The value of a comprehensive diagnosis of pelvic floor insufficiency

• Liliya R. Toktar
• Verаnika E. Pak
• Irina A. Samsonova
• Kseniya I. Lee
• Rustam F. Gaifulin
• Shahlo M. Dostieva
• Ludmila V. Kaushanskaya

Abstract

Background. Pelvic organ prolapse (POP) is an important medical and social problem of our time, inevitably leading to a reduction in the quality of life. All cases of genital prolapse are based on pelvic floor dysfunction (PFD), which can exist for a long time without obvious genital prolapse. The prevalence of PFD varies widely, primarily due to the lack of standardized diagnostic methods and criteria for diagnosis.

The aim of the study was to evaluate the diagnostic efficiency of a comprehensive perineologic examination.

Material and methods. A cohort prospective randomized comparative study included 141 women of reproductive age who applied to the gynecological department of the City Clinical Hospital # 29 named after N.E. Bauman in Moscow for planned surgical treatment. Patients were divided into groups – main (with PFD, n=112) and control (without PFD, n=29). Standard clinical and instrumental examination of gynecological patients was performed. To verify PFD, a comprehensive perineologic examination with assessment of the vaginal biotope was performed. The sensitivity and specificity for significant quantitative diagnostic parameters of pelvic floor dysfunction were calculated using the data obtained from the comprehensive perineologic examination.

Results. The most valuable parameters in assessing the pelvic floor were: FSFI and PISQ-12 questionnaires with an accuracy of 87 and 91%, respectively, and physical examination with an accuracy of 89.5%. Methods that are not used in routine gynecologic practice also showed their diagnostic value in verifying PFD: perineomanometry and pH evaluation of vaginal secretions.

Conclusion. These data demonstrate the value of a comprehensive approach to the diagnosis of pelvic floor insufficiency. Further studies are needed to assess the value of a comprehensive perineologic examination in the clinical practice of an obstetrician-gynecologist.

Keywords:pelvic floor dysfunction; genital prolapse; pelvic floor; comprehensive perineologic examination

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