Objective To determine whether women engaged in strenuous, provocative exercise are more likely to be incontinent in future life than similarly fit women who participated in less provocative exercise. Methods In this retrospective cohort study, female American Olympians who competed in swimming (low-impact group) and in gymnastics and track and field (high-impact group) between 1960 and 1976 completed a structured questionnaire. Primary outcome measures included the prevalence of the symptoms of stress and urge incontinence. Statistical analyses of results included χ 2 , Fisher exact test, two-tailed t tests, Wilcoxon rank sum test, and stepwise multiple logistic regression. P Results One hundred four women responded (response rate 51.2%). High-impact athletes were older (46.2 compared with 42.4 years) and were more likely to report incontinence when they were doing their sport as Olympians (35.8% compared with 4.5%) than low-impact athletes; low-impact athletes were more likely to be parous (83.3% compared with 60.7%). There was no difference in the prevalence of the symptom of stress incontinence between the highversus low-impact groups: any incontinence, 41.1% compared with 50%; daily or weekly incontinence, 10.7% compared with 8.3%; and incontinence that bothered them moderately or greatly, 10.7% compared with 4.2%. With our sample size, this study had 80% power to detect a fourfold difference in daily or weekly incontinence between groups, but only a 30% power to detect a twofold difference, given a baseline prevalence of 10%. When age, body mass index (BMI), parity, Olympic sport group, and incontinence during Olympic sport were entered into stepwise logistic regression analyses, only BMI was significantly associated with regular stress or urge incontinence symptoms. Conclusion Participation in regular, strenuous, highimpact activity when younger did not predispose women to a markedly higher rate of clinically significant urinary incontinence in later life.

Does prolonged high-impact activity contribute to later urinary incontinence? A retrospective cohort study of female olympians

Keywords:

basic science;
incontinence (female);
incontinence (male);
prolapse;
International Continence Society;
Annual Meeting

What was hot at the ICS meeting 2014

Background/aims The Anopress device is a new portable manometry system. The aim of this study is to formulate normative data using this new device by recording the anorectal function of asymptomatic subjects. Patient comfort was also assessed. Methods Anorectal function was assessed in asymptomatic volunteers using the Anopress. All volunteers were examined in a standardized way in accordance with the study protocol. Normative values for the Anopress were obtained from the recorded data and patient comfort was assessed using a visual analogue scale. Results We recruited 153 healthy volunteers. Eighty were female (23 parous; median age 39.5 [interquartile range {IQR}, 28.75-53.00]) and 73 were male (median age 40.5 [IQR, 29.00-52.25]). For the female cohort, the following normal range (2.5-97.5 percentile) values were recorded across the whole anal canal: resting pressure 40.0-103.0 mmHg; squeeze increment 35.0-140.6 mmHg; endurance 1.3-9.0 seconds; involuntary squeeze 41.1-120.8 mmHg; and strain pressure 22.1-77.9 mmHg. Similarly, the following male normal range (2.5-97.5 percentile) values were recorded across the whole anal canal: resting pressure 38.3-99.6 mmHg; squeeze increment 42.5-154.8 mmHg; involuntary squeeze 40.0-123.6 mmHg; endurance 2.0-10.0 seconds; and strain pressure 11.0-72.1 mmHg. The median visual analogue scale scores for discomfort during the measurement was 0.0 (IQR, 0.00-0.00). Conclusions Normative values for the Anopress device have been calculated by this study. The Anopress appears to be a safe and well tolerated way of measuring pressures from the entire anal canal. Further comparisons with other standard and commonly used manometry tests are, however, required to verify its reliability.

Evaluation of 153 Asymptomatic Subjects Using the Anopress Portable Anal Manometry Device

Objective
To assess the correlation between the anorectal function and bladder detrusor function in patients with complete spinal cord injury (SCI) according to the type of lesion.

/pdf/anorectal-manometric-and-urodynamic-parameters-according-to-40e000fudo.pdf

Anorectal Manometric and Urodynamic Parameters According to the Spinal Cord Injury Lesion

International Continence Society: 7th Annual Meeting, Portoroz 1977

[Purpose] To assess the influence of moderate physical exercise on pelvic floor muscle electromyographic (EMG) biofeedback signal in female non-athletes. [Subjects and Methods] A prospective, non-randomized study of 90 adult females (age ≥18 years) divided into three groups: Intervention (I), which began physical exercise upon study enrollment; Moderate Exercise (ME), comprising those who already engaged in physical activity; and Sedentary (S), comprising those who had a sedentary lifestyle. All participants underwent EMG biofeedback of the pelvic floor muscles upon study enrollment (T1) and at the end of the third subsequent month (T2). [Results] Mean age was 35.7 (SD: 7.5) years, with no significant difference between groups. T1 values in groups I and S were significantly lower than in group ME. There was no statistically significant difference between groups S and I. On comparison between groups at T2, values were highest in group I (18.5 µV vs. 15.3 µV in group S, vs. 16.1 µV in group ME). There was no significant difference between groups S and ME. On age-adjusted analysis, group I exhibited the greatest change between T1 and T2 (I, 4.7 µV; ME, 2.1 µV; S, 1.5 µV). [Conclusion] Females who exercise exhibit better pelvic floor muscle function than those who do not engage in physical activity.

Do moderate aerobic exercise and strength training influence electromyographic biofeedback of the pelvic floor muscles in female non-athletes?

RACIONAL: A manometria anorretal e metodo diagnostico empregado na pratica clinica para avaliacao de disturbios funcionais anorretais e do assoalho pelvico. As disfuncoes miccionais, anorretais e do assoalho pelvico tem sido consideradas como fatores contribuintes dos sintomas de bexiga hiperativa. OBJETIVO: Avaliar os resultados obtidos com manometria anorretal em mulheres adultas com diagnostico clinico e urodinâmico de bexiga hiperativa. METODOS: Vinte e cinco mulheres adultas (media de idade de 45.5±11.9 anos) com diagnostico clinico e urodinâmico de bexiga hiperativa submeteram-se a manometria anorretal e os resultados obtidos nesta avaliacao foram comparados aos de um grupo controle de 18 mulheres (media de idade de 33.9 ±10.7 anos) assintomaticas do ponto de vista urinario e sem criterios clinicos para diagnostico de bexiga hiperativa. O grupo de mulheres com bexiga hiperativa foi denominado BH e controle C. RESULTADO: Ocorreram seis (24%) casos de contracao paradoxal do puborretal no grupo BH e nenhuma no Grupo C. Houve 13 (52%) ocorrencias de hipertonia de repouso isolada ou associada a hipertonia de contracao no Grupo BH e sete (39%) no Grupo C. A media de pressao de repouso foi de 80.1 mmHg no Grupo BH e 67.6 mmHg no Grupo C. O total de ocorrencia de hipertonia de contracao no Grupo BH foi de 7(28%) e 11(61%) no Grupo C. A media de pressao de contracao foi de 182.2 mmHg no Grupo BH e 148.1 mmHg no Grupo. Com relacao ao reflexo inibitorio retoanal, a sensibilidade e a capacidade retal maxima nao houve diferenca estatisticamente significante entre os dois grupos. CONCLUSAO: As mulheres com bexiga hiperativa apresentaram maior ocorrencia de contracao paradoxal do puborretal em relacao as do grupo controle.

/pdf/anorectal-manometry-evaluation-in-adult-women-with-clinical-3n6k55kzrd.pdf

Anorectal manometry evaluation in adult women with clinical and urodynamic diagnostics of overactive bladder

Hypothesis / aims of study Pelvic floor muscles are those that help support the pelvic organs during rest and participate in the occlusion of the urogenital hiatus, playing an important role in maintaining urinary and anal continence [1]. The lack of knowledge or ignorance of these muscles makes awareness a mandatory step in any perineal re-education [2]. The aim of the study was to evaluate and quantify the influence of knowledge of genital anatomy on the function of contraction of your muscles.

Maria Lucia Campos Gonçalves

Papers

Do moderate aerobic exercise and strength training influence electromyographic biofeedback of the pelvic floor muscles in female non-athletes?

Anorectal manometry evaluation in adult women with clinical and urodynamic diagnostics of overactive bladder

Is there development in pelvic muscle strength after explanations of genital anatomy? – A randomized controlled trial