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Published in: International Urogynecology Journal 4/2017

01-04-2017 | Original Article

Prevalence and impact of pelvic floor dysfunction in an adult cystic fibrosis population: a questionnaire survey

Authors: Rebecca Chambers, Adam Lucht, Aisling Reihill, Judith Hough

Published in: International Urogynecology Journal | Issue 4/2017

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Abstract

Introduction and Hypothesis

Pelvic floor (PF) dysfunction in patients with cystic fibrosis (CF) is poorly understood due to lack of research. The aim of this study was to examine the prevalence, risk factors and bothersomeness of PF dysfunction and its implications for the clinical management of CF.

Methods

Of 64 adults with CF approached at a tertiary hospital, 60 were surveyed. A clinically meaningful score on the Australian Pelvic Floor Questionnaire (APFQ) is ≥1 in each of the bladder, bowel, sexual function and prolapse sections or a global PF score of ≥3. A frequency Likert scale was used to analyse the impact of PF dysfunction on the ability to perform physiotherapy lung management when well and unwell.

Results

The prevalence of clinically meaningful bladder dysfunction was 39 % in women and 12 % in men, the prevalence of bowel dysfunction was 54 % in women and 44 % in men, and the prevalence of sexual dysfunction was 43 % in women and 65 % in men. APFQ scores were clinically meaningful only for bowel dysfunction in women (median 1.47, IQR 0.59 – 2.28). PF dysfunction constrains lung management in up to 22 % of patients when well and in 37 % of patients when unwell.

Conclusions

PF dysfunction affects the adult CF population, with PF symptoms limiting the ability of up to one in three patients to participate in physiotherapy management.
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Literature
1.
go back to reference Baessler K, O’Neill S, Maher C, Battistutta D. Australian pelvic floor questionnaire: a validated interviewer-administered pelvic floor questionnaire for routine clinic and research. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(2):149–158.CrossRefPubMed Baessler K, O’Neill S, Maher C, Battistutta D. Australian pelvic floor questionnaire: a validated interviewer-administered pelvic floor questionnaire for routine clinic and research. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(2):149–158.CrossRefPubMed
2.
go back to reference MacLennan AH, Taylor AW, Wilson DH, Wilson D. The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery. Br J Obstet Gynaecol. 2000;107(12):1460–1470.CrossRef MacLennan AH, Taylor AW, Wilson DH, Wilson D. The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery. Br J Obstet Gynaecol. 2000;107(12):1460–1470.CrossRef
3.
go back to reference Smith JA. Cough frequency and patterns of cough in cystic fibrosis. J R Soc Med. 2006;99 Suppl 46:17–22.PubMed Smith JA. Cough frequency and patterns of cough in cystic fibrosis. J R Soc Med. 2006;99 Suppl 46:17–22.PubMed
5.
go back to reference White D, Stiller K, Roney F. The prevalence and severity of symptoms of incontinence in adult cystic fibrosis patients. Physiother Theory Pract. 2000;16(1):35–42.CrossRef White D, Stiller K, Roney F. The prevalence and severity of symptoms of incontinence in adult cystic fibrosis patients. Physiother Theory Pract. 2000;16(1):35–42.CrossRef
6.
go back to reference Dufeu N, Vitton V, Coltey B, Gomez C, Baumstark K, Bouvier M, et al. Fecal incontinence in adult CF patients: prevalence. J Cyst Fibros. 2013;12 Suppl 1:S112.CrossRef Dufeu N, Vitton V, Coltey B, Gomez C, Baumstark K, Bouvier M, et al. Fecal incontinence in adult CF patients: prevalence. J Cyst Fibros. 2013;12 Suppl 1:S112.CrossRef
7.
go back to reference Henman S, Barker H, Haworth C, Floto A, Adler A, Lyons A, et al. Prevalence of erectile dysfunction in cystic fibrosis. J Cyst Fibros. 2010;9 Suppl 1:S103.CrossRef Henman S, Barker H, Haworth C, Floto A, Adler A, Lyons A, et al. Prevalence of erectile dysfunction in cystic fibrosis. J Cyst Fibros. 2010;9 Suppl 1:S103.CrossRef
8.
go back to reference Wat D, Henman S, Barker H, Floto A, Adler A, Lyons A, et al. Aetiology of erectile dysfunction in cystic fibrosis. J Cyst Fibros. 2011;10 Suppl 1:S94.CrossRef Wat D, Henman S, Barker H, Floto A, Adler A, Lyons A, et al. Aetiology of erectile dysfunction in cystic fibrosis. J Cyst Fibros. 2011;10 Suppl 1:S94.CrossRef
9.
go back to reference Moran F, Bradley J, Boyle L, Elborn J. Incontinence in adult females with cystic fibrosis: a Northern Ireland survey. Int J Clin Pract. 2003;57(3):182–183.PubMed Moran F, Bradley J, Boyle L, Elborn J. Incontinence in adult females with cystic fibrosis: a Northern Ireland survey. Int J Clin Pract. 2003;57(3):182–183.PubMed
10.
go back to reference Gumery L, Lee J, Whitehouse J, Honeybourne D. The prevalence of urinary incontinence in adult cystic fibrosis males. J Cyst Fibros. 2005;4 Suppl 1:S97. Gumery L, Lee J, Whitehouse J, Honeybourne D. The prevalence of urinary incontinence in adult cystic fibrosis males. J Cyst Fibros. 2005;4 Suppl 1:S97.
12.
go back to reference McIntosh L, Ridley S, Innes JA. Multi-centre questionnaire survey of the incidence, prevalence and severity of urinary stress incontinence in women with CF in Scotland. J Cyst Fibros. 2006;5 Suppl 1:S98.CrossRef McIntosh L, Ridley S, Innes JA. Multi-centre questionnaire survey of the incidence, prevalence and severity of urinary stress incontinence in women with CF in Scotland. J Cyst Fibros. 2006;5 Suppl 1:S98.CrossRef
13.
go back to reference Baessler K, O’Neill S, Maher C, Battistutta D. A validated self-administered female pelvic floor questionnaire. Int Urogynecol J Pelvic Floor Dysfunct. 2010;21(2):163–172.CrossRef Baessler K, O’Neill S, Maher C, Battistutta D. A validated self-administered female pelvic floor questionnaire. Int Urogynecol J Pelvic Floor Dysfunct. 2010;21(2):163–172.CrossRef
14.
go back to reference Frankel SJ, Donovan JL, Peters TI, Abrams P, Dabhoiwala NF, Osawa D, et al. Sexual dysfunction in men with lower urinary tract symptoms. J Clin Epidemiol. 1998;51(8):677–685.CrossRefPubMed Frankel SJ, Donovan JL, Peters TI, Abrams P, Dabhoiwala NF, Osawa D, et al. Sexual dysfunction in men with lower urinary tract symptoms. J Clin Epidemiol. 1998;51(8):677–685.CrossRefPubMed
15.
go back to reference Donovan JL, Abrams P, Peters TJ, Kay HE, Reynard J, Chapple C, et al. The ICS-‘BPH’ study: the psychometric validity and reliability of the ICSmale questionnaire. BJU Int. 1996;77(4):554–562.CrossRef Donovan JL, Abrams P, Peters TJ, Kay HE, Reynard J, Chapple C, et al. The ICS-‘BPH’ study: the psychometric validity and reliability of the ICSmale questionnaire. BJU Int. 1996;77(4):554–562.CrossRef
16.
go back to reference Donovan J, Kay H, Peters T, Abrams P, Coast J, Matos-Ferreira A, et al. Using the ICSQoL to measure the impact of lower urinary tract symptoms on quality of life: evidence from the ICS-‘BPH’ study. BJU Int. 1997;80(5):712–721.CrossRef Donovan J, Kay H, Peters T, Abrams P, Coast J, Matos-Ferreira A, et al. Using the ICSQoL to measure the impact of lower urinary tract symptoms on quality of life: evidence from the ICS-‘BPH’ study. BJU Int. 1997;80(5):712–721.CrossRef
17.
go back to reference Likert R. A technique for the development of attitude scales. Educ Psychol Meas. 1952;12:313–315.CrossRef Likert R. A technique for the development of attitude scales. Educ Psychol Meas. 1952;12:313–315.CrossRef
18.
go back to reference Quanjer P, Stanojevic S, Cole T, Baur X, Hall G, Culver B, et al. Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Eur Respir J. 2012;40(6):1324–1343.CrossRefPubMedPubMedCentral Quanjer P, Stanojevic S, Cole T, Baur X, Hall G, Culver B, et al. Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Eur Respir J. 2012;40(6):1324–1343.CrossRefPubMedPubMedCentral
19.
go back to reference Thomas S, Stokes A, Angulatta V, Ketchell I, Duckers J. Stress urinary incontinence in adult CF patients: prevalence and physiotherapy management in Wales. J Cyst Fibros. 2012;11:S109.CrossRef Thomas S, Stokes A, Angulatta V, Ketchell I, Duckers J. Stress urinary incontinence in adult CF patients: prevalence and physiotherapy management in Wales. J Cyst Fibros. 2012;11:S109.CrossRef
20.
go back to reference Vella M, Cartwright R, Cardozo L, Parsons M, Madge S, Burns Y. Prevalence of incontinence and incontinence-specific quality of life impairment in women with cystic fibrosis. Neurourol Urodyn. 2009;28(8):986–989.CrossRefPubMed Vella M, Cartwright R, Cardozo L, Parsons M, Madge S, Burns Y. Prevalence of incontinence and incontinence-specific quality of life impairment in women with cystic fibrosis. Neurourol Urodyn. 2009;28(8):986–989.CrossRefPubMed
21.
go back to reference Hodges PW, Heijnen I, Gandevia SC. Postural activity of the diaphragm is reduced in humans when respiratory demand increases. J Physiol. 2001;537(Pt 3):999–1008.CrossRefPubMedPubMedCentral Hodges PW, Heijnen I, Gandevia SC. Postural activity of the diaphragm is reduced in humans when respiratory demand increases. J Physiol. 2001;537(Pt 3):999–1008.CrossRefPubMedPubMedCentral
22.
go back to reference Staskin D, Tubaro A, Norton PA, Ashton-Miller JA. Mechanisms of continence and surgical cure in female and male SUI: surgical research initiatives. Neurourol Urodyn. 2011;30(5):704–707.CrossRefPubMed Staskin D, Tubaro A, Norton PA, Ashton-Miller JA. Mechanisms of continence and surgical cure in female and male SUI: surgical research initiatives. Neurourol Urodyn. 2011;30(5):704–707.CrossRefPubMed
23.
go back to reference van der Doef H, Kokke F, Beek F, Woestenenk J, Froeling S, Houwen R. Constipation in pediatric cystic fibrosis patients: an underestimated medical condition. J Cyst Fibros. 2010;9(1):59–63.CrossRefPubMed van der Doef H, Kokke F, Beek F, Woestenenk J, Froeling S, Houwen R. Constipation in pediatric cystic fibrosis patients: an underestimated medical condition. J Cyst Fibros. 2010;9(1):59–63.CrossRefPubMed
24.
go back to reference Durnea C, Khashan A, Kenny L, Tabirca S, O’Reilly B. An insight into pelvic floor status in nulliparous women. Int Urogynecol J Pelvic Floor Dysfunct. 2014;25(3):337–345.CrossRef Durnea C, Khashan A, Kenny L, Tabirca S, O’Reilly B. An insight into pelvic floor status in nulliparous women. Int Urogynecol J Pelvic Floor Dysfunct. 2014;25(3):337–345.CrossRef
25.
go back to reference Longo L, Speri S, Sartori G, Doro R. Vaginal disorders in CF women: preliminary results of a nurse led study. J Cyst Fibros. 2002;1 Suppl 1:S172. Longo L, Speri S, Sartori G, Doro R. Vaginal disorders in CF women: preliminary results of a nurse led study. J Cyst Fibros. 2002;1 Suppl 1:S172.
26.
go back to reference Wilschanski M, Corey M, Durie P, Tullis E, Bain J, Asch M, et al. Diversity of reproductive tract abnormalities in men with cystic fibrosis. JAMA. 1996;276(8):607–608.CrossRefPubMed Wilschanski M, Corey M, Durie P, Tullis E, Bain J, Asch M, et al. Diversity of reproductive tract abnormalities in men with cystic fibrosis. JAMA. 1996;276(8):607–608.CrossRefPubMed
27.
go back to reference Button BM, Sherburn M, Chase J, McLachlan Z, Kotsimbos T, Wilson J. Urinary incontinence and bowel problems in women with CF and chronic obstructive pulmonary disease (COPD) compared with controls. J Cyst Fibros. 2004;3 Suppl 1:S94. Button BM, Sherburn M, Chase J, McLachlan Z, Kotsimbos T, Wilson J. Urinary incontinence and bowel problems in women with CF and chronic obstructive pulmonary disease (COPD) compared with controls. J Cyst Fibros. 2004;3 Suppl 1:S94.
28.
go back to reference Cornacchia M, Zenorini A, Perobelli S, Zanolla L, Mastella G, Braggion C. Prevalence of urinary incontinence in women with cystic fibrosis. BJU Int. 2001;88(1):44–48.CrossRefPubMed Cornacchia M, Zenorini A, Perobelli S, Zanolla L, Mastella G, Braggion C. Prevalence of urinary incontinence in women with cystic fibrosis. BJU Int. 2001;88(1):44–48.CrossRefPubMed
29.
go back to reference Schwartz CE, Sprangers MA. Methodological approaches for assessing response shift in longitudinal health-related quality-of-life research. Soc Sci Med. 1999;48(11):1531–1548.CrossRefPubMed Schwartz CE, Sprangers MA. Methodological approaches for assessing response shift in longitudinal health-related quality-of-life research. Soc Sci Med. 1999;48(11):1531–1548.CrossRefPubMed
30.
go back to reference The Thoracic Society of Australia and New Zealand. Physiotherapy for cystic fibrosis in Australia: a consensus statement. International Physiotherapy Group for Cystic Fibrosis, Australian Chapter. The Thoracic Society of Australia and New Zealand, Sydney, NSW. 2008. The Thoracic Society of Australia and New Zealand. Physiotherapy for cystic fibrosis in Australia: a consensus statement. International Physiotherapy Group for Cystic Fibrosis, Australian Chapter. The Thoracic Society of Australia and New Zealand, Sydney, NSW. 2008.
Metadata
Title
Prevalence and impact of pelvic floor dysfunction in an adult cystic fibrosis population: a questionnaire survey
Authors
Rebecca Chambers
Adam Lucht
Aisling Reihill
Judith Hough
Publication date
01-04-2017
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 4/2017
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-016-3152-z

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