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International Urogynecology Journal

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01-10-2013 | Original Article

The improvement of pelvic floor muscle function in POP patients after the Prolift procedure: results from surface electromyography

Authors: Lihua Wang, Xinliang Chen, Xiaocui Li, Yao Gong, Huaifang Li, Xiaowen Tong

Published in: International Urogynecology Journal | Issue 10/2013

Abstract

Introduction and hypothesis

Patients with pelvic organ prolapse (POP) have lower pelvic floor muscle (PFM) function. We hypothesized that pelvic reconstructive surgery could improve PFM function and strength.

Methods

The controlled, nonrandomized study recruited 37 POP patients in the Prolift group and 30 non-POP patients in the control group. Two urogynecologists performed the Prolift procedure. One experienced physiotherapist who was blinded to the grouping conducted the surface electromyography (SEMG) evaluation using an intravaginal probe. The patient was considered objectively cured if she had stage 0 or I according to the Pelvic Organ Prolapse Quantification system (POP-Q) at the 3rd month postoperatively. Two types of contractions, namely maximum voluntary contraction (MVC) and short, fast contractions (SFC) in 6 s were performed at each SEMG measurement. The SEMG data were collected once in the control group on admission and twice in the Prolift group (on admission and at the 3rd month postoperatively). The t test, Mann–Whitney U test, and Wilcoxon test were used for statistical analysis.

Results

A total of 36 POP patients were cured by the Prolift procedure. At the 3-month follow-up, the voltage and duration of MVC as well as the numbers and voltage of SFC increased significantly in the Prolift group. These variables were lower in POP patients compared to women without POP.

Conclusions

The restoration of pelvic anatomy may account for the improved PFM function with increased electrical activity in POP patients verified by SEMG. Evaluation of PFM function may be used as a clinical tool in the overall assessment of pelvic reconstructive surgeries.

Jelovsek JE, Maher C, Barber MD (2007) Pelvic organ prolapse. Lancet 369(9566):1027–1038. doi:10.1016/s0140-6736(07)60462-0 PubMedCrossRef

Braekken IH, Majida M, Ellström Engh M, Holme IM, Bø K (2009) Pelvic floor function is independently associated with pelvic organ prolapse. BJOG 116(13):1706–1714. doi:10.1111/j.1471-0528.2009.02379.x PubMedCrossRef

Rortveit G, Brown JS, Thom DH, Van Den Eeden SK, Creasman JM, Subak LL (2007) Symptomatic pelvic organ prolapse: prevalence and risk factors in a population-based, racially diverse cohort. Obstet Gynecol 109(6):1396–1403. doi:10.1097/01.aog.0000263469.68106.90 PubMedCrossRef

Bø K, Sherburn M (2005) Evaluation of female pelvic-floor muscle function and strength. Phys Ther 85(3):269–282PubMed

Benbouzid S, Cornu JN, Benchikh A, Chanu T, Haab F, Delmas V (2012) Pelvic organ prolapse transvaginal repair by the Prolift system: evaluation of efficacy and complications after a 4.5 years follow up. Int J Urol 19(11):1010–1016. doi:10.1111/j.1442-2042.2012.03090.x PubMedCrossRef

van Raalte HM, Lucente VR, Molden SM, Haff R, Murphy M (2008) One-year anatomic and quality-of-life outcomes after the Prolift procedure for treatment of posthysterectomy prolapse. Am J Obstet Gynecol 199(6):694.e1–694.e6. doi:10.1016/j.ajog.2008.07.058 CrossRef

Cho MK, Kim CH, Kang WD, Kim JW, Kim SM, Kim YH (2012) Anatomic and functional outcomes with the prolift procedure in elderly women with advanced pelvic organ prolapse who desire uterine preservation. J Minim Invasive Gynecol 19(3):307–312. doi:10.1016/j.jmig.2011.12.014 PubMedCrossRef

Chen YS, Cao Q, Ding JX, Hu CD, Feng WW, Hua KQ (2012) Midterm prospective comparison of vaginal repair with mesh vs Prolift system devices for prolapse. Eur J Obstet Gynecol Reprod Biol 164(2):221–226. doi:10.1016/j.ejogrb.2012.06.015 PubMedCrossRef

Roy S, Mohandas A, Coyne K, Gelhorn H, Gauld J, Sikirica V, Milani AL (2012) Assessment of the psychometric properties of the Short-Form Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) following surgical placement of Prolift +M: a transvaginal partially absorbable mesh system for the treatment of pelvic organ prolapse. J Sex Med 9(4):1190–1199. doi:10.1111/j.1743-6109.2011.02640.x PubMedCrossRef

10.

Botelho S, Pereira LC, Marques J, Lanza AH, Amorim CF, Palma P, Riccetto C (2012) Is there correlation between electromyography and digital palpation as means of measuring pelvic floor muscle contractility in nulliparous, pregnant, and postpartum women? Neurourol Urodyn. doi:10.1002/nau.22321

11.

Bø K, Majida M, Engh ME (2012) Does a ring pessary in situ influence the pelvic floor muscle function of women with pelvic organ prolapse when tested in supine? Int Urogynecol J 23(5):573–577. doi:10.1007/s00192-011-1598-6 PubMedCrossRef

12.

Pauliina A, Jorma P, Paula I, Olavi A (2002) Intravaginal surface EMG probe design test for urinary incontinence patients. Acupunct Electrother Res 27(1):37–44PubMed

13.

Grape HH, Dedering A, Jonasson AF (2009) Retest reliability of surface electromyography on the pelvic floor muscles. Neurourol Urodyn 28(5):395–399. doi:10.1002/nau.20648 PubMedCrossRef

14.

Yang X, Li H (2012) A modified anterior compartment reconstruction and Prolift-a for the treatment of anterior pelvic organ prolapse: a non-inferiority study. Arch Gynecol Obstet 285(6):1593–1597. doi:10.1007/s00404-011-2200-7 PubMedCrossRef

15.

Bump RC, Mattiasson A, Bø K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175(1):10–17PubMedCrossRef

16.

Altman D, Väyrynen T, Engh ME, Axelsen S, Falconer C et al (2008) Short-term outcome after transvaginal mesh repair of pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 19(6):787–793. doi:10.1007/s00192-007-0526-2 PubMedCrossRef

17.

Fatton B, Amblard J, Debodinance P, Cosson M, Jacquetin B (2007) Transvaginal repair of genital prolapse: preliminary results of a new tension-free vaginal mesh (Prolift technique)–a case series multicentric study. Int Urogynecol J Pelvic Floor Dysfunct 18(7):743–752. doi:10.1007/s00192-006-0234-3 PubMedCrossRef

18.

Slieker-ten Hove M, Pool-Goudzwaard A, Eijkemans M, Steegers-Theunissen R, Burger C, Vierhout M (2010) Pelvic floor muscle function in a general population of women with and without pelvic organ prolapse. Int Urogynecol J 21(3):311–319. doi:10.1007/s00192-009-1037-0 PubMedCrossRef

19.

Thompson JA, O’Sullivan PB, Briffa NK, Neumann P (2006) Altered muscle activation patterns in symptomatic women during pelvic floor muscle contraction and Valsalva manouevre. Neurourol Urodyn 25(3):268–276. doi:10.1002/nau.20183 PubMedCrossRef

20.

Thompson JA, O’Sullivan PB, Briffa NK, Neumann P (2006) Differences in muscle activation patterns during pelvic floor muscle contraction and Valsalva maneuver. Neurourol Urodyn 25(2):148–155. doi:10.1002/nau.20203 PubMedCrossRef

21.

Pierce LM, Baumann S, Rankin MR, Wasserman RM, Biaggi A, Kuehl TJ, Coates KW (2007) Levator ani muscle and connective tissue changes associated with pelvic organ prolapse, parity, and aging in the squirrel monkey: a histologic study. Am J Obstet Gynecol 197(1):60.e1–60.e9. doi:10.1016/j.ajog.2007.02.037 CrossRef

22.

Kerkhof MH, Hendriks L, Brölmann HA (2009) Changes in connective tissue in patients with pelvic organ prolapse–a review of the current literature. Int Urogynecol J Pelvic Floor Dysfunct 20(4):461–474. doi:10.1007/s00192-008-0737-1 PubMedCrossRef

23.

Badiou W, Granier G, Bousquet PJ, Monrozies X, Mares P, de Tayrac R (2008) Comparative histological analysis of anterior vaginal wall in women with pelvic organ prolapse or control subjects. A pilot study. Int Urogynecol J Pelvic Floor Dysfunct 19(5):723–729. doi:10.1007/s00192-007-0516-4 PubMedCrossRef

24.

Brækken IH, Majida M, Engh ME, Bø K (2010) Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial. Am J Obstet Gynecol 203(2):170.e1–170.e7. doi:10.1016/j.ajog.2010.02.037 CrossRef

25.

Bump RC, Hurt WG, Fantl JA, Wyman JF (1991) Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. Am J Obstet Gynecol 165(2):322–327, discussion 327–329PubMedCrossRef

26.

Enck P, Vodusek DB (2006) Electromyography of pelvic floor muscles. J Electromyogr Kinesiol 16(6):568–577. doi:10.1016/j.jelekin.2006.08.007 PubMedCrossRef

27.

Resende AP, Petricelli CD, Bernardes BT, Alexandre SM, Nakamura MU, Zanetti MR (2012) Electromyographic evaluation of pelvic floor muscles in pregnant and nonpregnant women. Int Urogynecol J 23(8):1041–1045. doi:10.1007/s00192-012-1702-6 PubMedCrossRef

28.

Auchincloss CC, McLean L (2009) The reliability of surface EMG recorded from the pelvic floor muscles. J Neurosci Methods 182(1):85–96. doi:10.1016/j.jneumeth.2009.05.027 PubMedCrossRef

Title: The improvement of pelvic floor muscle function in POP patients after the Prolift procedure: results from surface electromyography
Authors: Lihua Wang
Xinliang Chen
Xiaocui Li
Yao Gong
Huaifang Li
Xiaowen Tong
Publication date: 01-10-2013
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 10/2013
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-013-2094-y

At a glance: The STEP trials

Springer Medicine

The improvement of pelvic floor muscle function in POP patients after the Prolift procedure: results from surface electromyography

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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