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Cited by 267Pelvic floor disorders treatmentsPregnancy-related medical researchSexual function and dysfunction studies

Graphic integration of causal factors of pelvic floor disorders: an integrated life span model

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DeLancey, John O.L., Kane Low, Lisa, Miller, Janis M., Patel, Divya A., Tumbarello, Julie A.·2008·American Journal of Obstetrics and Gynecology
DOI 10.1016/j.ajog.2008.04.001PMC PMC2764236
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Abstract

There is growing interest in causal factors for pelvic floor disorders. These conditions include pelvic organ prolapse and urinary and fecal incontinence and are affected by a myriad of factors that increase occurrence of symptomatic disease. Unraveling the complex causal network of genetic factors, birth-induced injury, connective tissue aging, lifestyle and comorbid factors is challenging. We describe a graphical tool to integrate the factors affecting pelvic floor disorders. It plots pelvic floor function in 3 major life phases: (1) development of functional reserve during an individual's growth, (2) variations in the amount of injury and potential recovery that occur during and after vaginal birth, and (3) deterioration that occurs with advancing age. This graphical tool accounts for changes in different phases to be integrated to form a disease model to help assess the overlap of different causal factors.

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Crossref · 10.1016/j.ajog.2008.04.001

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  • POP is a common condition in middle-aged and elderly women that seriously affects health and quality of life and can induce anxiety, depression, and other mental disorders.

    “POP is common in middle-aged and elderly women, which seriously affects the health and quality of life of those women with symptomatic disorders, and easily induces anxiety, depression, and other mental disorders (Whiteside et al. 2004, Delancey et al. 2008, Dietz 2008).”

    From Risk factors for the recurrence of pelvic organ prolapse: a meta-analysis (2023) · cites this paper as Delancey et al. 2008

    The Introduction says pelvic organ prolapse increases with age, and the Conclusion says pelvic floor disorders can be disruptive to quality of life. The paper does not say that prolapse induces anxiety, depression, or other mental disorders; its quality-of-life statement concerns pelvic floor disorders generally. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • The recurrence rate of POP after reconstructive surgery can be as high as 58%.

    “According to the literature, the recurrence rate of POP after reconstructive surgery can be as high as 58% (Whiteside et al. 2004, Delancey et al. 2008, Fritel et al. 2009, Friedman et al. 2018).”

    From Risk factors for the recurrence of pelvic organ prolapse: a meta-analysis (2023) · cites this paper as Delancey et al. 2008

    The Introduction mentions recurrence of pelvic floor disorders after surgery, but it gives no recurrence rate. Searches for “58%” and recurrence after reconstructive surgery found no passage supporting that figure specifically for pelvic organ prolapse; page numbers are unavailable in our copy. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Genetic factors, parity, obesity, and birth-induced injury during delivery are risk factors for POP development and recurrence after operation.

    “In recent years, it has been reported that genetic factors, parity, obesity, birth-induced injury during delivery, etc. are risk factors for POP development and recurrence after operation (Tegerstedt and Hammarstr€ om 2004, Diez-Itza, Aizpitarte and Becerro 2007, Delancey et al. 2008, Fritel et al. 2009, Friedman et al. 2018).”

    From Risk factors for the recurrence of pelvic organ prolapse: a meta-analysis (2023) · cites this paper as Delancey et al. 2008

    The Introduction (page unavailable) links genetic and reproductive factors, obesity, and childbirth injury to pelvic floor disorders; it also says instrumented delivery and pelvic floor injury may increase the likelihood of prolapse or recurrence after surgery. It does not clearly identify parity itself as a risk factor, or establish that each listed factor increases postoperative recurrence specifically. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

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Authors
DeLancey, J. O. L., Kane Low, L., Miller, J. M., Patel, D. A., & Tumbarello, J. A.
Affiliations
University of Michigan (US)
Corresponding author
DeLancey, John O.L.
ORCID
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
2008-12
Volume
199
Issue
6
Pages
610.e1-610.e5
ISSN
0002-9378 (ISSN-L)
DOI
10.1016/j.ajog.2008.04.001
PMC
PMC2764236
OpenAlex
W2142301107
Cited by
267
References
7
Citations by year
2026: 11 · 2025: 18 · 2024: 32 · 2023: 21 · 2022: 33 · 2021: 12 · 2020: 27 · 2019: 14 · 2018: 12 · 2017: 12 · 2016: 12 · 2015: 13 · 2014: 11 · 2013: 10 · 2012: 5
FWCI
4.86
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
Eunice Kennedy Shriver National Institute of Child Health and Human Development (P50HD044406)
Topics
  • Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy-related medical research
  • Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
Keywords
pelvic floor dysfunction, causal factors, pelvic organ prolapse, urinary incontinence, fecal incontinence, probabilistic graphical models, connective tissue aging, genetic factors, disease models
MeSH terms
Adolescent, Adult, Aged, Chronic Disease, Computer Graphics, Computer Simulation, Fecal Incontinence, Female, Humans, Human Development, Life Style, Middle Aged, Models, Biological, Pregnancy, Quality of Life, Risk Factors, Sensitivity and Specificity, Severity of Illness Index, Urinary Incontinence, Uterine Prolapse, Comorbidity, Incidence, Age Distribution, Pelvic Floor, Delivery, Obstetric, Young Adult

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