Pelvic organ prolapse and urogynecological assessment in women with spinal cord injury

TY - JOUR

T1 - Pelvic organ prolapse and urogynecological assessment in women with spinal cord injury

AU - Elmelund, Marlene

AU - Biering-Sørensen, Fin

AU - Bing, Mette Hornum

AU - Klarskov, Niels

PY - 2019/1/1

Y1 - 2019/1/1

N2 - STUDY DESIGN: Observational cross-sectional study.OBJECTIVES: Due to weakened pelvic floor muscles, the risk of pelvic organ prolapse (POP) may increase after a spinal cord injury (SCI); hence, the aim of this study was to investigate the occurrence of POP after SCI and to evaluate the need for urogynecological consultations offered to women with SCI.SETTING: Clinic for Spinal Cord Injuries, Rigshospitalet, Denmark.METHODS: Women with SCI who visited our SCI-clinic during January 2013-January 2018 were offered a specialized urogynecological consultation. Any symptoms of POP, urinary/fecal incontinence, or bladder/bowel emptying problems were registered, and POP was classified according to the POP quantification system during a pelvic examination. Differences in baseline characteristics between women with POP stage 0-1 and POP stage ≥2 were investigated.RESULTS: A total of 98 women were included in the study. Fourteen women (14%) reported POP symptoms and 21 women (21%) had anatomical POP stage ≥2. The group with POP stage ≥2 had a significantly higher age, higher parity, more with vaginal delivery, and more postmenopausal women, but the groups did not differ on median time after injury, neurological level, and completeness of injury. A total of 71% experienced urinary incontinence, 27% experienced fecal incontinence, 63% experienced bladder emptying problems, and 70% experienced bowel emptying problems. Consequently, 65% received treatment.CONCLUSIONS: Women with SCI are not in increased risk of developing anatomical POP. Nonetheless, the high occurrence of other urogynecological issues and the high treatment-rate supports the need for specialized urogynecological consultations offered to women with SCI.

AB - STUDY DESIGN: Observational cross-sectional study.OBJECTIVES: Due to weakened pelvic floor muscles, the risk of pelvic organ prolapse (POP) may increase after a spinal cord injury (SCI); hence, the aim of this study was to investigate the occurrence of POP after SCI and to evaluate the need for urogynecological consultations offered to women with SCI.SETTING: Clinic for Spinal Cord Injuries, Rigshospitalet, Denmark.METHODS: Women with SCI who visited our SCI-clinic during January 2013-January 2018 were offered a specialized urogynecological consultation. Any symptoms of POP, urinary/fecal incontinence, or bladder/bowel emptying problems were registered, and POP was classified according to the POP quantification system during a pelvic examination. Differences in baseline characteristics between women with POP stage 0-1 and POP stage ≥2 were investigated.RESULTS: A total of 98 women were included in the study. Fourteen women (14%) reported POP symptoms and 21 women (21%) had anatomical POP stage ≥2. The group with POP stage ≥2 had a significantly higher age, higher parity, more with vaginal delivery, and more postmenopausal women, but the groups did not differ on median time after injury, neurological level, and completeness of injury. A total of 71% experienced urinary incontinence, 27% experienced fecal incontinence, 63% experienced bladder emptying problems, and 70% experienced bowel emptying problems. Consequently, 65% received treatment.CONCLUSIONS: Women with SCI are not in increased risk of developing anatomical POP. Nonetheless, the high occurrence of other urogynecological issues and the high treatment-rate supports the need for specialized urogynecological consultations offered to women with SCI.

KW - Adult

KW - Aged

KW - Cross-Sectional Studies

KW - Fecal Incontinence/diagnosis

KW - Female

KW - Humans

KW - Middle Aged

KW - Needs Assessment

KW - Pelvic Organ Prolapse/diagnosis

KW - Risk Assessment

KW - Severity of Illness Index

KW - Spinal Cord Injuries/complications

KW - Urinary Incontinence/diagnosis

U2 - 10.1038/s41393-018-0181-0

DO - 10.1038/s41393-018-0181-0

M3 - Journal article

C2 - 30097630

SN - 1362-4393

VL - 57

SP - 18

EP - 25

JO - Spinal Cord

JF - Spinal Cord

ER -