Pelvic floor function is independently associated with pelvic organ prolapse
Abstract
Objective To investigate the risk factors for pelvic organ prolapse (POP), including physical activity, clinically measured joint mobility and pelvic floor muscle (PFM) function. Design One‐to‐one age‐ and parity‐matched case–control study. Setting Akershus university hospital and one outpatient physiotherapy clinic in Norway. Population Forty‐nine women with POP (POP quantification, stage ≥II) and 49 controls (stages 0 and I) were recruited from community gynaecologists and advertisements in newspapers. Methods Validated questionnaires, interview and clinical examination, including Beighton’s scoring system (joint hypermobility) and vaginal pressure transducer measurements (PFM function), were used. Univariate and multivariate conditional logistic regression analyses for one‐to‐one matched case–control studies were used, and odds ratios with 95% CIs are reported. Main outcome measures Pelvic floor muscle function (strength, endurance and resting pressure), socioeconomic status, body mass index, heavy occupational work, physical activity, family history, obstetric factors and markers of connective tissue weakness (striae, varicose veins, bruising, diastasis recti abdominis, joint hypermobility). Results No significant differences were found between groups with regard to postmenopausal status, current smoking, current low‐intensity exercise, type of birth (caesarean, forceps, vacuum), birth weight, presence of striae, diastasis recti abdominis and joint hypermobility. Body mass index (OR 5.0; 95% CI 1.1–23.0), socioeconomic status (OR 10.5; 95% CI 2.2–50.1), heavy occupational work (OR 9.6; 95% CI 1.3–70.3), anal sphincter lacerations (OR 4.5; 95% CI 1.0–20.0), PFM strength (OR 7.5; 95% CI 1.5–36.4) and endurance (OR 11.5; 95% CI 2.0–66.9) were independently related to POP. Conclusions Body mass index, socioeconomic status, heavy occupational work, anal sphincter lacerations and PFM function were independently associated with POP, whereas joint mobility and physical activity were not.
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Women with POP-Q stage II or more have 40-62% reduced pelvic floor muscle strength compared to matched controls with normal supports (POP-Q stage 0 and I).
“Women with Pelvic Organ Prolapse Quantification system (POP-Q) stage II or more have 40–62% reduced PFM strength [14, 19]”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [19]
Women with POP-Q stage II or more have 53% reduced pelvic floor muscle endurance and lower vaginal resting pressure compared to matched controls with normal supports (POP-Q stage 0 and I).
“53% reduced PFM endurance and lower vaginal resting pressure compared to matched controls with normal supports, defined as POP-Q stage 0 and I [19].”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [19]
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“Women with Pelvic Organ Prolapse Quantification system (POP-Q) stage II or more have 40–62% reduced PFM strength [14, 19], 53% reduced PFM endurance and lower vaginal resting pressure compared to matched controls with normal supports, defined as POP-Q stage 0 and I [19].”
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- Authors
- Brækken, I., Majida, M., Ellström Engh, M., Holme, I., & Bø, K.
- Affiliations
- Akershus University Hospital (NO)
- Norwegian School of Sport Sciences (NO)
- ORCID
- Bø, K
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2009-11-11
- Volume
- 116
- Issue
- 13
- Pages
- 1706-1714
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- OpenAlex
- W1553276288
- Cited by
- 146
- References
- 55
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 24 · 2023: 7 · 2022: 3 · 2021: 4 · 2020: 8 · 2019: 11 · 2018: 8 · 2017: 10 · 2016: 11 · 2015: 11 · 2014: 8 · 2013: 12 · 2012: 10
- FWCI
- 5.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Akershus Universitetssykehus
- 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 organ prolapse, pelvic floor muscle function, risk factors, body mass index, socioeconomic status, joint hypermobility, physical activity, pelvic floor muscle strength, pelvic floor muscle endurance
- MeSH terms
- Adult, Anal Canal, Connective Tissue Diseases, Female, Humans, Middle Aged, Motor Activity, Occupational Diseases, Risk Factors, Social Class, Uterine Prolapse, Vagina, Body Mass Index, Case-Control Studies, Pelvic Floor, Delivery, Obstetric, Muscle Strength
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