Pelvic organ prolapse and pelvic floor muscle strength

[摘要] English: The objective of the study was to research the relationship between pelvic floor muscle strength (PFMS) and pelvic organ prolapse (POP), and to find a threshold of PFMS where POP will manifest itself.A clinical cross-sectional analytic study was indicated. PFMS was tested with digital assessment using the modified Oxford scale and EMG testing with a vaginal electrode. Prolapse was assessed with the Pelvic Organ Prolapse Quantification (POP-Q) terminology. The analysis included 117 women.The correlation (-0.57) of the digital assessment of PFMS with POP is significant (p < 0.0001). 100% of women with grade 0 PFMS had a POP (POP-Q stage I-IV), while only 30% of women with a grade 5 PFMS had a POP of lesser severity (only stage I). Regarding EMG measurement of PFMS, there was a moderately significant correlation (r = -0.62; p < 0,001). However, one of the most interesting findings of the study was a significant correlation (-0.55) between the endurance of the PFM as was measured with EMG and POP (p < 0.0001). Women with either a stage 0 or I POP could hold a PFM contraction at a target set at 50% of the average of their three maximum contractions for a median of 12 seconds, while women with a more severe POP (stage II, III and IV) could hold the contraction for only 1 to 3 seconds.The results confirm clinical observations of the correlation between a weak PFM and a more severe POP. The study demonstrated that the threshold of PFMS where symptomatic POP manifests itself is grade 2 regarding digital testing using a modified Oxford scale (positive predictive value 60%; negative predictive value 85%; accuracy 73%) and 15μV when using EMG-testing (positive predictive value 60%; negative predictive value 68%; accuracy 74%).These results have clinical implications: women with a risk for developing symptomatic POP can be identified earlier and treated conservatively.

[发布机构] University of the Free State