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Changes in pelvic floor mobility in uncomplicated pregnant women over 28 gestational week and its relation with subjective urinary incontinence complaints

Year 2022, Volume: 39 Issue: 1, 160 - 163, 01.01.2022

Abstract

To describe the mobility of the anterior pelvic compartment and hiatal enlargement measures in pregnancy with urinary stress incontinence complaints and their relation to the perceived subjective urinary incontinence severity. Forty-six pregnant women were included in this observational prospective cohort study, the ultrasonographic parameters of the pelvic anterior compartment including hiatal anteroposterior (AP) diameter, retrovesical angle (RVA), bladder neck descent (BND), urethral rotation angle (URA) and cystocele level were compared with the subjective urinary complaints in healthy third trimester pregnant women. Hiatal AP diameter, RVA and BND on Valsalva did not significantly correlate with gestational week (p=0.292, r=0.096; p=0.079, r=0.159; p=0.901, r=0.011, respectively). Urethral rotation angle was significantly increased in women after 39th gestational week (p=0.037, t=-2.17). Hiatal AP diameter, BND and RVA on maximal Valsalva did not differ with estimated fetal weight above and below 3000 gr. Total severity and bother scores of the M-ISI scale was found as similar among women with open (>1400) RVA and intact (<1400) RVA (p=0.556 and p=0.779, respectively). Only nocturia frequency (β=.379, t=4.035, p=.000) positively predicted the incontinence severity score. The pelvic floor ultrasound parameters of the anterior compartment may not predict the subjective urinary incontinence severity in third trimester of pregnancy. Nocturia was found to contribute for subjective impaired urinary function. The idea of being pregnant may suppress the general complaints related with changes in pelvic floor mobility.

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References

  • 1. Eason E, Labrecque M, Marcoux S, Mondor M. Effects of carrying a pregnancy and of method of delivery on urinary incontinence: a prospective cohort study. BMC pregnancy and childbirth. 2004;4(1):1-6.
  • 2. Wesnes SL, Rortveit G, Bø K, Hunskaar S. Urinary incontinence during pregnancy. Obstetrics & Gynecology. 2007;109(4):922-928.
  • 3. Dietz HP, Eldridge A, Grace M, Clarke B. Does pregnancy affect pelvic organ mobility? Australian and New Zealand Journal of Obstetrics and Gynaecology. 2004;44(6):517-520.
  • 4. Huebner M, Antolic A, Tunn R. The impact of pregnancy and vaginal delivery on urinary incontinence. International Journal of Gynecology & Obstetrics. 2010;110(3):249-251.
  • 5. Wesnes SL, Hunskår S, Bo K, Rortveit G. The effect of urinary incontinence status during pregnancy and delivery mode on incontinence postpartum. A cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. 2009;116(5):700-707.
  • 6. Çırpan T, Akercan F, Akman L, İtil İM, Askar N. Postpartum Incontinence in a Young Women: Report of a Case and Review of the Literatüre. Turk J Obstet Gynecol. 2005;2(3):246-248.
  • 7. Dietz HP, Steensma AB. Which women are most affected by delivery-related changes in pelvic organ mobility? European Journal of Obstetrics & Gynecology and Reproductive Biology. 2003;111(1):15-18.
  • 8. Abdullah B, Ayub S, Zahid AM, Noorneza A, Isa MR, Ng P. Urinary incontinence in primigravida: the neglected pregnancy predicament. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2016;198:110-115.
  • 9. Akkus Y, Pinar G. Evaluation of the prevalence, type, severity, and risk factors of urinary incontinence and its impact on quality of life among women in Turkey. International urogynecology journal. 2016;27(6):887-893.
  • 10. Dolan LM, Walsh D, Hamilton S, Marshall K, Thompson K, Ashe RG. A study of quality of life in primigravidae with urinary incontinence. International Urogynecology Journal. 2004;15(3):160-164.
  • 11. Kocaöz S, Talas MS, Atabekoğlu CS. Urinary incontinence in pregnant women and their quality of life. Journal of clinical nursing. 2010;19(23‐24):3314-3323.
  • 12. Shek K, Dietz HP. Assessment of pelvic organ prolapse: a review. Ultrasound Obstet Gynecol. 2016;48(6):681-692.
  • 13. Dietz H, Lekskulchai O. Ultrasound assessment of pelvic organ prolapse: the relationship between prolapse severity and symptoms. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2007;29(6):688-691.
  • 14. Chantarasorn V, Dietz H. Diagnosis of cystocele type by clinical examination and pelvic floor ultrasound. Ultrasound in obstetrics & gynecology. 2012;39(6):710-714.
  • 15. Sargın MA, Yassa M, Taymur BD, Ergun E, Akca G, Tug N. Adaptation and validation of the Michigan incontinence severity index in a Turkish population. Patient preference and adherence. 2016;10:929.
  • 16. Suskind AM, Dunn RL, Morgan DM, DeLancey JO, McGuire EJ, Wei JT. The Michigan incontinence symptom index (M‐ISI): A clinical measure for type, severity, and bother related to urinary incontinence. Neurourology and urodynamics. 2014;33(7):1128-1134.
  • 17. Yassa M, Tug N. Uterus-preserving laparoscopic lateral suspension with mesh operation in pelvic organ prolapse: initial experience in a single tertiary center with a median 24-month follow-up. Geburtshilfe und Frauenheilkunde. 2019;79(9):983.
  • 18. Franco EM, Parés D, Colomé NL, Paredes JRM, Tardiu LA. Urinary incontinence during pregnancy. Is there a difference between first and third trimester? European Journal of Obstetrics & Gynecology and Reproductive Biology. 2014;182:86-90.
  • 19. Dietz HP, Moore KH, Steensma AB. Antenatal pelvic organ mobility is associated with delivery mode. Australian and New Zealand journal of obstetrics and gynaecology. 2003;43(1):70-74.
  • 20. Chan S, Cheung R, Yiu K, Lee L, Leung T, Chung T. Pelvic floor biometry during a first singleton pregnancy and the relationship with symptoms of pelvic floor disorders: a prospective observational study. BJOG: An International Journal of Obstetrics & Gynaecology. 2014;121(1):121-129.
  • 21. Reimers C, Stær‐Jensen J, Siafarikas F, Saltyte‐Benth J, Bø K, Ellström Engh M. Change in pelvic organ support during pregnancy and the first year postpartum: a longitudinal study. BJOG: An International Journal of Obstetrics & Gynaecology. 2016;123(5):821-829.
  • 22. Horowitz E, Yogev Y, Hod M, Kaplan B. Prolapse and elongation of the cervix during pregnancy. International journal of gynaecology and obstetrics. 2002;77(2):147-148.
  • 23. Wiafe YA, Whitehead B, Venables H, Dassah ET. Acceptability of intrapartum ultrasound by mothers in an African population. Journal of ultrasound. 2020;23(1):55-59.
Year 2022, Volume: 39 Issue: 1, 160 - 163, 01.01.2022

Abstract

Project Number

none

References

  • 1. Eason E, Labrecque M, Marcoux S, Mondor M. Effects of carrying a pregnancy and of method of delivery on urinary incontinence: a prospective cohort study. BMC pregnancy and childbirth. 2004;4(1):1-6.
  • 2. Wesnes SL, Rortveit G, Bø K, Hunskaar S. Urinary incontinence during pregnancy. Obstetrics & Gynecology. 2007;109(4):922-928.
  • 3. Dietz HP, Eldridge A, Grace M, Clarke B. Does pregnancy affect pelvic organ mobility? Australian and New Zealand Journal of Obstetrics and Gynaecology. 2004;44(6):517-520.
  • 4. Huebner M, Antolic A, Tunn R. The impact of pregnancy and vaginal delivery on urinary incontinence. International Journal of Gynecology & Obstetrics. 2010;110(3):249-251.
  • 5. Wesnes SL, Hunskår S, Bo K, Rortveit G. The effect of urinary incontinence status during pregnancy and delivery mode on incontinence postpartum. A cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. 2009;116(5):700-707.
  • 6. Çırpan T, Akercan F, Akman L, İtil İM, Askar N. Postpartum Incontinence in a Young Women: Report of a Case and Review of the Literatüre. Turk J Obstet Gynecol. 2005;2(3):246-248.
  • 7. Dietz HP, Steensma AB. Which women are most affected by delivery-related changes in pelvic organ mobility? European Journal of Obstetrics & Gynecology and Reproductive Biology. 2003;111(1):15-18.
  • 8. Abdullah B, Ayub S, Zahid AM, Noorneza A, Isa MR, Ng P. Urinary incontinence in primigravida: the neglected pregnancy predicament. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2016;198:110-115.
  • 9. Akkus Y, Pinar G. Evaluation of the prevalence, type, severity, and risk factors of urinary incontinence and its impact on quality of life among women in Turkey. International urogynecology journal. 2016;27(6):887-893.
  • 10. Dolan LM, Walsh D, Hamilton S, Marshall K, Thompson K, Ashe RG. A study of quality of life in primigravidae with urinary incontinence. International Urogynecology Journal. 2004;15(3):160-164.
  • 11. Kocaöz S, Talas MS, Atabekoğlu CS. Urinary incontinence in pregnant women and their quality of life. Journal of clinical nursing. 2010;19(23‐24):3314-3323.
  • 12. Shek K, Dietz HP. Assessment of pelvic organ prolapse: a review. Ultrasound Obstet Gynecol. 2016;48(6):681-692.
  • 13. Dietz H, Lekskulchai O. Ultrasound assessment of pelvic organ prolapse: the relationship between prolapse severity and symptoms. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2007;29(6):688-691.
  • 14. Chantarasorn V, Dietz H. Diagnosis of cystocele type by clinical examination and pelvic floor ultrasound. Ultrasound in obstetrics & gynecology. 2012;39(6):710-714.
  • 15. Sargın MA, Yassa M, Taymur BD, Ergun E, Akca G, Tug N. Adaptation and validation of the Michigan incontinence severity index in a Turkish population. Patient preference and adherence. 2016;10:929.
  • 16. Suskind AM, Dunn RL, Morgan DM, DeLancey JO, McGuire EJ, Wei JT. The Michigan incontinence symptom index (M‐ISI): A clinical measure for type, severity, and bother related to urinary incontinence. Neurourology and urodynamics. 2014;33(7):1128-1134.
  • 17. Yassa M, Tug N. Uterus-preserving laparoscopic lateral suspension with mesh operation in pelvic organ prolapse: initial experience in a single tertiary center with a median 24-month follow-up. Geburtshilfe und Frauenheilkunde. 2019;79(9):983.
  • 18. Franco EM, Parés D, Colomé NL, Paredes JRM, Tardiu LA. Urinary incontinence during pregnancy. Is there a difference between first and third trimester? European Journal of Obstetrics & Gynecology and Reproductive Biology. 2014;182:86-90.
  • 19. Dietz HP, Moore KH, Steensma AB. Antenatal pelvic organ mobility is associated with delivery mode. Australian and New Zealand journal of obstetrics and gynaecology. 2003;43(1):70-74.
  • 20. Chan S, Cheung R, Yiu K, Lee L, Leung T, Chung T. Pelvic floor biometry during a first singleton pregnancy and the relationship with symptoms of pelvic floor disorders: a prospective observational study. BJOG: An International Journal of Obstetrics & Gynaecology. 2014;121(1):121-129.
  • 21. Reimers C, Stær‐Jensen J, Siafarikas F, Saltyte‐Benth J, Bø K, Ellström Engh M. Change in pelvic organ support during pregnancy and the first year postpartum: a longitudinal study. BJOG: An International Journal of Obstetrics & Gynaecology. 2016;123(5):821-829.
  • 22. Horowitz E, Yogev Y, Hod M, Kaplan B. Prolapse and elongation of the cervix during pregnancy. International journal of gynaecology and obstetrics. 2002;77(2):147-148.
  • 23. Wiafe YA, Whitehead B, Venables H, Dassah ET. Acceptability of intrapartum ultrasound by mothers in an African population. Journal of ultrasound. 2020;23(1):55-59.
There are 23 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Clinical Research
Authors

Üzeyir Kalkan 0000-0001-5223-6697

Murat Yassa 0000-0001-8661-1192

Burçak Sevim This is me 0000-0002-8854-6088

Ayça Buran This is me 0000-0001-8898-3889

Pınar Birol 0000-0002-2194-0726

Arzu Tekin 0000-0001-8054-2624

Nıyazı Tug 0000-0001-7442-834X

Project Number none
Early Pub Date January 3, 2022
Publication Date January 1, 2022
Submission Date July 27, 2021
Acceptance Date August 31, 2021
Published in Issue Year 2022 Volume: 39 Issue: 1

Cite

APA Kalkan, Ü., Yassa, M., Sevim, B., Buran, A., et al. (2022). Changes in pelvic floor mobility in uncomplicated pregnant women over 28 gestational week and its relation with subjective urinary incontinence complaints. Journal of Experimental and Clinical Medicine, 39(1), 160-163.
AMA Kalkan Ü, Yassa M, Sevim B, Buran A, Birol P, Tekin A, Tug N. Changes in pelvic floor mobility in uncomplicated pregnant women over 28 gestational week and its relation with subjective urinary incontinence complaints. J. Exp. Clin. Med. January 2022;39(1):160-163.
Chicago Kalkan, Üzeyir, Murat Yassa, Burçak Sevim, Ayça Buran, Pınar Birol, Arzu Tekin, and Nıyazı Tug. “Changes in Pelvic Floor Mobility in Uncomplicated Pregnant Women over 28 Gestational Week and Its Relation With Subjective Urinary Incontinence Complaints”. Journal of Experimental and Clinical Medicine 39, no. 1 (January 2022): 160-63.
EndNote Kalkan Ü, Yassa M, Sevim B, Buran A, Birol P, Tekin A, Tug N (January 1, 2022) Changes in pelvic floor mobility in uncomplicated pregnant women over 28 gestational week and its relation with subjective urinary incontinence complaints. Journal of Experimental and Clinical Medicine 39 1 160–163.
IEEE Ü. Kalkan, “Changes in pelvic floor mobility in uncomplicated pregnant women over 28 gestational week and its relation with subjective urinary incontinence complaints”, J. Exp. Clin. Med., vol. 39, no. 1, pp. 160–163, 2022.
ISNAD Kalkan, Üzeyir et al. “Changes in Pelvic Floor Mobility in Uncomplicated Pregnant Women over 28 Gestational Week and Its Relation With Subjective Urinary Incontinence Complaints”. Journal of Experimental and Clinical Medicine 39/1 (January 2022), 160-163.
JAMA Kalkan Ü, Yassa M, Sevim B, Buran A, Birol P, Tekin A, Tug N. Changes in pelvic floor mobility in uncomplicated pregnant women over 28 gestational week and its relation with subjective urinary incontinence complaints. J. Exp. Clin. Med. 2022;39:160–163.
MLA Kalkan, Üzeyir et al. “Changes in Pelvic Floor Mobility in Uncomplicated Pregnant Women over 28 Gestational Week and Its Relation With Subjective Urinary Incontinence Complaints”. Journal of Experimental and Clinical Medicine, vol. 39, no. 1, 2022, pp. 160-3.
Vancouver Kalkan Ü, Yassa M, Sevim B, Buran A, Birol P, Tekin A, Tug N. Changes in pelvic floor mobility in uncomplicated pregnant women over 28 gestational week and its relation with subjective urinary incontinence complaints. J. Exp. Clin. Med. 2022;39(1):160-3.