Pelvic Floor Through Life Flashcards
What is endometriosis?
- Endometrial tissue grows outside uterus
- Commonly in ovaries, fallopian tubes, connective tissue, vagina, cervix, bowel, rectum, and bladder
Endometriosis affects more than ___% of American women between 15 and 44, and is most common in woman aged ___ to ___
11%
Aged 30-40
What are common symptoms of endometriosis?
Pain
Bleeding & spotting
Infertility
Digestive disturbances
What are risk factors for endometriosis?
- nulliparous
- menstrual periods >7 days
- menstrual cycles < 27 days
- family history
What is primary dysmenorrhea? What are risk factors?
- Most common type of dysmenorrhea
- Pain is usually caused by contractions of the uterus (womb). The uterus contracts during menstruation to help the uterine lining leave the body. Teens may get dysmenorrhea soon after they get their first period. For most women, primary dysmenorrhea gets less painful as they get older. But some women get severe menstrual pain.
- RiskFactors: menarche began before11, Long/heavy periods, Smoking, Stress
What is Secondary dysmenorrhea?
Caused by associated medical condition like:
- Endometriosis- In response to monthly changes in estrogen, the lining breaks down and bleeds outside of the uterus and can cause swelling and pain.
- Uterine fibroids are tumors that grow in or on the wall of the uterus (almost always benign)
- Ovarian cysts: usually don’t cause symptoms other than pain during your period or at ovulation.
What is Interstitial Cystitis/Painful bladder Syndrome?
Chronic bladder pain that (sometimes the pelvis and genitals)
• Affects 3-8 million women in the US
• May affect white women more
• Sx: pain, urinary frequency, bladder pressure, dyspareunia, dysuria, hematuria
• Differential diagnosis includes chronic urinary tract infection
What is Chronic Pelvic Pain Syndrome (CPPS) in Men?
Persistent pain in the perineal or genital region without evidence of bacterial infection
• Usually effects young men (mean age of 43)
• Prevalence is 2-16% in the US
• Symptoms: abdominal pain, frequent urination, ED, post- ejaculator, penile pain, testicular pain
• Comprises the most common form (up to 90%) of ‘prostatitis” cases
• Typically caused by hypertonicity and/or nerve irritation
What is Pudendal Neuralgia?
- Chronic pain due to injury of pudendal n. (S2-S4)
- typically caused by stretch/compression (ex. Forceps delivery, chronic straining, weightlifting, biking, prolonged sitting, hypertonic pelvic floor, pelvic girdle instability)
- symptoms: shooting, stabbing, and burning pain and tenesmus
What is Persistent Genital Arousal Disorder (PGAD)?
Unwanted sensation of genital arousal that is not resolved with orgasm
• Symptoms: throbbing, tingling, pain, tension, or irritation in the genitals with or without spontaneous orgasm
• It’s generally caused by irritation of the dorsal branch of the pudendal nerve via compression or overstretch including by Tarlov cysts
• Reported in up to 4% of the population, although likely under-reported
• Reported in women more often than men
What is Vulvodynia & vestibulodynia?
• Vulvodynia: persistent, idiopathic vulvar pain. It can be in all areas of the vulva or localized to certain structures only, such as the clitoris, urthera, or vestibule.
• Vestibulodynia is idiopathic pain at the vestibule. It’s the most common form of vulvodynia.
• Mostly affects vulva-owners between age 20-60.
What is vaginismus (lavator ani syndrome)?
Muscles around the opening of the vagina and surrounding involuntarily contract/tighten, making insertion painful if not impossible.
• Impacts mostly 18-35 year-old vagina owners
What are some pregnancy-related MSK changes?
- chin pushing forward
- eyes focused down
- slouching constricts rib cage so breathing difficult and indigestion
- slack muscles ollow out the back and tilts pelvis forward causing backache, strained abs, and excess pressure on bladder
- knees pressed back so strain joints and push pelvis forward
- weight on inner borders so strain foot arch and calves causing leg aches
What is Daistasis Rectus Abdominis
Separation and thinning of the rectus abdominus muscles and stretching of the linea alba by > 2 inches
• Prevalence: 33.1%, 60.0%, 45.4%, and 32.6% at gestation wk 21, 6 wks, 6 mo and 12 mo post partum
What is pregnancy-related pelvis girdle pain?
Specific form of LBP
• Affects the lumbo-sacral junction, SIJ, coccyx, and symphysis pubis
• Prevalence= 20% of pregnant women
What are symptoms of pelvic girdle pain?
• Pain with walking & running
• Pain with single leg WB activities (i.e.: dressing, stairs, lunges)
• Pain with bed mobility
• Pain with straddle movements
• Pain with lifting, bending, pushing, pulling
• Feeling “unstable” in pelvis
• Decreased tolerance to sit, stand, walk
What are signs of pelvic girdle pain?
- Waddle gait pattern
- Clicking/grinding in pubis area
- Provoked pain with resisted ABD & ADD
- Limited ABD AROM
What are some high risk pregnancy conditions?
• Premature Rupture of Membranes
• Incompetent Cervix
• Placenta Previa
• Pregnancy Induced Hypertension
• Pre-eclampsia
• Gestational Diabetes
• Multiple Gestations
• Premature Labor
• Spinal Cord Injury
What are pelvic floor dysfunctions? Examples? What causes this weakening?
Conditions that develop because of weakening of the support structures of the pelvic floor
• Examples: Pelvic organ prolapse, Stress urinary incontinence, Urge urinary incontinence or overactive bladder, Fecal incontinence or accidental bowel leakage
What causes that weakening to happen?
• Pregnancy/child birth
• Aging/menopause
• Genetics
• Obesity
• Smoking
• Chronic constipation
• Cancer treatment
What is Pelvic Organ Prolapse?
• Weakening of the pelvic floor leads to the pelvic floor organs falling out the vagina
• This happens gradually. You won’t suddenly wake up one day with your uterus hanging out!
• This can occur in 1 in 3 women (~30%).
What is Stress Urinary Incontinence?
• Support structures around urethra (tube that drains the bladder) are weakened.
• When you cough, sneeze, lift something heavy, or even just stand up, urine leaks out.
• This can occur in 1 in 3 women (~30%).
What is Post Prostatectomy Urinary Incontinence?
• Prostate cancer treatment is leading cause of stress UI in men
• Commonly caused by nerves, urinary sphincter, and obesity
• UI is associated with increased risk of depression, sleep disruption, lost productivity in the workplace and sexual dysfunction.
• Incontinent men, compared with incontinent women, reported more restrictions on social activities, possibly because UI is considered more “normal” for women.
What is an overactive bladder/urge incontinence?
• Affects up to 40% of men and 30% of women i
• The prevalence increases with age
• Sudden urge to urinate, sometimes followed by leaking
• Triggers include key in the door, running water, and seeing a toilet
• Occurs when the detrusor muscle contracts too often, and before the bladder is full
What is the prostate?
•Size of walnut
• Produces fluid that makes up a part of semen
• Throughout a man’s lifetime the prostate normally increases in weight about 21 times, compared to its birth weight
