Physiotherapeutic Treatment for Levator Ani Avulsion after Delivery: A Transperineal Three-dimensional Ultrasound Assessment.

Background: Levator ani avulsion is defined as the interruption of the insertion of this muscle on the pubic bone. It is currently recognized as an important triggering factor for genital prolapse. Although surgical interventions are available, there are no conservative strategies for this muscular injury.

Transperineal three-dimensional ultrasound for analyzing the effects of perineal stretching with EPI-NO in women with multiple pregnancies: a pilot study.

Objective: To compare the changes in the pelvic floor of women with twin pregnancies who practiced muscle stretching with the EPI-NO vaginal dilator, as assessed using transperineal three-dimensional ultrasound (3DUS).

Method: This prospective cross-sectional case-control study included nulliparous women in the third trimester of their multiple pregnancies and divided them into the control group (CG,  = 9) and EPI-NO group (EpiG,  = 9). During pretreatment, the women underwent transperineal 3DUS to establish the morphometric measurements of the pelvic floor.

Device to predict pelvic floor integrity during vaginal delivery: an intra- and interrater reliability study of the Epi-no distensibility measurement.

Objective: To determine the test-retest reliability of the pelvic floor distensibility evaluation with Epi-no device.

Methods: Prospective, blinded observational study with 32 women pregnant from 35 gestational weeks. An Epi-no balloon was inflated within the pregnant woman's vagina and the maximum circumference achieved was measured using a standard metric measuring tape.

Lower urinary tract symptoms and perineal function in women with and without fibromyalgia: a cross-sectional study.

Introduction And Hypothesis: Fibromyalgia (FM) studies have focused on pain, but a 2010 review of the diagnostic criteria pointed to other symptoms including urinary incontinence (UI). Women with FM present pain, fatigue, and reduced muscle strength; the research hypothesis was that pelvic floor (PF) muscles would be weaker; therefore, FM could be associated with lower urinary tract symptoms (LUTS) and compromise quality of life (QoL). The aim of this paper was to compare PF function, urinary symptoms, and their impact on QoL in women with and without FM and to verify if there is association between FM and LUTS.

Quantitative assessment of pelvic floor muscle extensibility in pregnant women with a perineal elasticity meter.

The objective of this study was to compare measurements of pelvic floor muscle extensibility in pregnant women obtained through the Epi-no and perineal elasticity meter (PEM) devices. This was an observational, cross-sectional study with a consecutive sample, conducted in a prenatal care outpatient clinic. The pelvic floors of 62 healthy pregnant women with gestational ages between 35 and 40 weeks were assessed.

Can Abdominal Hypopressive Technique Change Levator Hiatus Area?: A 3-Dimensional Ultrasound Study.

This study aimed to evaluate the levator hiatus area (LHA) at rest and during the performance of maximal pelvic floor muscle (PFM) contractions, during the abdominal hypopressive technique (AHT), and during the combination of PFM contractions (PFMCs) and the AHT. The study included 17 healthy nulliparous women who had no history of pelvic floor disorders. The LHA was evaluated with the patients in the lithotomy position.

Determination of a cutoff value for pelvic floor distensibility using the Epi-no balloon to predict perineal integrity in vaginal delivery: ROC curve analysis. Prospective observational single cohort study.

Context And Objective: Several risk factors are involved in perineal lacerations during vaginal delivery. However, little is known about the influence of perineal distensibility as a protective factor. The aim here was to determine a cutoff value for pelvic floor distensibility measured using the Epi-no balloon, which could be used as a predictive factor for perineal integrity in vaginal delivery.

Urinary incontinence related to perineal muscle strength in the first trimester of pregnancy: cross-sectional study.

Objective To analyze pelvic floor muscle strength (PFMS), urinary continence and quality of life related to urinary incontinence (UI) of women in the first trimester of pregnancy. Method Cross-sectional study with a sample of 500 women who started prenatal care in a complementary healthcare facility in Guarulhos, state of São Paulo, from 2012 and 2013. Pelvic floor muscle strength was evaluated through perineometry.

Perineal Distensibility Using Epi-no in Twin Pregnancies: Comparative Study with Singleton Pregnancies.

The aims of this study were to compare perineal distensibility between women with twin and singleton pregnancies and to correlate these women's perineal distensibility with anthropometric data. This prospective cross-sectional case-control study was conducted among nulliparous women, of whom 20 were pregnant with twins and 23 with a single fetus. Perineal distensibility was evaluated in the third trimester by means of Epi-no, which was introduced into the vagina and inflated up to the maximum tolerable limit.

Assessing the impact of twin pregnancies on the pelvic floor using 3-dimensional sonography: a pilot study.

Objectives: The purpose of this study was to compare the morphologic characteristics of the pelvic floor musculature between women with twin and singleton pregnancies.

Methods: We conducted a cross-sectional case-control study of 40 nulliparous women aged 20 to 38 years to compare women with singleton pregnancies (n = 23) to women with twin pregnancies (n = 17). Biometric measurements of the levator hiatus and the sagittal and coronal diameters were made by transperineal 3-dimensional sonography between the 28th and 38th gestational weeks.

Distensibility and strength of the pelvic floor muscles of women in the third trimester of pregnancy.

Objective: The objective of this study was to compare the role of the pelvic floor muscles between nulliparous and multiparous women in the third trimester of pregnancy, by analyzing the relationship between electrical activity (surface electromyography-EMG), vaginal palpation (modified Oxford scale), and perineal distensibility (Epi-no).

Methods: This was an observational cross-sectional study on a sample of 60 healthy pregnant women with no cervical dilation, single fetus, gestational age between 35 and 40 weeks, and maternal age ranging from 15 to 40 years. The methods used were bidigital palpation (modified Oxford scale, graded 0-5), surface EMG (electrical activity during maximal voluntary contraction), and perineal distensibility (Epi-no device).

Parturient perineal distensibility tolerance assessed by EPI-NO: an observational study.

Objective: To determine how parturient women tolerate the use of a perineal distensibility assessment technique using the EPI-NO device.

Methods: An observational study with a total of 227 full-term parturient women was performed. During the evaluation with EPI-NO, parturient patients were asked about their sensation of discomfort.

Electromyographic evaluation of pelvic floor muscles in pregnant and nonpregnant women.

Introduction And Hypothesis: We compared the maximal voluntary contraction (MVC) and strength of pelvic floor muscles (PFM) of pregnant and nonpregnant women using surface electromyography (SEMG).

Methods: Fifteen pregnant primiparous women and 15 nulliparous nonpregnant women were evaluated. The healthy pregnant women were in the third trimester of pregnancy with a single fetus and did not have any neuromuscular alterations.

Pelvic floor muscle and transversus abdominis activation in abdominal hypopressive technique through surface electromyography.

Aims: The abdominal hypopressive technique (AHT) is performed mainly via transversus abdominis (TrA) activation and has been indicated for pelvic floor muscle (PFM) disorders. In some European countries, this technique has become widely used. This study aimed to investigate PFM and TrA activation during the AHT through surface electromyography.

Effects of the Paula method in electromyographic activation of the pelvic floor: a comparative study.

Introduction And Hypothesis: To determine if Paula method of circular muscles contraction e.g., those surrounding the eyes, mouth and fingers, could increase pelvic floor muscle (PFM) activity.

[Electrical stimulation of the pelvic floor versus vaginal cone therapy for the treatment of stress urinary incontinence].

Purpose: to compare the effects of functional electrostimulation of the pelvic floor and therapy with cones in women with stress urinary incontinence (SUI).

Methods: randomized clinical study for which 45 patients with SUI were selected. The effects of functional electrostimulation of the pelvic floor were evaluated in the SUI treatment of 24 women, with the use of clinical data (micturition diary, pad test and a questionnaire about quality of life - I-QoL).

Single-blind, randomized, controlled trial of pelvic floor muscle training, electrical stimulation, vaginal cones, and no active treatment in the management of stress urinary incontinence.

Purpose: To compare the effectiveness of pelvic floor exercises, electrical stimulation, vaginal cones, and no active treatment in women with urodynamic stress urinary incontinence.

Patients And Methods: One hundred eighteen subjects were randomly selected to receive pelvic floor exercises (n=31), ES (n=30), vaginal cones (n=27), or no treatment (untreated control) (n=30). Women were evaluated before and after completion of six months of treatment by the pad test, quality of life questionnaire (I-QOL), urodynamic test, voiding diary, and subjective response.

Impact of supervised physiotherapeutic pelvic floor exercises for treating female stress urinary incontinence.

Context And Objective: Urinary incontinence is a public health problem that affects more than 200 million people worldwide. Stress incontinence is the most prevalent type. Pelvic floor muscle exercises have been used for treating it, although there is no consensus regarding their application.