Aims: Ultrasound is used in the delivery room to assess fetal head position, engagement during labor, and anal sphincter injuries in the immediate postpartum period. The transperineal approach allows for direct visualization of the structures of interest without altering anatomical landmarks. Various ultrasound measurements during labor have been described in the literature, and their use varies widely across maternity units.
View Article and Find Full Text PDFIntroduction: Numerous anatomical theories have been developed to explain women stress urinary incontinence (SUI) and improve its management. The transperineal ultrasound is an efficient and non-invasive exam that perfectly studies the bladder neck movement and the urethral anatomy. The measurement of the static portion of the distal urethral length, considered as the functional urethral length (FUL), and of the posterior urethral closure angle (PUCA) have not been studied before and could be of interest.
View Article and Find Full Text PDFEur J Obstet Gynecol Reprod Biol
December 2024
Aims: The Antwerp Pelvic Floor Knowledge Questionnaire (APFK-Q) is a self-administered tool used for assessing women's knowledge of the pelvic floor, an essential element of pelvic health education initiatives. The aim of this study was to validate the French version of the APFK-Q and to assess its psychometric properties.
Methods: Acceptability of the cultural adaptation of APFK-Q in French (translation/back-translation) was assessed in two groups of women: one group not working in the healthcare sector (non-healthworkers, n = 112), and another of student midwives (n = 29).
Objective: Pelvic floor health education workshops for women appear to improve women's knowledge and pelvic floor symptoms. Our aim was to obtain expert consensus on the content and format of a pelvic floor health education program using the Delphi method.
Material And Methods: A two-round Delphi study was conducted involving French-speaking multidisciplinary experts in pelvic floor dysfunction management.
Background: Recent recommendations from the French High Authority of Health on pelvic organ prolapse (POP) management underline the value of a pelvic examination.
Objectives: The aim of this paper was to analyze the literature and identify the best evidence available regarding pelvic examination for women presenting prolapse-associated symptoms in terms of diagnosis and predictability of treatment success.
Search Strategy: The databases were queried similarly using Medical Subject Headings (MeSH) and non-MeSH terms broadly related to pelvic examination and POP management.
Objective: To evaluate the health status and recovery of women after mid-urethral sling (MUS) revision in response to complications.
Design: Cross-sectional study using a questionnaire sent to women from a registry.
Setting: Twenty-two French surgical centres.
Background: Midurethral slings are the gold standard for treating stress urinary incontinence, but their complications may raise concerns. Complications may differ by the approach used to place them.
Objective: This study aimed to compare serious complications and reoperations for recurrence after midurethral sling procedures when using the retropubic vs the transobturator route for female stress urinary incontinence.
Introduction: The number of deliveries by forceps decreases significantly in favour of the vacuum. Now, when the use of forceps is necessary, physicians less experimented with this procedure are likely to induce serious and preventable perineal or foetal injuries. Training therefore becomes essential.
View Article and Find Full Text PDFBackground: Incontinence occurs frequently in the postpartum period. Several theoretical pathophysiological models may underlie the hypothesis that different types of management of the active phase of the second stage of labor have different effects on pelvic floor muscles and thus perhaps affect urinary and anal continence.
Objective: This study aimed to evaluate the impact of "moderate pushing" on the occurrence of urinary or anal incontinence compared with "intensive pushing," and to determine the factors associated with incontinence at 6 months postpartum.
J Clin Med
February 2023
(1) Background: Pelvic organ prolapse (POP) can be managed using a vaginal pessary. However, the decision-making process whereby health professionals choose the right pessary is unclear. The objective of this study was to focus on the experience of experts in pessary use and to propose an algorithm.
View Article and Find Full Text PDFJ Gynecol Obstet Hum Reprod
March 2023
When a patient presents with symptoms suggestive of pelvic organ prolapse (POP), clinical evaluation should include an assessment of symptoms, their impact on daily life and rule out other pelvic pathologies. The prolapse should be described compartment by compartment, indicating the extent of the externalization for each. The diagnosis of POP is clinical.
View Article and Find Full Text PDFBackground: The non-surgical solution for Pelvic Organ Prolapse (POP) typically consists of a pessary fitting. We aimed to assess patient satisfaction and symptom improvement 6 months after a pessary fitting and to identify risk factors associated with pessary failure.
Methods: Six months after a pessary fitting, patient satisfaction was assessed by the PGII score; symptoms and quality of life were assessed using validated questionnaires (PFDI-20, ICIQ-SF, PISQ-12, USP, and PFIQ-7).
Background: The Clavien-Dindo classification, used to describe postoperative complications, does not take into account patient perception of severity. Our main objective was to assess women's perception of postoperative pelvic floor repair complications and compare it to the classification of Clavien-Dindo.
Methods: Women and surgeons participating in the VIGI-MESH registry concerning pelvic floor repair surgery were invited to quote their perception of complication severity through a survey based on 30 clinical vignettes.
J Gynecol Obstet Hum Reprod
May 2022
Objective: Uterine fibroids are often associated with lower urinary tract symptoms (LUTS), the exact prevalence of which has been underexplored. Our main objective was to evaluate the effect of surgical treatment of fibroids on LUTS. Our secondary objectives were to assess the prevalence of LUTS in women undergoing fibroid surgery and to analyze the relationship between the characteristics of fibroids and the severity of symptoms.
View Article and Find Full Text PDFPessary fitting and follow-up for women with pelvic organ prolapse (POP) can be performed by different health care practitioners (HCPs). We aimed to investigate knowledge and current practices among the main HCPs involved in pessary use in France. We sent an electronic questionnaire about pessary use to the members of eight French learned societies between April and October 2020.
View Article and Find Full Text PDFBMC Pregnancy Childbirth
March 2021
Background: We aimed at developing a core outcome and variables of interest set to investigate the effects of mediolateral episiotomy on Obstetric Anal Sphincter Injury (OASI) during and after operative delivery in nulliparous women in a large-scale one-year observational French study including 15,000 women (INSTRUMODA).
Methods: A list of outcomes and variables of interest was suggested to obstetricians participating in the INSTRUMODA study using online questionnaires divided into 7 categories: the woman's history and course of pregnancy, course of labor, modalities of operative delivery, episiotomy characteristics, immediate maternal morbidity, one-year maternal morbidity, immediate neonatal morbidity. We used a three-round DELPHI method to reach a consensus.
J Gynecol Obstet Hum Reprod
September 2021
Objective: Laparoscopic sacrocolpopexy is the standard surgery to correct apical pelvic organ prolapse. It is currently mainly practiced in the context of a conventional hospitalization, but more and more practitioners are developing it as an outpatient procedure. The objective of this study was to evaluate the feasibility of outpatient laparoscopic sacrocolpopexy and patient satisfaction.
View Article and Find Full Text PDFIntroduction: Pelvic floor disorders (PFD) are common conditions impacting quality of life and sexuality may worsen after ovarian cancer therapies. Our objective was to describe the prevalence of PFD and sexuality in women with ovarian cancer (OC).
Methods: We reviewed articles indexed in the MEDLINE database until June 2020 and selected articles assessing UI, POP, FI and sexual dysfunction in a population of women with OC.
Objective: We aimed to assess the impact of an educational program on the symptoms and quality of life of patients undergoing supervised pelvic floor muscle training (PFMT). Secondary objectives included: baseline assessment of patients' knowledge of the pelvic floor; and patient satisfaction and symptom improvement after the entire PFMT program.
Material And Methods: An observational questionnaire-based study in women attending a PFMT program consisting of four educational sessions, one visual feedback session, and five personalized training sessions.