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Assessment of pelvic floor muscle function after vaginal delivery. Clinical value of different tests
Andrea Sartore1, Roberto Pregazzi, Paolo Bortoli
1Department of Obstetrics and Gynecology, Epidemiology Unit, University of Trieste, Istituto di Ricovero e Cura a Carattere Scientifico, Burlo Garofolo, Via dell'Istria 65/1-34137, Trieste, Italy. sartore@burlo.trieste.it
Objective:
To evaluate the efficacy of different tests in identifying pelvic floor dysfunction after vaginal delivery.
Study Design:
One hundred ninety-seven primiparae were investigated 2 months after vaginal delivery. They underwent pelvic floor muscle assessment by digital test, vaginal manometry and uroflowmetric stop test. Puerperae were divided into continent and incontinent subpopulations. Variables were subjected to Student's t test and Fisher's exact test to verify the difference between the subpopulations. Kappa values were used to correlate the tests.
Results:
Perineal performance in incontinent primiparae was weaker in all the tests; only the urine stream interruption test score showed significantly different values (P = .0026), but it did not correlate with the other two tests.
Conclusion:
A simple, objective, noninvasive and low-cost technique, such as the urine stream interruption test, is useful in assessing pelvic floor performance after vaginal delivery but reflects urethrovesical support function rather than pelvic muscle function in toto.
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