Kearney, R. orcid.org/0000-0002-1489-4397, Salvatore, S. orcid.org/0000-0001-5601-045X, Khullar, V. orcid.org/0000-0002-4775-7495 et al. (5 more authors) (2025) Do we have the evidence to produce tools to enable the identification and personalization of management of women's pelvic floor health disorders through the perinatal and perimenopausal periods? ICI‐RS 2024. Neurourology and Urodynamics. ISSN 0733-2467
Abstract
Introduction
There is an increasing recognition of the impact of ageing on pelvic floor health and the consequences in populations with rising proportions of women over the age of 65 years. A think tank was held at the ICI-RS 2024 to discuss the evidence to support the personalisation of women's pelvic floor health during the perinatal and perimenopausal period.
Methods
Data was collected and presented on the evidence to support the development of tools to personalise pelvic floor health care. Epidemiological, imaging, patient-reported outcomes, and evidence of tool development questionnaires were discussed. The current evidence and research gaps for potential intervention to prevent the pelvic floor disorders of pelvic organ prolapse, overactive bladder, urinary incontinence and faecal incontinence during the perinatal and perimenopasual time periods were discussed and identified.
Results
Epidemiological studies highlight that vaginal delivery and in particular operative vaginal delivery is the single biggest modifiable risk factor for the future development of pelvic floor dysfunction. The oestrogen depletion resulting from the perimenopause and menopause can lead to the development of Genitourinary syndrome of menopause (GSM) which is associated with the risk of developing pelvic floor dysfunction. Ultrasound is a useful technique for assessing the pelvic floor and has been used to assess bladder neck mobility, distensibility of the puborectalis muscle and the striated urethral sphincter volume antenatally with some studies reporting a correlation between these measurements and the need for Caesarean section and development of postpartum stress urinary incontinence. Further studies are needed to standardise these measurements. There are no patient reported outcome questionnaires validated for use in the perinatal and postmenopausal period. The UR- choice tool has been developed to counsel women on the risk of postpartum pelvic floor disorders occurring. However, further evaluation in larger numbers is required.
Conclusion
There is significant interest in developing tools to counsel women on the risks of developing pelvic floor dysfunction post partum and after the menopause. Further evaluation of the UR-choice tool was considered a research priority. The timepoint of cervical screening for research into interventions such as pelvic floor health education, lifestyle optimisation and perimenopausal vaginal oestrogen supplementation was identified.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2025 The Author(s). Neurourology and Urodynamics published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/ |
Keywords: | Pelvic floor dysfunction; Pelvic health personalisiation; Perinatal health; Tools; perimenopausal health |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 07 Mar 2025 11:10 |
Last Modified: | 07 Mar 2025 11:10 |
Status: | Published online |
Publisher: | Wiley |
Refereed: | Yes |
Identification Number: | 10.1002/nau.70019 |
Related URLs: | |
Sustainable Development Goals: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:224131 |