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Published in: International Urogynecology Journal 1/2011

Open Access 01-01-2011 | Original Article

A questionnaire on pelvic floor dysfunction postpartum

Authors: Charlotte Luthander, Thomas Emilsson, Gunnar Ljunggren, Margareta Hammarström

Published in: International Urogynecology Journal | Issue 1/2011

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Abstract

Introduction and hypothesis

The incidence of obstetric anal sphincter injuries is used in Sweden as a measurement of quality of care and this might influence the reporting. However, the correlation between reported diagnosis of pelvic floor injury at delivery and pelvic floor symptoms a year later is unknown. A questionnaire could identify such symptoms and provide beneficial feedback to obstetrical practices.

Methods

We made a cross-sectional study by sending out a questionnaire about pelvic floor dysfunction to 599 women depending on reported injury at delivery. The answers provided by the groups were then compared.

Results

The questionnaire identified women with pelvic floor dysfunction. Anal incontinence was most common among women with obstetric anal sphincter injuries but also occurred among women delivered vaginally without known tears.

Conclusion

We suggest that a questionnaire is used 12–18 months after delivery to establish the short-time outcome in terms of pelvic floor dysfunction.
Literature
1.
go back to reference Rothbarth J, Bemelman WA, Meijerink WJ, Stiggelbout AM, Zwinderman AH, Buyze-Westerweel ME, Delemarre JB (2001) What is the impact of fecal incontinence on quality of life? Dis Colon Rectum 44:67–71CrossRefPubMed Rothbarth J, Bemelman WA, Meijerink WJ, Stiggelbout AM, Zwinderman AH, Buyze-Westerweel ME, Delemarre JB (2001) What is the impact of fecal incontinence on quality of life? Dis Colon Rectum 44:67–71CrossRefPubMed
2.
go back to reference Roos AM, Sultan AH, Thakar R (2009) St. Mark's incontinence score for assessment of anal incontinence following obstetric anal sphincter injuries (OASIS). Int Urogynecol J Pelvic Floor Dysfunct 20:407–410CrossRefPubMed Roos AM, Sultan AH, Thakar R (2009) St. Mark's incontinence score for assessment of anal incontinence following obstetric anal sphincter injuries (OASIS). Int Urogynecol J Pelvic Floor Dysfunct 20:407–410CrossRefPubMed
3.
go back to reference Due U, Ottesen M (2009) The Danish anal sphincter rupture questionnaire: validity and reliability. Acta Obstet Gynecol Scand 88:36–42CrossRefPubMed Due U, Ottesen M (2009) The Danish anal sphincter rupture questionnaire: validity and reliability. Acta Obstet Gynecol Scand 88:36–42CrossRefPubMed
4.
go back to reference Pauls RN, Occhino J, Dryfhout V, Karram MM (2008) Effects of Pregnancy on Body Image and Pelvic floor dysfunction; a prospective study. Int Urogynecol J Pelvic Floor Dysfunct 19(11):1495–1501CrossRefPubMed Pauls RN, Occhino J, Dryfhout V, Karram MM (2008) Effects of Pregnancy on Body Image and Pelvic floor dysfunction; a prospective study. Int Urogynecol J Pelvic Floor Dysfunct 19(11):1495–1501CrossRefPubMed
5.
go back to reference Snooks SJ, Swash M, Mathers SE, Henry MM (1990) Effect of vaginal delivery on the pelvic floor: a 5-year follow-up. Br J Surg 77:1358–1360CrossRefPubMed Snooks SJ, Swash M, Mathers SE, Henry MM (1990) Effect of vaginal delivery on the pelvic floor: a 5-year follow-up. Br J Surg 77:1358–1360CrossRefPubMed
6.
go back to reference Sultan AH, Kamm MA, Hudson CN, Thomas JM, Bartram CI (1993) Anal-sphincter disruption during vaginal delivery. N Engl J Med 329:1905–1911CrossRefPubMed Sultan AH, Kamm MA, Hudson CN, Thomas JM, Bartram CI (1993) Anal-sphincter disruption during vaginal delivery. N Engl J Med 329:1905–1911CrossRefPubMed
7.
go back to reference Sultan AH, Kamm MA, Hudson CN (1994) Pudendal nerve damage during labour: prospective study before and after childbirth. Br J Obstet Gynaecol 101:22–28CrossRefPubMed Sultan AH, Kamm MA, Hudson CN (1994) Pudendal nerve damage during labour: prospective study before and after childbirth. Br J Obstet Gynaecol 101:22–28CrossRefPubMed
8.
go back to reference Pirhonen JP, Grenman SE, Haadem K, Gudmundsson S, Lindqvist P, Siihola S, Erkkola RU, Marsal K (1998) Frequency of anal sphincter rupture at delivery in Sweden and Finland—result of difference in manual help to the baby's head. Acta Obstet Gynecol Scand 77:974–977CrossRefPubMed Pirhonen JP, Grenman SE, Haadem K, Gudmundsson S, Lindqvist P, Siihola S, Erkkola RU, Marsal K (1998) Frequency of anal sphincter rupture at delivery in Sweden and Finland—result of difference in manual help to the baby's head. Acta Obstet Gynecol Scand 77:974–977CrossRefPubMed
9.
go back to reference Zetterstrom J, Lopez A, Anzen B, Norman M, Holmstrom B, Mellgren A (1999) Anal sphincter tears at vaginal delivery: risk factors and clinical outcome of primary repair. Obstet Gynecol 94:21–28CrossRefPubMed Zetterstrom J, Lopez A, Anzen B, Norman M, Holmstrom B, Mellgren A (1999) Anal sphincter tears at vaginal delivery: risk factors and clinical outcome of primary repair. Obstet Gynecol 94:21–28CrossRefPubMed
10.
go back to reference Faltin DL, Otero M, Petignat P, Sangalli MR, Floris LA, Boulvain M, Irion O (2006) Women's health 18 years after rupture of the anal sphincter during childbirth: I. Fecal incontinence. Am J Obstet Gynecol 194:1255–1259CrossRefPubMed Faltin DL, Otero M, Petignat P, Sangalli MR, Floris LA, Boulvain M, Irion O (2006) Women's health 18 years after rupture of the anal sphincter during childbirth: I. Fecal incontinence. Am J Obstet Gynecol 194:1255–1259CrossRefPubMed
11.
go back to reference Poen AC, Felt-Bersma RJ, Dekker GA, Deville W, Cuesta MA, Meuwissen SG (1997) Third degree obstetric perineal tears: risk factors and the preventive role of mediolateral episiotomy. Br J Obstet Gynaecol 104:563–566CrossRefPubMed Poen AC, Felt-Bersma RJ, Dekker GA, Deville W, Cuesta MA, Meuwissen SG (1997) Third degree obstetric perineal tears: risk factors and the preventive role of mediolateral episiotomy. Br J Obstet Gynaecol 104:563–566CrossRefPubMed
12.
go back to reference Sultan AH, Kamm MA, Hudson CN, Bartram CI (1994) Third degree obstetric anal sphincter tears: risk factors and outcome of primary repair. BMJ 308:887–891PubMed Sultan AH, Kamm MA, Hudson CN, Bartram CI (1994) Third degree obstetric anal sphincter tears: risk factors and outcome of primary repair. BMJ 308:887–891PubMed
13.
go back to reference Groom KM, Paterson-Brown S (2002) Can we improve on the diagnosis of third degree tears? Eur J Obstet Gynecol Reprod Biol 101:19–21CrossRefPubMed Groom KM, Paterson-Brown S (2002) Can we improve on the diagnosis of third degree tears? Eur J Obstet Gynecol Reprod Biol 101:19–21CrossRefPubMed
14.
go back to reference Andrews V, Sultan AH, Thakar R, Jones PW (2006) Occult anal sphincter injuries—myth or reality? BJOG 113:195–200CrossRefPubMed Andrews V, Sultan AH, Thakar R, Jones PW (2006) Occult anal sphincter injuries—myth or reality? BJOG 113:195–200CrossRefPubMed
15.
go back to reference Faltin DL, Boulvain M, Floris LA, Irion O (2005) Diagnosis of anal sphincter tears to prevent fecal incontinence: a randomized controlled trial. Obstet Gynecol 106:6–13CrossRefPubMed Faltin DL, Boulvain M, Floris LA, Irion O (2005) Diagnosis of anal sphincter tears to prevent fecal incontinence: a randomized controlled trial. Obstet Gynecol 106:6–13CrossRefPubMed
16.
go back to reference Fornell EK, Berg G, Hallbook O, Matthiesen LS, Sjodahl R (1996) Clinical consequences of anal sphincter rupture during vaginal delivery. J Am Coll Surg 183:553–558PubMed Fornell EK, Berg G, Hallbook O, Matthiesen LS, Sjodahl R (1996) Clinical consequences of anal sphincter rupture during vaginal delivery. J Am Coll Surg 183:553–558PubMed
17.
go back to reference Tegerstedt G, Miedel A, Maehle-Schmidt M, Nyren O, Hammarstrom M (2005) A short-form questionnaire identified genital organ prolapse. J Clin Epidemiol 58:41–46CrossRefPubMed Tegerstedt G, Miedel A, Maehle-Schmidt M, Nyren O, Hammarstrom M (2005) A short-form questionnaire identified genital organ prolapse. J Clin Epidemiol 58:41–46CrossRefPubMed
18.
go back to reference Eliasson K, Nordlander I, Mattsson E, Larson B, Hammarstrom M (2004) Prevalence of urinary leakage in nulliparous women with respect to physical activity and micturition habits. Int Urogynecol J Pelvic Floor Dysfunct 15:149–153CrossRefPubMed Eliasson K, Nordlander I, Mattsson E, Larson B, Hammarstrom M (2004) Prevalence of urinary leakage in nulliparous women with respect to physical activity and micturition habits. Int Urogynecol J Pelvic Floor Dysfunct 15:149–153CrossRefPubMed
19.
go back to reference Uustal Fornell E (2003) Pelvic floor dysfunction: a clinical and epidemiological study. Univ, Linköping Uustal Fornell E (2003) Pelvic floor dysfunction: a clinical and epidemiological study. Univ, Linköping
20.
go back to reference Jorge JM, Wexner SD (1993) Etiology and management of fecal incontinence. Dis Colon Rectum 36:77–97CrossRefPubMed Jorge JM, Wexner SD (1993) Etiology and management of fecal incontinence. Dis Colon Rectum 36:77–97CrossRefPubMed
21.
go back to reference Fernando RJ, Sultan AH, Kettle C, Radley S, Jones P, O'Brien PM (2006) Repair techniques for obstetric anal sphincter injuries: a randomized controlled trial. Obstet Gynecol 107:1261–1268CrossRefPubMed Fernando RJ, Sultan AH, Kettle C, Radley S, Jones P, O'Brien PM (2006) Repair techniques for obstetric anal sphincter injuries: a randomized controlled trial. Obstet Gynecol 107:1261–1268CrossRefPubMed
22.
go back to reference Scheer I, Andrews V, Thakar R, Sultan AH (2008) Urinary incontinence after obstetric anal sphincter injuries (OASIS)—is there a relationship? Int Urogynecol J Pelvic Floor Dysfunct 19:179–183CrossRefPubMed Scheer I, Andrews V, Thakar R, Sultan AH (2008) Urinary incontinence after obstetric anal sphincter injuries (OASIS)—is there a relationship? Int Urogynecol J Pelvic Floor Dysfunct 19:179–183CrossRefPubMed
23.
go back to reference Glazener CM, Herbison GP, MacArthur C, Lancashire R, McGee MA, Grant AM, Wilson PD (2006) New postnatal urinary incontinence: obstetric and other risk factors in primiparae. BJOG 113:208–217CrossRefPubMed Glazener CM, Herbison GP, MacArthur C, Lancashire R, McGee MA, Grant AM, Wilson PD (2006) New postnatal urinary incontinence: obstetric and other risk factors in primiparae. BJOG 113:208–217CrossRefPubMed
24.
go back to reference Farrell SA, Allen VM, Baskett TF (2001) Parturition and urinary incontinence in primiparas. Obstet Gynecol 97:350–356CrossRefPubMed Farrell SA, Allen VM, Baskett TF (2001) Parturition and urinary incontinence in primiparas. Obstet Gynecol 97:350–356CrossRefPubMed
25.
go back to reference Fritsch H, Pinggera GM, Lienemann A, Mitterberger M, Bartsch G, Strasser H (2006) What are the supportive structures of the female urethra? Neurourol Urodyn 25:128–134CrossRefPubMed Fritsch H, Pinggera GM, Lienemann A, Mitterberger M, Bartsch G, Strasser H (2006) What are the supportive structures of the female urethra? Neurourol Urodyn 25:128–134CrossRefPubMed
26.
27.
go back to reference Tegerstedt G, Miedel A, Maehle-Schmidt M, Nyren O, Hammarstrom M (2006) Obstetric risk factors for symptomatic prolapse: a population-based approach. Am J Obstet Gynecol 194:75–81CrossRefPubMed Tegerstedt G, Miedel A, Maehle-Schmidt M, Nyren O, Hammarstrom M (2006) Obstetric risk factors for symptomatic prolapse: a population-based approach. Am J Obstet Gynecol 194:75–81CrossRefPubMed
28.
go back to reference Wagenius J, Laurin J (2003) Clinical symptoms after anal sphincter rupture: a retrospective study. Acta Obstet Gynecol Scand 82:246–250PubMed Wagenius J, Laurin J (2003) Clinical symptoms after anal sphincter rupture: a retrospective study. Acta Obstet Gynecol Scand 82:246–250PubMed
29.
go back to reference Poen AC, Felt-Bersma RJ, Strijers RL, Dekker GA, Cuesta MA, Meuwissen SG (1998) Third-degree obstetric perineal tear: long-term clinical and functional results after primary repair. Br J Surg 85:1433–1438CrossRefPubMed Poen AC, Felt-Bersma RJ, Strijers RL, Dekker GA, Cuesta MA, Meuwissen SG (1998) Third-degree obstetric perineal tear: long-term clinical and functional results after primary repair. Br J Surg 85:1433–1438CrossRefPubMed
30.
go back to reference Vaccaro C, Clemons JL (2008) Anal sphincter defects and anal incontinence symptoms after repair of obstetric anal sphincter lacerations in primiparous women. Int Urogynecol J Pelvic Floor Dysfunct 19:1503–1508CrossRefPubMed Vaccaro C, Clemons JL (2008) Anal sphincter defects and anal incontinence symptoms after repair of obstetric anal sphincter lacerations in primiparous women. Int Urogynecol J Pelvic Floor Dysfunct 19:1503–1508CrossRefPubMed
31.
go back to reference Mahony R, Behan M, Daly L, Kirwan C, O'Herlihy C, O'Connell PR (2007) Internal anal sphincter defect influences continence outcome following obstetric anal sphincter injury. Am J Obstet Gynecol 196(217):e211–e215 Mahony R, Behan M, Daly L, Kirwan C, O'Herlihy C, O'Connell PR (2007) Internal anal sphincter defect influences continence outcome following obstetric anal sphincter injury. Am J Obstet Gynecol 196(217):e211–e215
Metadata
Title
A questionnaire on pelvic floor dysfunction postpartum
Authors
Charlotte Luthander
Thomas Emilsson
Gunnar Ljunggren
Margareta Hammarström
Publication date
01-01-2011
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 1/2011
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-010-1243-9

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