Showing papers by "Kari Bø published in 2010"

Are former female elite athletes more likely to experience urinary incontinence later in life than non-athletes?

Abstract: The aim of the present study was to investigate whether former female elite athletes are more likely to experience urinary incontinence (UI) later in life than non-athletes and to assess possible risk factors for UI in athletes. Three hundred and thirty-one former elite athletes (response rate 81%) and 640 controls replied to a postal questionnaire including validated questions on UI. While competing in sport, 10.9% and 2.7% of the former elite athletes reported stress urinary incontinence (SUI) and urge incontinence, respectively. Presently, 36.5% of the former elite athletes and 36.9% of the controls reported SUI. 9.1% and 9.4% reported urge incontinence. Among former elite athletes, those with two or three children were more likely than nulliparous women to have UI now. Also, among former athletes, UI was more common in women with vs those without UI while competing (odds ratio 8.57, 95% confidence interval: 3.55-20.71). Age, menopause and being regularly physically active now were not associated with UI in either group. Based on this study, the prevalence of UI does not seem to be higher in former athletes than in controls. However, the results indicate that UI early in life, as reported during elite sport, is a strong predictor of UI later in life.

Validation of three-dimensional perineal ultrasound and magnetic resonance imaging measurements of the pubovisceral muscle at rest

Abstract: Objective To compare biometric measurements of the pubovisceral muscle during rest, measured using transperineal three-dimensional (3D) ultrasound and magnetic resonance imaging (MRI). Methods In this prospective study, 18 female volunteers underwent 3D perineal ultrasound examination and MRI. All women were examined at rest in the supine position and the following measurements were taken: area and anteroposterior and transverse diameters of the levator hiatus; thickness of the pubovisceral muscle, measured lateral to the vagina and to the rectum, on the right and left sides; length of the levator–urethra gap (LUG), measured from the center of the urethra to the insertion of the pubovisceral muscle on the pubic bone. Interclass correlation coefficients (ICC) between the measurements obtained with 3D ultrasound and with MRI were calculated. To quantify the intermeasurement agreement, the bias and SDs were calculated, and limits of agreement constructed. One investigator performed all the analyses. Results There was no significant difference between the mean values of the measurements by 3D perineal ultrasound and those by MRI. The ICC values showed very good agreement (range, 0.80–0.97). There was a significant positive bias for LUG on the left side and muscle thickness on the right side of the vagina. Conclusion These results suggest that 3D ultrasound could be used instead of MRI when evaluating static pelvic floor anatomy in women without pelvic organ prolapse at rest. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.

Urinary Incontinence and Weight Change During Pregnancy and Postpartum: A Cohort Study

Abstract: Weight gain during pregnancy may contribute to increased urinary incontinence (UI) during and after pregnancy, but scientific support is lacking. The effect of weight loss on UI postpartum is unclear. From 1999 to 2006, investigators in the Norwegian Mother and Child Cohort Study recruited pregnant women during pregnancy. This study was based on 12,679 primiparous women who were continent before pregnancy. Data were obtained from questionnaires answered at weeks 15 and 30 of pregnancy and 6 months postpartum. Weight gain greater than the 50th percentile during weeks 0–15 of pregnancy was weakly associated with higher incidence of UI at week 30 compared with weight gain less than or equal to the 50th percentile. Weight gain greater than the 50th percentile during pregnancy was not associated with increased prevalence of UI 6 months postpartum. For each kilogram of weight loss from delivery to 6 months postpartum among women who were incontinent during pregnancy, the relative risk for UI decreased 2.1% (relative risk = 0.98, 95% confidence interval: 0.97, 0.99). Weight gain during pregnancy does not seem to be a risk factor for increased incidence or prevalence of UI during pregnancy or postpartum. However, weight loss postpartum may be important for avoiding incontinence and regaining continence 6 months postpartum.

Self-reporting compared to motion monitor in the measurement of physical activity during pregnancy

Abstract: Most pregnancy-studies have relied on retrospective, cross-sectional surveys to measure physical activity level. Questionnaires are cost-effective, but validity of the data may be questionable. Objective. The aim of the present study was to validate a physical activity and pregnancy questionnaire (PAPQ) with a portable activity monitor (ActiReg®). Design. Prospective comparison study. Setting. Healthy pregnant women recruited in a capital area. Population. Seventy-seven pregnant women wore the ActiReg® sensors during waking hours for seven consecutive days and answered the PAPQ. Main outcome measures. Agreement between the two methods was analyzed by Bland–Altman plots and Spearman correlation coefficients. Results. The results indicated only small differences between the PAPQ and the ActiReg® in cross-tabulation of total physical activity level and proportion of participants meeting the current exercise guidelines. The correlation between the methods was good (r = 0.59) for time spent in activiti...

Physiotherapy as an adjunct to prolapse surgery: an assessor-blinded randomized controlled trial.

Abstract: Introduction This assessor-blinded randomized controlled trial investigated the effect of a pre- and post-operative physiotherapy-supervised pelvic floor muscle (PFM) training program in women undergoing surgery for prolapse or hysterectomy. Methods Participants were assessed pre-operatively, and at 3, 6, and 12 months post-operatively by a blinded physiotherapy assessor. Following randomization, participants were allocated to a control group (CG) which included “usual care” (as provided by the surgeon and the hospital staff), or a treatment group (TG) which included one pre-operative and seven post-operative treatment sessions over 12 months. Primary outcomes were bladder and prolapse symptoms, measured by the Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionnaire (IIQ). Results Fifty-one participants were randomized. The 12-month post-operative findings showed there was no difference in the prevalence of the primary outcomes (ORs 1.2, 1.3). There were no significant differences between groups on the change scores of the UDI (mean: 44.1 [5.1]; 54.0 [5.4], P = 0.20) nor the IIQ (median: 0.0 [9,14]; 10.0 [5,19], P = 0.09). The repeated measures analyses also demonstrated no significant changes. Conclusion The program tested did not improve bladder or prolapse symptoms in this trial. Reasons may include the effectiveness of surgery alone, wide variance in data, small sample size, insufficient training by the TG, and PFM training by the usual care group. Neurourol. Urodynam. 29:719–725, 2010. © 2010 Wiley-Liss, Inc.

Pelvic floor muscle strength, endurance and vaginal resting pressure are positively associated with muscle thickness, size of levator hiatus and position of the bladder in women with prolapse stage I, II and III. A 3D/4D ultrasound study

Abstract: Hypothesis / aims of study To date there is scant knowledge about the relationship between pelvic floor muscle (PFM) strength and morphology of the pelvic floor including position of the pelvic organs. The aim of the present study was to investigate the association between three PFM variables (strength, endurance and vaginal resting pressure) and muscle thickness, size of levator hiatus and position of the bladder in women with pelvic organ prolapse (POP) stage I, II and III.

Heart rate and blood pressure in response to pelvic floor muscle training during pregnancy

Abstract: Hypothesis / aims of study A recent Cochrane review has recommended pelvic floor muscle training (PFMT) during pregnancy to prevent urinary incontinence (1). No complications or side effects have been reported after PFMT, but attempts of maximal contraction with a holding period may increase blood pressure and heart rate. Anecdotally, some women complain of light headache and dizziness when starting a PFMT program. The aim of the present study was to assess whether heart rate (HR) and blood pressure (BP) change significantly in response to PFMT during pregnancy