Severity and bother of prolapse symptoms in women with pelvic floor myofascial pain.

Dixon, Alison M.; Fitzgerald, Colleen M.; Brincat, Cynthia

Introduction and hypothesis: Our aim was to assess severity and bother of pelvic organ prolapse (POP) in women with pelvic floor myofascial pain (PFMP). Methods: We conducted a retrospective chart review assessing new patients within a hospital-based multispecialty group from January 2010 through September 2014 using the International Classification of Diseases, 9th edition, diagnosis codes for POP. Data from Pelvic Organ Prolapse Quantification (POP-Q) system assessment, Pelvic Floor Distress Inventory-20, (PFDI-20), and clinical assessment of pelvic floor muscles were collected. Results: Of 539 patients identified with POP, 174 (32%) had PFMP on physical exam. The mean stage of prolapse in those with PFMP was 2 [standard deviation (SD) ± 0.93] vs 3 (SD ± 0.80) in those without pain. There was a difference in the presence of prolapse beyond the hymen, with 98 (56%) of those with PFMP having their most dependent point above the hymen (Ba, Bp, or C) and 276 (76%) of those without PFMP having their most dependent point beyond the hymen (p =.000). Women with PFMP were predominantly white, had less-advanced prolapse, and more reported pain or discomfort (adjusted p value =.011, prolapse beyond the hymen p =.000, PFDI -20 p =.003). Conclusions: One in three women with a diagnosis of POP were found to have PFMP. On average, when pain was present, women had a lower stage of prolapse and were more severely bothered by their pelvic floor symptoms. Although limited by its nature as a retrospective analysis, this study suggests alternative etiologies, and thereby treatments, for symptom bother in women with mild prolapse.

INTERNATIONAL Statistical Classification of Diseases & Related Health Problems; PELVIC floor; UTERINE prolapse; PELVIC organ prolapse; PAIN; NOSOLOGY; STANDARD deviations

International Urogynecology Journal, 2019, Vol 30, Issue 11, p1829

0937-3462

Academic Journal

10.1007/s00192-019-03916-x