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Pelvic-Floor Muscle Function in Women With Pelvic Organ Prolapse

DF Borello-France, PT, PhD, is Assistant Professor, Department of Physical Therapy, 111 Health Sciences Bldg, Duquesne University, Pittsburgh, PA 15282 (USA)
VL Handa, MD, is Associate Professor, Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Md
MB Brown, PhD, is Professor, Department of Biostatistics, University of Michigan, Ann Arbor, Mich
P Goode, MD, MSN, is Associate Director for Clinical Programs, Geriatric Research, Education, and Clinical Center, Birmingham Veterans Affairs Medical Center, and Professor of Medicine, University of Alabama at Birmingham, Birmingham, Ala
K Kreder, MD, is Professor and Vice Chair, Department of Urology, University of Iowa, Iowa City, Iowa
LL Scheufele, PT, BScPT, BCIA-PMDB, GCFP, is Pelvic Floor Physical Therapist, Johns Hopkins Bayview Medical Center, Baltimore, Md
AM Weber, MD, MS, is Project Scientist, Pelvic Floor Disorders Network, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Md
Pelvic Floor Disorders Network (see listing of member sites and investigators in the Footnotes)

Address all correspondence to Dr Borello-France at: borellofrance{at}duq.edu

Background and Purpose: The purpose of this study was to determine whether pelvic organ prolapse severity, pelvic symptoms, quality of life, and sexual function differ based on pelvic-floor muscle function in women planning to have prolapse surgery.

Subjects and Methods: Three hundred seventeen women without urinary stress incontinence who were enrolled in a multicenter surgical trial were examined to determine pelvic-floor muscle function (by Brink scale score). The subjects were 61.6±10.2 (±SD) years of age. Thirteen percent of the subjects had stage II (to the hymen) pelvic organ prolapse, 68% had stage III (beyond the hymen) prolapse, and 19% had stage IV (complete vaginal eversion) prolapse. Subjects with lowest (3–6) and highest (10–12) Brink scale scores were compared on prolapse severity, pelvic symptoms and bother, quality of life, and sexual function.

Results: Subjects with the highest Brink scores (n=75) had less advanced prolapse, smaller genital hiatus measurements, and less urinary symptom burden compared with those with the lowest Brink scores (n=56). The results indicated that pelvic-floor muscle function was not associated with condition-specific quality of life or sexual function.

Discussion and Conclusion: Although modestly clinically significant, better pelvic-floor muscle function was associated with less severe prolapse and urinary symptoms.