Comparisons of pelvic floor muscle performance, anxiety, quality of life and life stress in women with dry overactive bladder compared with asymptomatic women.

UNLABELLED: Study Type - Therapy (case control) Level of Evidence 3b What's known on the subject? and What does the study add? Abnormal pelvic floor muscle function has been associated with chronic pelvic pain syndromes. This study adds evidence about pelvic muscle performance in women with dry overactive bladders. OBJECTIVES: To determine if pelvic floor muscle surface electromyography (sEMG) measurements differed between women with dry overactive bladder (OAB) symptoms and asymptomatic controls. To determine whether pelvic floor muscle performance was associated with anxiety scores, quality of life and life stress measures PATIENTS AND METHODS: We enrolled 28 women with urinary urgency and frequency without urinary incontinence, and 28 age-matched controls. sEMG was used to assess pelvic muscle performance. Participants also completed the Beck Anxiety Inventory, Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire and Recent Life Changes Questionnaire. RESULTS: Anxiety scores were significantly higher in women with dry OAB than in controls. No significant differences were found in sEMG measures of pelvic muscle contraction or relaxation between the two groups. There was no significant correlation between sEMG pretest resting baseline measurements and the Beck Anxiety Inventory, the Pelvic Floor Distress Inventory, the Pelvic Floor Impact Questionnaire or life stress scores among symptomatic women. As expected, women with dry OAB had significantly higher scores on the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire. CONCLUSIONS: This study supports a relationship between dry OAB symptoms and anxiety that warrants further exploration. Resting sEMG baselines were not elevated and did not support the hypothesis that women with dry OAB are unable to relax their pelvic floor muscles.

The day-to-day impact of urogenital aging: perspectives from racially/ethnically diverse women.

BACKGROUND: Urogenital symptoms affect up to half of women after menopause, but their impact on women's day-to-day functioning and wellbeing is poorly understood. METHODS: Postmenopausal women aged 45 to 80 years reporting urogenital dryness, soreness, itching, or pain during sex were recruited to participate in in-depth focus groups to discuss the impact of their symptoms. Focus groups were homogenous with respect to race/ethnicity and stratified by age (for White or Black women) or language (for Latina women). Transcripts of sessions were analyzed according to grounded theory. RESULTS: Six focus groups were conducted, involving 44 women (16 White, 14 Black, 14 Latina). Five domains of functioning and wellbeing affected by symptoms were identified: sexual functioning, everyday activities, emotional wellbeing, body image, and interpersonal relations. For some participants, symptoms primarily affected their ability to have and enjoy sex, as well as be responsive to their partners. For others, symptoms interfered with everyday activities, such as exercising, toileting, or sleeping. Participants regarded their symptoms as a sign that they were getting old or their body was deteriorating; women also associated symptoms with a loss of womanhood or sexuality. Additionally, participants reported feeling depressed, embarrassed, and frustrated about their symptoms, and expressed reluctance to discuss them with friends, family, or health care providers. CONCLUSIONS: Urogenital symptoms can have a marked impact on sexual functioning, everyday activities, emotional wellbeing, body image, and interpersonal relations after menopause. Clinicians may need to question women actively about these symptoms, as many are reluctant to seek help for this problem.