Bladder and bowel symptoms following imprisonment in West Australian female prisons.

Purpose: The purpose of this paper is to investigate the presence of bladder and bowel symptoms in women recently imprisoned in Western Australian prisons, specifically; stress, urge and mixed urinary incontinence, faecal incontinence, nocturia, nocturnal enuresis and constipation and the impact on the quality of life (QOL).

Design/methodology/approach: Over a 12-month period 29 women, recently released from Western Australia's female prisons, were surveyed using a questionnaire previously validated for the prison population. The Short Form King's Health Questionnaire and a modified version of the Manchester Health Questionnaire were used to assess the effects of these symptoms on QOL.

How Might We Screen for Psychological Factors in People With Pelvic Pain? An e-Delphi Study.

Objective: Persistent pelvic pain (PPP) is a complex condition often influenced by psychological factors that can alter treatment outcomes. These factors are potentially modifiable; however, currently there is no instrument to screen for them. The purpose of this study was to determine: (1) which psychological factors should be screened in individuals with PPP, and (2) the most appropriate statements to represent these psychological factors.

Rehabilitative ultrasound imaging of pelvic floor muscle function.

This commentary provides an overview of the current concepts and evidence related to rehabilitative ultrasound imaging of pelvic floor (levator ani) function. As this is an emerging topic, the goal is to provide a basic understanding of ultrasound imaging applications related to levator ani function: the available quantitative and qualitative information, the limitations, as well as how ultrasound imaging can be incorporated as a form of biofeedback during rehabilitation. Furthermore, as the ability to compile and compare existing evidence depends on the degree of similarity in methodology by investigators, this commentary highlights points of consideration and provides guidelines, as well as an agenda, for future investigation.

Comparison of transperineal and transabdominal ultrasound in the assessment of voluntary pelvic floor muscle contractions and functional manoeuvres in continent and incontinent women.

Transperineal (TP) and transabdominal (TA) ultrasounds were used to assess bladder neck (TP) and bladder base (TA) movement during voluntary pelvic floor muscle (PFM) contraction and functional tasks. A sonographer assessed 60 asymptomatic (30 nulliparous, 30 parous) and 60 incontinent (30 stress, 30 urge) women with a mean age of 43 (SD=7) years, BMI of 24 (SD=4) kg m2 and a median parity of 2 (range, 0-5), using both ultrasound methods. The mean of three measurements for bladder neck and bladder base (sagittal view) movement for each task was assessed for differences between the groups.

Assessment of voluntary pelvic floor muscle contraction in continent and incontinent women using transperineal ultrasound, manual muscle testing and vaginal squeeze pressure measurements.

The aims of the study were: (1) to assess women performing voluntary pelvic floor muscle (PFM) contractions, on initial instruction without biofeedback teaching, using transperineal ultrasound, manual muscle testing, and perineometry and (2) to assess for associations between the different measurements of PFM function. Sixty continent (30 nulliparous and 30 parous) and 60 incontinent (30 stress urinary incontinence (SUI) and 30 urge urinary incontinence (UUI)) women were assessed. Bladder neck depression during attempts to perform an elevating pelvic floor muscle (PFM) contraction occurred in 17% of continent and 30% of incontinent women.

Altered muscle activation patterns in symptomatic women during pelvic floor muscle contraction and Valsalva manouevre.

Aims: To investigate the muscle activation patterns of the abdomino-pelvic region used by incontinent women during a pelvic floor muscle (PFM) contraction and a Valsalva manouevre compared to healthy, asymptomatic subjects.

Methods: Thirteen incontinent (symptomatic) women, identified using ultrasound to be consistently depressing the bladder base during PFM contraction, and thirteen continent women (asymptomatic) able to perform an elevating PFM contraction were assessed using surface electromyography (EMG) of the PFM, abdominal and chest wall muscles and vaginal and intra-abdominal pressure (IAP) measurements during PFM contraction and Valsalva under ultrasound surveillance.

Results: There were no differences between groups in age, parity or BMI.

Differences in muscle activation patterns during pelvic floor muscle contraction and Valsalva maneuver.

Aims: To investigate the different muscle activation patterns around the abdomino-pelvic cavity in continent women and their effect on pressure generation during a correct pelvic floor muscle (PFM) contraction and a Valsalva maneuver.

Methods: Thirteen continent women were assessed. Abdominal, chest wall, and PFM activity and vaginal and intra-abdominal pressure (IAP), were recorded during two tasks: PFM contraction and Valsalva whilst bladder base position was monitored on trans-abdominal ultrasound.

Assessment of pelvic floor movement using transabdominal and transperineal ultrasound.

The aims of the study were (1) to assess the reliability of transabdominal (TA) and transperineal (TP) ultrasound during a pelvic floor muscle (PFM) contraction and Valsalva manoeuvre and (2) to compare TA ultrasound with TP ultrasound for predicting the direction and magnitude of bladder neck movement in a mixed subject population. A qualified sonographer assessed 120 women using both TA and TP ultrasound. Ten women were tested on two occasions for reliability.

Levator plate movement during voluntary pelvic floor muscle contraction in subjects with incontinence and prolapse: a cross-sectional study and review.

Transabdominal ultrasound was used to assess 104 women with incontinence and prolapse. The bladder was used as a marker of levator plate (LP) movement. The women were asked to draw in and lift the pelvic floor muscles (PFM) and a change in position of the LP in a cranial or caudal direction during contraction was documented.