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Pelvic Diagnosis in Rehabilitation

Pelvic floor muscle evaluation in incontinent patients.
Amaro JL, Moreira EC, De Oliveira Orsi Gameiro M, Padovani CR
Int Urogynecol J Pelvic Floor Dysfunct 2005 Jan 12;.

The aim of this study was to assess pelvic floor muscle (PFM) strength and perception and its correlation with stress urinary incontinence (SUI). One hundred and one women were divided into two groups according to the presence (G1=51 patients) or absence (G2=50 patients) of SUI. Subjective [urine stream interruption test (UST), visual survey of perineal contraction and transvaginal digital palpation to assess pelvic muscle contraction] and objective evaluations of pelvic floor muscles in all patients were performed (vaginal manometry). During the UST, 25.5% of G1 patients and 80% of G2 patients were able to interrupt the urine stream (p<0.05). Digital evaluation of pelvic muscular contraction showed higher strength in G2 than in G1 patients (p<0.0001). Perineometer evaluation of PFM strength was significantly higher in the continent group (p<0.001). Pelvic floor muscle weakness in incontinent patients demonstrates the importance of functional and objective evaluation of this group of muscles.

Does the size of the vaginal probe affect measurement of pelvic floor muscle strength?
Bo K, Raastad R, Finckenhagen HB
Acta Obstet Gynecol Scand 2005 Feb;84(2):129-33.

Background. The most commonly used method to measure pelvic floor muscle (PFM) strength is vaginal squeeze pressure. There are, however, several apparatuses available for this purpose, and sizes of the probes differ significantly. The aim of the present investigation was to assess whether the size of two commonly used vaginal probes influences measurement of PFM strength. Methods. Twenty female physical therapy students, mean age 25.1 years (range 21-38), participated in the study. All were able to contract the PFM, as assessed by means of vaginal palpation and observation of inward movement of the perineum. Two measuring devices with different lengths and diameters, the Peritron and the Camtech, were used in order to assess vaginal squeeze pressure. Each woman performed six contractions with each apparatus. Results. Mean maximum squeeze pressure for the whole group with the Camtech was 19.7 cm H(2)O (95% CI: 16.5-22.9) and with the Peritron 36.5 cm H(2)O (95% CI: 31.7-41.3), P < 0.01. Nine women preferred the Camtech, four preferred the Peritron, and seven did not have any specific preferences. Conclusions. Measurements of vaginal squeeze pressure differ depending on the vaginal probe used. Results from published studies using various probes should, therefore, not be compared or combined in systematic reviews or meta-analysis.