Female pelvic floor myofascial syndrome and its relationship with lower urinary tract storage symptoms

Background: Pelvic floor myofascial syndrome is defined as non-articular skeletal muscle pain, characterized by the presence of trigger points. Present in 14-23% of patients with chronic pelvic pain. It has an impact on urinary function. The prevalence of lower urinary tract symptoms is 15-67%, with storage symptoms predominating in patients with PFMS. Objective was to determine the relationship between female pelvic floor myofascial syndrome and lower urinary tract storage symptoms.Methods: This was a retrospective, observational, descriptive, cross-sectional, homodemic and single-center study at University Hospital Doctor José Eleuterio González, Monterrey, Nuevo Leon, Mexico from period one from April 1st to June 30th, 2022. Type of non-probabilistic convenience sampling. Database in Excel 2016, Pearson's ?² statistical test in the SPSS V25® program.Results: 136 patients with PFMS and LUTS storage were evaluated. The most frequent age group was 46-55 years with 33.1% (N=45); the marital status was married with 74.3% (N=101). In relation to education 55.9% (N=76) with a bachelor's degree. The most frequent storage symptoms were nocturia 67.6% (N=92) p<0.05, frequency 60.3% (N=82) p=0.512, urgency 57.4% p<0.005.Conclusions: Knowing the correlation between PFMS and storage LUTS can guide specific pain treatment with review of urinary symptoms. In patients with nocturia, frequency, urgency, SUI and UUI, a physical examination should be performed and included trigger points in the pelvic floor. Nocturia is the most prevalent storage LUTS in PFMS.

Lower urinary tract symptoms secondary to a vaginal leiomioma the female prostate: case report

This is a case report of lower urinary tract symptoms secondary to a vaginal leiomioma “the female prostate”. A 45-year-old female patient with no significant personal history, sensation of a vaginal foreign body accompanied by lower urinary tract symptoms, on vaginal physical examination with a 7×7 cm deep tumor, increased consistency, not painful, without hemorrhage. Magnetic resonance imaging with hypointense T1 and T2 images, few linear hyperintense areas in T2, homogeneous postgadolinium enhancement 69×66×53 mm, solid tumor dependent on the vaginal vault. Tumor markers CA 19-9: 5.98 U/ml, CEA: 1.09 ng/ml and CA 125: 11.73 U/ml. Open surgery was performed in which a 8×6 cm tumor was found in the vaginal vault dependent on the posterior wall of the vagina. Histopathological report: conventional leiomyoma measuring 9×7.5 cm in long axes, without nuclear atypia. With resolution of symptoms in the lower urinary tract, with normal urinary frequency, without presence of urgency, without urinary incontinence or voiding symptoms. It is important to identify and diagnose lower urinary tract symptoms always, since they could be an initial manifestation of pelvic tumors in which the treatment approach should not be delayed.

Pelvic floor dysfunction in Mexican women

Background: Pelvic floor dysfunction (PFD) is a term used to describe a variety of disorders that involve moderate to severe impairment of the pelvic floor muscles. Throughout their lives, up to 46% of women will present at least one form of PFD and may even have a combination of this pathology. These afflictions have a profound influence on women抯 general well-being and quality of life, as well as being an immense economic burden for global health systems.Methods: This was a populational study which used surveys made in Google Forms of different questionnaires validated in Spanish [Urinary Incontinence Questionnaire (ICIQ), Female Sexual Function Index (IFSF), CPPQ Questionnaire for chronic pelvic pain, Wexner anal incontinence scale and quality of life] which were taken by women with access to social networks and who agreed to carry out an anonymous survey.Results: Seven hundred and twenty-one participants were evaluated, a total of 61.4% (443) responded positively to involuntary loss of urine, 35% had presented discomfort during sexual activity or lack of sexual interest, 14% had genital pain and 16% reported involuntary loss of feces or gas. Of all the patients that answered any of these questioners positively, only 33% had sought medical attention in the past.Conclusions: We concluded that in our population PFD is underdiagnosed. Our populations prevalence of urinary incontinence and pelvic pain is within the internationally described margins; anal incontinence is above international reports, and our population presented a lower prevalence of sexual dysfunction. With this new information we must impulse awareness to guide various preventive behaviors.

Multimodal treatment of myophasal chronic pelvic pain in women: institutional experience

Background: Chronic pelvic pain of myofascial origin is an underdiagnosed condition and with partial responses to the different treatment modalities. The objective of this study was to report the results of the multimodal management of Myofascial Chronic Pelvic Pain.Methods: Retrospective cohort of 33 patients with myofascial chronic pelvic pain, during the period 01 January 2016 to August 31, 2018, who were treated based on trigger point infiltration and analgesic vaginal electrostimulation. The analogous visual pain scale (VAS) was used at the beginning, sixth, twelfth and six months after the last electrostimulation session, in order to measure the effect of the treatment.Results: During the study period, 32 patients with chronic myofascial pelvic pain were found who received the multimodal scheme that is offered in our clinic. The average score of the EVA before starting the treatment was 8.5 points, at the sixth session of the treatment the average EVA was 3.6 points, at the twelfth session of 1.3 points and the average score of the EVA at six months after the last session of the multimodal treatment was 2.9 points. A significant difference was demonstrated in the average EVA score in the first with respect to the sixth, twelfth and six months (p = <0.000). There were no complications or adverse effects secondary to the multimodal treatment.Conclusions: Multimodal treatment was associated with progressive improvement in 80% of patients with miofascial chronic pelvic pain.