Management of Pelvic Floor Disorders in Young Women
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RECONSTRUCTED BLADDER FUNCTION & DYSFUNCTION (M KAUFMAN, SECTION EDITOR)
Management of Pelvic Floor Disorders in Young Women Margaret Hines 1 & Rachel High 1 & Jill M. Danford 2 Accepted: 30 July 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review This review is meant to guide female pelvic medicine providers on treatment of pelvic floor disorders in the relatively uncommon population of younger women. Recent Findings Presented herein are recent data on pelvic floor muscle training in the postpartum period to help with prevention of pelvic floor disorders as well as surgical outcomes in younger women. Summary Although new evidence is available on prevention and treatment for younger patients, more RCTs and cohort studies are needed. Keywords Pelvic organ prolapse . Stress urinary incontinence . Fecal incontinence . Overactive bladder . Obstetrical anal injury
Introduction Prevalence Pelvic floor disorders (PFDs) include pelvic organ prolapse (POP), urinary and fecal/anal incontinence (UI and FI/AI), and defecatory dysfunction. PFDs are often considered pathology of older women; however, 2.6–22.9% of patients under 40 report urinary incontinence and 2.5% report prolapse symptoms [1••, 2••]. Analincontinence numbers rangefrom 5 to 25%, depending on specific populations studied. Nygaard et al., in their original prevalence study in 2008, reported 9.7% of women aged 20–49 with any pelvic floor disorder, while 6 years later, Wu et al. reported 19.9% [1••, 3]. Young women are in a different life stage than postmenopausalwomen:some This article is part of the Topical Collection on Reconstructed Bladder Function & Dysfunction * Jill M. Danford [email protected] Margaret Hines [email protected] Rachel High [email protected] 1
Department of Obstetrics and Gynecology, Baylor Scott and White, 2401 S 31st St, Temple, TX 76508, USA
2
Department of Surgery, Division of Urology, Baylor Scott and White, 2401 S 31st St, Temple, TX 76508, USA
are currently pregnant while others are still considering conception. Many desire to retain their uterus, despite not desiring to continue childbearing. The younger population also raises the question of durability of surgical correction of their pelvic floor disorder. In this review, we will discuss the management and treatment of all pelvic floor disorders and how it pertains to the specific population of women under 50 years of age.
Patient Understanding Despite more mainstream media about PFDs, many women believe their condition is rare or, in the instance of prolapse, did not know this disorder that could occur [4]. Many women present with concern for malignancy or with minimal understanding of their pelvic anatomy. Younger women have less insight into prolapse than incontinence, as fewer peers have experienced prolapse in this population, and more women under 50 are oblivious to prolapse at all [5]. Parden et al. surveyed women in a higher education system to determine the difference between adolescent women
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