (OR = 5.7; 95% CI, 1.3-25.0) and posttraumatic stress disorder (P = .01), and had more PFPT visits for longer postoperatively than those without pain (P = .03). Nineteen respondents (32.2%) reported not dilating and were younger (P = .02), more likely to be lesbian, pansexual, or asexual (P = .01), and experienced depression (P = .01). Forty-four respondents (77.2%) were sexually active in the past 6 months, which was not associated with pain during dilation. However, respondents self-reporting dilation pain had greater dissatisfaction with their sex life (P = .02). Patient dilation practices following vaginoplasty differ from protocols recommended by surgeons. Dilation goals should be adapted to individual patient characteristics and needs.
{"title":"Dilation Outcomes for Transgender and Nonbinary Patients Following Gender-Affirming Vaginoplasty in a US County Safety-Net System","authors":"Elizabeth Kvach, Ryan O’Connell, S. Sairafi, Krystyna Holland, Nancy Wittmer","doi":"10.1097/jwh.0000000000000303","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000303","url":null,"abstract":"\u0000 \u0000 The study purpose was to report neovaginal dilation outcomes and identify factors associated with pain, dilation discontinuation, and sexual function for transgender individuals who underwent gender-affirming vaginoplasty.\u0000 \u0000 \u0000 \u0000 A retrospective cohort study design was employed of transgender patients 18 years or older undergoing full-depth vaginoplasty and pelvic floor physical therapy (PFPT) between May 2018 and April 2021 at a safety-net hospital through medical record review and an online survey developed with a patient advisory board. Exclusion criterion was minimal-depth vaginoplasty or loss to follow-up.\u0000 \u0000 \u0000 \u0000 In total, 137 patients included underwent full-depth vaginoplasty (46.7% survey response rate) 796.2 days (mean) postoperatively. Patients received 4.3 PFPT visits, with the last visit 12.4 weeks postoperatively (mean). Ninety patients (64.3%) achieved the 2 widest dilators, and 68 patients dilated to a depth of 5.5 inches or more (49.6%). The mean progression time between dilators was 5 weeks. Twenty-nine patients (21.2%) had pain preventing dilation, associated with minor or any surgical complication (OR = 5.7; 95% CI, 1.3-25.0) and posttraumatic stress disorder (P = .01), and had more PFPT visits for longer postoperatively than those without pain (P = .03). Nineteen respondents (32.2%) reported not dilating and were younger (P = .02), more likely to be lesbian, pansexual, or asexual (P = .01), and experienced depression (P = .01). Forty-four respondents (77.2%) were sexually active in the past 6 months, which was not associated with pain during dilation. However, respondents self-reporting dilation pain had greater dissatisfaction with their sex life (P = .02).\u0000 \u0000 \u0000 \u0000 Patient dilation practices following vaginoplasty differ from protocols recommended by surgeons. Dilation goals should be adapted to individual patient characteristics and needs.\u0000","PeriodicalId":518889,"journal":{"name":"Journal of Women's & Pelvic Health Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1097/jwh.0000000000000305
Natália Cardoso Campos, Gabriela Martins de Carvalho, Rafaela Aparecida de Santos, Rafael Dias de Brito Oliveira, Mariana Maia de Oliveira Sunemi, E. M. Figueiredo
Pelvic floor dysfunctions (PFD) have been increasingly reported in young female athletes, but it is likely that young women, not specific to athletes, might also experience symptoms of PFD. This study investigated the occurrence of PFD symptoms in young women from the general population, their degree of bother and functional and clinical factors associated with these occurrences. Online survey was conducted with young women from the general population, not specific to athletes. Sociodemographic and clinical data, symptoms of urinary (UI) and anal incontinence (AI), pelvic organ prolapse, dyspareunia, chronic pelvic pain, and functional constipation, as well as their degree of bother were collected using validated questionnaires. Fisher exact and χ2 tests, Student t tests, and logistic regression models were applied (α = .05). A total of 337 women aged 18 to 25 years were investigated. The overall occurrence of PFD was 60.0%. Dyspareunia was the most prevalent symptom (49.2%), followed by UI (44.2%) and constipation (21.7%). Higher degree of bother was reported for UI, AI, and chronic pelvic pain, respectively. Constipation (P < .001) and anxiety (P = .004) were associated with occurrence of PFD, increasing the chances of PFD by 4 and 2 times, respectively. The high occurrence, co-occurrence, and bother of PFD in young women suggest impairments in pelvic floor muscle functions that should be investigated by physical therapists. Educational programs including preventive strategies and the role of physical therapists in the treatment of PFD should be provided from early ages.
{"title":"Prevalence, Bother, and Risk Factors Associated With Occurrence of Pelvic Floor Dysfunctions in Young Women: A Cross-Sectional Survey","authors":"Natália Cardoso Campos, Gabriela Martins de Carvalho, Rafaela Aparecida de Santos, Rafael Dias de Brito Oliveira, Mariana Maia de Oliveira Sunemi, E. M. Figueiredo","doi":"10.1097/jwh.0000000000000305","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000305","url":null,"abstract":"\u0000 \u0000 Pelvic floor dysfunctions (PFD) have been increasingly reported in young female athletes, but it is likely that young women, not specific to athletes, might also experience symptoms of PFD. This study investigated the occurrence of PFD symptoms in young women from the general population, their degree of bother and functional and clinical factors associated with these occurrences.\u0000 \u0000 \u0000 \u0000 Online survey was conducted with young women from the general population, not specific to athletes. Sociodemographic and clinical data, symptoms of urinary (UI) and anal incontinence (AI), pelvic organ prolapse, dyspareunia, chronic pelvic pain, and functional constipation, as well as their degree of bother were collected using validated questionnaires. Fisher exact and χ2 tests, Student t tests, and logistic regression models were applied (α = .05).\u0000 \u0000 \u0000 \u0000 A total of 337 women aged 18 to 25 years were investigated. The overall occurrence of PFD was 60.0%. Dyspareunia was the most prevalent symptom (49.2%), followed by UI (44.2%) and constipation (21.7%). Higher degree of bother was reported for UI, AI, and chronic pelvic pain, respectively. Constipation (P < .001) and anxiety (P = .004) were associated with occurrence of PFD, increasing the chances of PFD by 4 and 2 times, respectively.\u0000 \u0000 \u0000 \u0000 The high occurrence, co-occurrence, and bother of PFD in young women suggest impairments in pelvic floor muscle functions that should be investigated by physical therapists. Educational programs including preventive strategies and the role of physical therapists in the treatment of PFD should be provided from early ages.\u0000","PeriodicalId":518889,"journal":{"name":"Journal of Women's & Pelvic Health Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141848271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1097/jwh.0000000000000311
{"title":"Empowering Pelvic Health: The Impact of the New Research Committee","authors":"","doi":"10.1097/jwh.0000000000000311","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000311","url":null,"abstract":"","PeriodicalId":518889,"journal":{"name":"Journal of Women's & Pelvic Health Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141843007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1097/jwh.0000000000000297
{"title":"Academy of Pelvic Health Physical Therapy 2024 Combined Sections Meeting Platforms and Posters","authors":"","doi":"10.1097/jwh.0000000000000297","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000297","url":null,"abstract":"","PeriodicalId":518889,"journal":{"name":"Journal of Women's & Pelvic Health Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140533131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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