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Do women notice the impact of childbirth-related levator trauma on pelvic floor and sexual function? Results of an observational ultrasound study - International Urogynecology Journal - ISBN: 0937-3462, 1433-3023 - p.1-10

Auteur·e(s) :

Thibault-Gagnon, Stéphanie; Yusuf, Sara; Langer, Suzanne; Wong, Vivien; Shek, Ka Lai; Martin, Andrew; Dietz, Hans Peter

Année de publication :

2014

URL(s) :

http://link.springer.com/article/10.1007/s00192-01…
https://doi.org/10.1007/s00192-014-2331-z

Résumé (français)  :

A FINIR
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Atteintes du muscle releveur de l’anus liées à l’accouchement: les femmes rapportent-elles un effet sur le plancher pelvien et les fonctions sexuelles?

Introduction et hypothèses. On suppose que le muscle releveur de l’anus joue un rôle important dans les fonctions sexuelles; cependant, il y a à ce jour peu de publications sur l’effet des traumatismes du muscle releveur lié à l’accouchement sur les fonctions sexuelles. Nous formons l’hypothèse que les les traumatismes du muscle releveur liés à l’accouchement ont un effet négatif sur les fonctions sexuelles

Méthode

Abstract (English)  :

Introduction and hypothesis The levator ani is thought to play an important role in sexual function; however, to date little literature has been published on the impact of delivery–related levator trauma on female sexual function. We hypothesised that delivery-related levator trauma has a negative impact on women’s reports of pelvic floor and sexual function postpartum. Methods In 294 primigravid women with a singleton pregnancy, four-dimensional (4D) translabial ultrasound imaging was used to assess delivery–related levator avulsion and levator hiatal over-distension, and postpartum pelvic floor and sexual function was assessed by an in-house validated questionnaire. Associations between questionnaire responses and levator avulsion and hiatal over-distension were investigated using standard linear modelling methods. Results Levator avulsion was diagnosed in 14 % of women (42 out of 292; 25 unilateral, 17 bilateral) and was found to be significantly associated with lower scores for the pelvic floor integrity and function domain of the questionnaire (P < 0.0005). Avulsion was associated with lower scores for this domain (no avulsion = 2.78, unilateral avulsion = 2.61, bilateral avulsion = 2.29). This association remained significant after controlling for potential confounders (p = 0.013). Avulsion was not associated with any of the other domains of sexual function and levator hiatal over-distension was not associated with scores for any of the questionnaire domains. Conclusions The effect of levator avulsion on pelvic floor and sexual function an average of 5.2 months after childbirth seems to be limited to a perception of increased vaginal and pelvic floor muscle laxity, and reduced pelvic floor muscle efficiency. The impact of levator hiatal over-distension on postpartum pelvic floor and sexual function appears to be negligible.

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Mots-clés :

➡ sexualité

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Import 07/08/2014 — 07 Aug 2014