Lumbopelvic pain in women with pelvic floor dysfunction: a cross-sectional study

Cecchi Salata M1, Farias Porto J1, da Silva Xavier S1, da Cruz Silva A1, Gontijo Ribeiro T1

Research Type

Clinical

Abstract Category

Female Lower Urinary Tract Symptoms (LUTS) / Voiding Dysfunction

Abstract 378
Open Discussion ePosters
Scientific Open Discussion Session 5
Wednesday 27th September 2023
13:05 - 13:10 (ePoster Station 3)
Exhibit Hall
Pelvic Floor Pain, other Retrospective Study Motor Dysfunction
1. UNICEPLAC
Presenter
M

Mariana Cecchi Salata

Links

Poster

Abstract

Hypothesis / aims of study
To verify the presence of lumbar pain in women with pelvic floor dysfunctions.
Study design, materials and methods
This is an observational, cross-sectional, descriptive and retrospective study captured refers to the evaluations that took place in the period between 2019 and 2022. Data collection was based on obtaining information from medical records, where the following variables were collected: age, reproductive status, obstetric history, voiding, anal and sexual complaints, presence of pelvic organ prolapse and low back pain. Dysfunctions were based on patient reports. For the selection of medical records, the following inclusion criteria were used: female patients, aged between 18 and 60 years, who presented complaints of pelvic floor dysfunction. Incompletely completed medical records were excluded from this study. The variables were tabulated in the Microsoft Excel 2019 program, as well as the descriptive analysis of the data. Numerical variables were presented in means, standard deviations and categorical variables in absolute frequency and percentages.
Results
The sample consisted of 80 medical records of women who had complaints of pelvic floor dysfunction, wich 48 women were in menacme (60%) and 32 in climacteric (40%). There was an average of 2.18 pregnancies (SD: 1.96), 1.2 deliveries (SD: 1.69), 0.23 abortions (SD: 0.55) and 0.75 cesarean sections (SD: 1 ,09). Lumbopelvic pain was reported by 49 women (61.25%), and genito-pelvic pain/penetration disorder (77.5%) and urinary incontinence (76.25%) were the main complaints in this group.
Interpretation of results
In our analysis, we found that 76.25% of women with PFM dysfunction and low back pain complained of urinary incontinence. This condition has a strong epidemiological correlation with lumbar-pelvic pain, as it is known that patients with musculoskeletal disorders in the spine are more likely to develop urinary symptoms as a result of alterations in the control of the trunk stabilizing muscles (transversus abdominis, rectus abdomen and multifidus), which can generate an increase in intra-abdominal pressure and weaken the pelvic floor (1). Another important finding was the high prevalence of genito-pelvic pain/penetration disorder in the group of women with low back pain (77.5%), corroborating with another study, where 70.6% were found, correlating this condition to increased tonus at rest and decreased relaxation capacity, verified through the high sensitivity to palpation of the pelvic floor muscles, which were hyperactive, resulting in severe pain , reflecting on urogynecological and musculoskeletal symptoms (2). It is worth emphasizing that other factors predispose the occurrence of PFM dysfunction and lumbar-pelvic pain, like age, obesity, pregnancy and hormonal changes that can generate biomechanical changes in the body's center of gravity, resulting in postural changes and impairment of the abdominal wall musculature, impairing trunk stability and overloading the pelvic floor muscles (3).
Concluding message
The findings of this study reinforce the correlation between pelvic floor dysfunction and lumbopelvic pain. This association is related to the deficiency of the trunk stabilizing mechanism, composed of the muscles of the pelvic floor and spine. Urinary incontinence and genito-pelvic pain/penetration disorder were the main complaints presented by women with low back pain. It is suggested that more randomized clinical trials be carried out, in order to verify the effectiveness of the combined interventions, so that it is possible to develop more effective and lasting treatment proposals.
Figure 1 Complaint of lumbopelvic pain in women with pelvic floor muscle dysfunction
Figure 2 Pelvic floor disorders in women with low back pain
References
  1. WELK, B.; BAVERSTOCK, R.; Is there link between back pain and utinary symptoms? Neurourology and Urodynamics. p. 1-10, 2020.
  2. DUFOUR, S.; VANDYKEN, B.; FORGET, M. J.; VANDYKEN, C. Associaction between lumbopelvic pain and pelvic floor dysfunction in women: a cross sectional study. Musculoskeletal Science and Practice, n. 17, 2017.
  3. SANT’ANNA, P. C. F.; OLINTO, M. T. A.; BAIRROS, F. S.; GARCEZ, A.; COSTA, J. S. D. Chronic low back pain in a population of women in Southern Brazil: prevalence and associated factors. Fisioter Pesqui. v. 28, n. 1, p. 9-17, 2021.
Disclosures
Funding None. Clinical Trial No Subjects Human Ethics Committee UNICEPLAC Ethics Committee (CAAE: 40693020.8.0000.5058). Helsinki Yes Informed Consent Yes
21/08/2024 07:32:15