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.

Urethro-cutaneous fistula: a rare complication in anti-incontinence surgery with trans-obturator tapes sling

This case report presents a rare complication of tension-free mid-urethral tape surgery by the obturator approach (TOT) in the form of a urethro-cutaneous fistula. The patient underwent successful surgical repair, highlighting the importance of intraoperative cystoscopy to minimize surgical risks and complications. Tension-free mid-urethral tape surgery is a commonly performed procedure for the treatment of stress urinary incontinence (SUI). However, complications can occur, albeit rarely. In this case, a 52-year-old female patient developed a urethro-cutaneous fistula following TOT surgery. The fistula was identified by the presence of urine leakage at the right inguinal level, leading to significant distress and discomfort for the patient. Prompt diagnosis and appropriate management are crucial in such cases. The patient underwent surgical repair, which involved excision of the fistulous tract. The procedure was successful, resulting in complete resolution of the fistula and restoration of normal urinary function. In conclusion, this case report highlights the occurrence of a rare complication, namely a urethro-cutaneous fistula, following TOT surgery. The successful surgical repair emphasizes the importance of prompt diagnosis and appropriate management. Furthermore, the authors propose that an intraoperative cystoscopic evaluation be considered, even after a TOT procedure. Especially in cases that present risk factors or in hospital-school institutions. By implementing this practice, surgeons can enhance patient safety and improve surgical outcomes in anti-incontinence procedures.

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.