The pelvic floor requires an integrated anatomical structure owing to its multiple functions. Therefore, it is necessary to study methods for improving muscle recruitment during training. This study ...aimed to analyze the effect of using an innovative vaginal trainer on the bioelectrical activity of the pelvic floor muscles. Pelvic positioning and interference factors, such as age, childbirth, sexual activity, urinary incontinence, and menopause, were also analyzed. A cross-sectional study assessed 30 women using an evaluation form, International Consultation on Incontinence Questionnaire-Short Form, and surface electromyography. The root mean square of a 5-second contraction period, peak root mean square values, area values, % maximal voluntary contraction (root mean square normalized by peak signal), and median frequency were collected. These findings with and without the use of a vaginal educator were compared in the anteversion, neutral, and retroversion pelvic positions. The use of a vaginal educator was found to increase the electromyographic activity of the pelvic floor muscles in the neutral position. In this position, older women showed an increased peak contraction when using the educator. Multiparas also benefited from increased bioelectric activity (root mean square and area). Sexually active women increased their bioelectric activity in a neutral position when using the trainer, exerting less effort in retroversion (%-maximal voluntary contraction). Incontinent and menopausal women exhibited slower body-building activation (decreased frequency) with the device, which requires further investigation. Our innovative biofeedback device induced greater recruitment of muscle fibers, is more effective in the neutral pelvic position, and may be effective in training the pelvic floor muscles, even in women with a greater tendency toward pelvic floor dysfunction.
Obstetric causes are classified as direct (complications of pregnancy, childbirth or the puerperium) or indirect (caused by pregnancy but not directly caused by it). This study aimed to analyze ...maternal mortality from obstetric causes in Brazil from 2011 to 2021.
This was an ecological study on mortality and live births. The outcomes were the specific risk of mortality from direct and indirect cause adjustment and death during pregnancy and the puerperium. Binary and multiple linear logistic regressions were used to assess the influence of sociodemographic factors and maternal and child health indicators on maternal mortality and time of death (pregnancy and puerperium).
Regarding mortality during pregnancy and during the puerperium, increased (p = 0.003) and decreased (p = 0.004) mortality over the years, respectively; residing in the northern region was associated with lower (p < 0.05) and greater (p = 0.035) odds; and the Maternal Mortality Committee was the primary and least active source of investigation, respectively (p < 0.0001). The number of deaths from indirect causes increased with age (p < 0.001) and in the northern region (p = 0.011) and decreased in the white (< 0.05) and stable union (0.002) regions. Specifically, for mortality risk, the age group women aged 15-19 years presented an increase in cesarean section (p < 0.001) was greater than that of women who had < 4 antenatal visits (p < 0.001), education women who completed high school (8 to 11 years) was greater when they had < 4 prenatal visits (p = 0.018), and marital status unmarried women had more than 4 antenatal visits (p < 0.001); cesarean birth (p = 0.010) and < 4 antenatal visits (p = 0.009) were predictors of marriage; and women in a stable union who had < 4 prenatal visits and live births to teenage mothers (p < 0.001) were predictors. Women who had no education (p = 0.003), were divorced (p = 0.036), had cesarean deliveries (p < 0.012), or lived in the north or northeast (p < 0.008) had higher indirect specific mortality risk.
Sociodemographic factors and maternal and child health indicators were related to different patterns of obstetric mortality. Obstetric mortality varied by region, marital status, race, delivery, prenatal care, and cause of death.
Stress urinary incontinence (SUI) results from an increase in intravesical pressure, which exceeds the pressure at which the urethra remains closed. Symptoms cause social and sexual intercourse ...discomfort directly or indirectly, which affect health-related quality of life and are associated with pelvic floor muscle (PFM) dysfunction. We aimed to verify the variation in strength and PFM bioelectrical activity and sexual function in women with SUI. Additionally, we analyzed the impact of this dysfunction on quality of life. This was an observational cross-sectional study. Women aged 25−55 years with frequent sexual intercourse were included. Women with SUI were included in a study group (G2, n = 17), and those without any type of incontinence were included in a control group (G1, n = 16). Primary outcomes were level of strength and PFM bioelectrical activity and sexual function as determinants of worse SUI in the control group. Secondary outcomes were associated between the primary outcomes and severity of urinary loss, impact on daily life, and quality of life in women with SUI. In the domains evaluated in the Female Sexual Function Index (FSFI), only sexual desire was lower in women with SUI (G2) than in the controls (p = 0.033). During analysis of G1 variables, a positive and moderate correlation was observed between power/myoeletric activation and maximum voluntary contraction (MVC) (p < 0.01), peak (p < 0.01), and mean amplitudes (p = 0.017). There was a high positive correlation between sexual arousal and other variables, including vaginal lubrication, sexual orgasm, and total FSFI value (p < 0.001 for all analyses). During evaluation of G2 variables, the MVC was positively correlated with the peak and mean amplitudes (p < 0.0001). Additionally, there was a high and positive correlation between the mean amplitudes (%MVC) and personal relationships (KHQ) (p = 0.001); the same was observed between the total (ICIQ) and activities of daily living (ICIQ) (p < 0.0001). Therefore, women with SUI presented with lower sexual desire and bioelectric activity but were not related to PFM strength. Additionally, the domains of sexual function and certain variables of quality of life are aggravated by SUI.
Pelvic floor musculature assessment methods are generally invasive, subjective, and technologically expensive. Therefore, there is a need to identify other methods that can predict changes in the ...function of these muscles. This study aimed to verify whether the levels of strength and myoelectric activity of pelvic floor muscles (PFM) can be related to handgrip strength (HGS), to ensure faster and earlier identification of possible dysfunctions of this musculature. Furthermore, we verified whether these variables vary across different age groups. This was a cross-sectional observational study involving 44 healthy women. The women were divided into two groups: the young (18−35 years) and middle-aged (36−55 years) adult groups. Social, anthropometric, and clinical data were collected from the participants, and a functional assessment of their PFM was performed by bidigital palpation, electromyographic biofeedback (sEMG), and HGS (using a dynamometer). The levels of physical and sexual activity were measured using the International Physical Activity Questionnaire (IPAQ) and Sexual Quotient−Female version (SQ-F) questionnaire. There were no differences in HGS, power/pressure, sEMG, SQ-F score, or IPAQ score between the two groups (p > 0.05). Moderate correlation (r = 0.601; p = 0.019) was observed during multivariate analysis. HGS is related to mean amplitudes (p = 0.123), MVC (p = 0.043), sexual function (p = 0.049), and physical activity (p = 0.004). We therefore conclude that there were no differences between HGS and PFM strength in young adult and middle-aged women. Furthermore, HGS is related to the PFM functionality, sexual function, and physical activity.
Background: The Pilates Method is a program of physical and mental training that involves the whole body, aiming at the gain of muscular strength, mainly of the central region, formed by the ...abdominal muscles, the spine and the pelvic floor muscles (PFM). The PFM responds to sexual stimulation, with increased local blood circulation and involuntary contractions during orgasm. The training of this musculature assists in the female sexual function. Objective: To evaluate the influence of Pilates Mat associated with perineal contraction in the female sexual response. Method: Uncontrolled clinical trial in which participated twelve women between 20 and 50 years old, who performed Mat Pilates classes associated with perineal exercises, three times a week. The sexual response was evaluated through the Female Sexual Function Index (FSFI) and the contraction capacity of PFM through the Functional Evaluation of the Pelvic Floor (FEPF) before and after 21 sessions. Results: Given the proposed treatment, the FSFI responded positively (0.0099), with an improvement in the median and interquartile range that initially was 25.6 ± 5.4 and increased to 28.4 ± 1.2. The Functional Evaluation of the Pelvic Floor (FEPF) also achieved significant improvement (p= 0.0077), increased from the initial median and interquartile range of 2 ± 1.5 to 4 ± 1. Conclusion: Mat Pilates provides encouraging results, and its use is relevant to promote improved sexual response and strength gain of the pelvic floor muscle.
RESUMO O objetivo deste artigo é avaliar o índice de função sexual de mulheres submetidas à histerectomia total com ooforectomia bilateral (HT-OB), a prevalência de incontinência urinária por esforço ...(IUE) e sua associação com a realização desse procedimento cirúrgico em um hospital de referência em Belém (PA). Foram incluídas 162 mulheres, com vida sexual ativa, alocadas em dois grupos: aquelas que realizaram HT-OB em período superior a 12 meses (n=68), e aquelas que não realizaram (n=94). Utilizou-se o questionário female sexual function index (FSFI) para avaliação da função sexual, e um questionário desenvolvido pelos pesquisadores para coletar dados sociais, econômicos e clínicos, incluindo informações quanto à presença de IUE. O valor de significância foi definido como p<0,05. Houve diferença significativa no índice de função sexual entre o grupo HT-OB e o grupo-controle, com escore geral do FSFI de 23,56 e 28,68, respectivamente (p=0,0001). Os domínios desejo, excitação, lubrificação (p<0,0001), orgasmo (p=0,04), satisfação (p=0,0006) e dor (p=0,015) apresentaram escores inferiores em mulheres histerectomizadas. A prevalência de sintomas de IUE no grupo HT-OB foi de 35,3%, sendo observada associação significativa entre a presença desses sintomas e a realização da histerectomia (p=0,02). Mulheres que realizam HT-OB têm maior risco de disfunção sexual, e este procedimento cirúrgico é associado ao desenvolvimento de IUE.
ABSTRACT The objective of this article was to evaluate the sexual function index of women submitted to total hysterectomy with bilateral oophorectomy (THBO), the prevalence of urinary incontinence (SUI) and its association with the performance of this surgical procedure in a reference hospital in Belém, Pará. One hundred sixty-two women with active sexual life were included in two groups: those who have undergone THBO for more than 12 months (n=68), and those who have not (n=94). The Female Sexual Function Index (FSFI) questionnaire was used to evaluate sexual function along with a questionnaire developed by the researchers to collect social, economic and clinical data, including information on the presence of SUI. The significance level was defined as p<0.05. There was a significant difference in the sexual function index between THBO group and the control group, with an FSFI overall score of 23.56 and 28.68, respectively (p=0.0001). Desire, arousal, lubrication (p<0.0001), orgasm (p=0.04), satisfaction (p=0.0006) and pain (p=0.015) domains had lower scores in hysterectomized women. The prevalence of SUI symptoms in THBO group was 35.3%, and a significant association was observed between the presence of SUI and hysterectomy (p=0.02). Women who undergo THBO have a higher risk of sexual dysfunction, and this surgical procedure is associated with the development of SUI.
RESUMEN El presente artículo tuvo el objetivo de evaluar el índice de función sexual de mujeres sometidas a histerectomía total con ooforectomía bilateral (HT-OB), la prevalencia de incontinencia urinaria de esfuerzo (IUE) y su asociación con la realización de este procedimiento quirúrgico en un hospital de referencia en Belém (Brasil). Se incluyeron a 162 mujeres con vida sexual activa, que fueron divididas en dos grupos: las que se sometieron a HT-OB durante el período superior a 12 meses (n=68) y las que no lo había hecho (n=94). Se les aplicaron el cuestionario female sexual function index (FSFI), para evaluar la función sexual, y un cuestionario desarrollado por investigadores para recopilar datos sociales, económicos y clínicos, con informaciones en cuanto a la presencia de IUE. El valor de significación fue de p<0,05. Hubo una diferencia significativa en el índice de función sexual entre el grupo HT-OB y el grupo control, con un puntaje general de FSFI de 23,56 y 28,68, respectivamente (p=0,0001). Los dominios deseo, excitación, lubricación (p<0,0001), orgasmo (p=0,04), satisfacción (p=0,0006) y dolor (p=0,015) tuvieron puntajes más bajos en mujeres histerectomizadas. La prevalencia de síntomas de IUE fue del 35,3% en el grupo HT-OB, además se observó una asociación significativa entre la presencia de estos síntomas y la realización de la histerectomía (p=0,02). Las mujeres que se someten a HT-OB tienen un mayor riesgo de disfunción sexual, y este procedimiento quirúrgico está asociado al desarrollo de IUE.
Background: Sexual dysfunctions constitute a public health problem that affects many women during all stages of life, being able to influence physical and mental health, interfering with quality of ...life. Physical therapy plays a fundamental role in addressing these dysfunctions, with simple and low cost resources, promoting significant results in these cases. Objective: To analyze the effectiveness of a physical therapy protocol on the sexual function of women with genital-pelvic pain/penetration disorder. Methods: Uncontrolled clinical trial, in which participated 15 women with a mean age of 28 ± 4.2 years, who had 16 physical therapy sessions twice a week. The pelvic physiotherapy protocol consisted of the application of electroanalgesia, perineal massage, kinesiotherapy and vaginal dilators. Sexual function was assessed by the Female Sexual Function Index (FSFI) and pain by the Visual Analog Scale (VAS). Results: Given the proposed treatment, the FSFI responded significantly (p=0.0003) with a median improvement that was 19.70 initially and increased to 28.40 later. The VAS also obtained significant improvement (p=0.0003), from the initial median of 8.00 to final 0.00. Conclusion: It is suggested that the physical therapy program has brought significant results in sexual function and pain in women with genital-pelvic pain/penetration disorder.
Relation Between Episiotomy and Osteomioarticular Symptoms Rodrigues, Cibele Nazaré Câmara; Filho, Milton Fernandes da Conceição; Guimarães da Silva, Diego Sá ...
European Scientific Journal (Kocani),
10/2016, Letnik:
12, Številka:
30
Journal Article
Childbirth is a social and cultural phenomenon which has faced drastic changes from twentieth century as a shift to a gynecological position and an episiotomy routine. Fascia represents “the ...philosophy of the body” and any pathologic alteration in that tissue will affect the whole body. This study aims to verify the relation between episiotomy and osteomioarticular symptoms. 60 women who participated in this study were divided equally into two groups: group I (vaginal delivery with episiotomy) and group II (vaginal delivery without episiotomy). To assess them, we used an Initial assessment form and a Nordic Musculoskeletal Questionnaire. The data were analyzed with the Spearman Correlation Test and t Student Test for independent samples with a statistical significance of p≤0,05. Based on the results of the study, 60% women from group I related low back repercussions during the last year, while 53% women from group I related hip/lower limbs repercussions during the last week. Level of pain and musculoskeletal complaints prevailed in group I, as well. We concluded that there is a high prevalence of osteomioarticular symptoms in women who had episiotomy in her deliveries.
A disfunção sexual feminina abrange condições caracterizadas por alterações na resposta sexual típica em um ou mais das seguintes área do ciclo da resposta sexual: desejo, excitação, orgasmo ou dor. ...A Fisioterapia direcionada ao assoalho pélvico da mulher pode fortalecer a musculatura e proporcionar melhor consciência do próprio corpo, dando-lhe assim, condições de uma vida sexual satisfatória. O objetivo deste estudo é descrever a percepção de mulheres sobre a qualidade da função sexual/afetiva após o tratamento de fisioterapia pélvica para a disfunção sexual. Trata-se de uma pesquisa qualitativa envolvendo entrevistas semiestruturadas com mulheres que realizaram tratamento fisioterapêutico para disfunção sexual. O tratamento e a análise de dados foram baseadas na técnica de Análise de Conteúdo. As entrevistadas avaliam positivamente a terapia a qual foram submetidas, com destaque à humanização das fisioterapeutas que a atenderam, além da melhora física de suas disfunções, com impacto em seus relacionamentos sexuais e afetivos.
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