ABSTRACT
INTRODUCTION AND HYPOTHESIS: Fibromyalgia (FM) studies have focused on pain, but a 2010 review of the diagnostic criteria pointed to other symptoms including urinary incontinence (UI). Women with FM present pain, fatigue, and reduced muscle strength; the research hypothesis was that pelvic floor (PF) muscles would be weaker; therefore, FM could be associated with lower urinary tract symptoms (LUTS) and compromise quality of life (QoL). The aim of this paper was to compare PF function, urinary symptoms, and their impact on QoL in women with and without FM and to verify if there is association between FM and LUTS. METHODS: We performed a cross-sectional study with 126 sexually active women aged between 19 and 65 years old, distributed in two groups, women with FM (FG n = 62) and without FM (NFG n = 64). Perineal function was the primary outcome and was assessed by perineometry and bidigital vaginal palpation (PERFECT Scheme). Presence of LUTS was assessed by interview based on international definition, and the impact of UI on QoL was evaluated by the King's Health Questionnaire (KHQ). RESULTS: FG presented worse PF function on clinical exam (p < 0.001) and perineometry (p = 0.04). LUTS was more frequent among FG (p < 0.001). In terms of QoL, FG obtained lower KHQ scores for general health perception (p < 0.001) and sleep/energy (p < 0.003) domains. The odds of presenting LUTS is 5.03 (95%CI 2.35-10.75) higher in women with FM. CONCLUSION: Women with FM had worse perineal function, had more LUTS, and presented UI more frequently, which negatively impacts on QoL.
Subject(s)
Fibromyalgia/complications , Lower Urinary Tract Symptoms/complications , Perineum/pathology , Adult , Aged , Cross-Sectional Studies , Female , Fibromyalgia/physiopathology , Humans , Lower Urinary Tract Symptoms/physiopathology , Middle Aged , Pelvis/pathology , Pressure , Quality of Life , Sample Size , Surveys and Questionnaires , Treatment Outcome , Urinary Incontinence/complications , Urinary Incontinence/physiopathology , Young AdultABSTRACT
El estudio tuvo por objetivo describir la irrigación de la flexura cólica derecha, con la finalidad de proporcionar conocimientos anatómicos más amplios respecto del tema, y que éstos puedan ser utilizados para mejorar la práctica quirúrgica. Fueron utilizadas 40 piezas anatómicas de abdomen de cadáveres humanos, de ambos sexos y diferentes edades, fijados en formaldehido al 10 por ciento, pertenecientes al Departamento de Morfología de la Universidad Federal de Alagoas, Brasil. Se observó que la flexura cólica derecha estaba irrigada: en la mayoría de los casos (42,5 por ciento) por la arcada anastomótica, formada por la rama ascendente de la arteria cólica derecha con la rama derecha de la arteria cólica media; en el 27,5 por ciento de los casos por la anastomosis entre la rama derecha de la arteria cólica media y la rama ascendente de la arteria íleo cólica; en el 22,5 por ciento de los casos por las ramas ascendente y descendente de la arteria cólica derecha y en el 7,5 por ciento de los casos por la anastomosis entre las ramas derecha e izquierda de la arteria cólica media. Podemos concluir que la arteria cólica media fue el vaso con mayor presencia (77,5 por ciento) en la irrigación de la flexura cólica derecha. La anastomosis predominante en la flexura cólica derecha ocurrió entre la rama ascendente de la arteria cólica derecha y la rama derecha de la arteria cólica media.
This study has as objective present data about the irrigation of the right colic flexure, in order to proportionate an ample anatomic understanding about this subject, and that can be useful to perfect the surgical exercise. Was utilized 40 abdominal anatomic pieces of human corpses, of both sexes and variable ages, fixed in formaldehyde at 10 percent, belonging to Departament of Morphology of the Universidade Federal de Alagoas, Brazil. Was observed that the right colic flexure was presented in the majority of the cases (42.5 percent) irrigated by the anastomotic arcade composed by ascending branch of right colic artery with the right branch of the middle colic artery; following by the anastomosis between the right branch of middle colic artery and the ascending branch of ileocolic artery, in 27.5 percent of the cases. The ascendant and descendant branches of the right colic artery nourished the right colic flexure in the 22.5 percent of cases; at the present the anastomosis between the right and left branches of the middle colic artery irrigated the right colic flexure in 7.5 percent of the cases. We concluded that the middle colic artery was the most present vase (77.5 percent) in irrigation of the right colic flexure. The most prevalent anastomosis in the right colic flexure occurred between the ascending branch of right colic artery and the right branch of middle colic artery.
