Assessment of pelvic floor muscle function after vaginal delivery. Clinical value of different tests.
OBJECTIVE
To evaluate the efficacy of different tests in identifying pelvic floor dysfunction after vaginal delivery.


METHODS
One hundred ninety-seven primiparae were investigated 2 months after vaginal delivery. They underwent pelvic floor muscle assessment by digital test, vaginal manometry and uroflowmetric stop test. Puerperae were divided into continent and incontinent subpopulations. Variables were subjected to Student's t test and Fisher's exact test to verify the difference between the subpopulations. Kappa values were used to correlate the tests.


RESULTS
Perineal performance in incontinent primiparae was weaker in all the tests; only the urine stream interruption test score showed significantly different values (P = .0026), but it did not correlate with the other two tests.


CONCLUSIONS
A simple, objective, noninvasive and low-cost technique, such as the urine stream interruption test, is useful in assessing pelvic floor performance after vaginal delivery but reflects urethrovesical support function rather than pelvic muscle function in toto.
Sartore
Andrea
A
Department of Obstetrics and Gynecology, Epidemiology Unit, University of Trieste, Istituto di Ricovero e Cura a Carattere Scientifico, Burlo Garofolo, Via dell'Istria 65/1-34137, Trieste, Italy. sartore@burlo.trieste.it
Pregazzi
Roberto
R
Bortoli
Paolo
P
Grimaldi
Eva
E
Ricci
Giuseppe
G
Guaschino
Secondo
S
D000328:Adult; D036861:Delivery, Obstetric / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008365:Manometry; D009119:Muscle Contraction / Q000502:physiology; D009135:Muscular Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D007744:Obstetric Labor Complications / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D010173:Palpation; D017773:Pelvic Floor / Q000503:physiopathology*; D011247:Pregnancy; D015203:Reproducibility of Results; D012212:Rheology; D014550:Urinary Incontinence, Stress / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D014563:Urodynamics / Q000502:physiology*; D014621:Vagina / Q000503:physiopathology