High prevalence of pelvic floor muscle dysfunction in hospitalized elderly women with urinary incontinence

Int Urogynecol J. 2012 Sep;23(9):1231-7. doi: 10.1007/s00192-011-1628-4. Epub 2012 Jan 4.

Abstract

Introduction and hypothesis: The purpose of this study was to determine pelvic floor muscle (PFM) function in hospitalized elderly women with urinary incontinence (UI).

Methods: A cross-sectional study was performed using data of 704 patients, routinely collected by means of a clinical UI assessment.

Results: Only 25.5% of the patients were able to perform normal PFM contractions (Oxford grading scale score ≥3); 74.5% were unable to contract their PFM or showed weak PFM activity without circular contraction or elevation of the vagina. Vulvovaginal mucosal dystrophy was noted in 84% of the patients. A significant positive correlation of PFM function was found to cognitive status (MMSE score), mobility (Tinetti performance score), and history of previous PFM training; a negative correlation of PFM function was found to patients' age and vulvovaginal mucosal dystrophy, and no significant correlation to body mass index, parity, or history of hysterectomy.

Conclusions: Targeted clinical UI assessment including digital vaginal palpation should be performed in all incontinent elderly women in order to detect PFM dysfunction and to optimize therapeutic measures.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition Disorders / complications
  • Cross-Sectional Studies
  • Female
  • Humans
  • Mobility Limitation
  • Mucous Membrane / pathology
  • Mucous Membrane / physiopathology
  • Muscle Contraction*
  • Muscle, Skeletal / physiopathology*
  • Pelvic Floor / physiopathology*
  • Statistics, Nonparametric
  • Urinary Incontinence / complications
  • Urinary Incontinence / physiopathology*
  • Vagina / pathology
  • Vagina / physiopathology*
  • Vulva / pathology
  • Vulva / physiopathology*