title: Pelvic floor muscle problems mediate sexual problems in young adult rape victims.
abstract: BACKGROUND
  Prior studies have addressed sexual abuse and sexual function in adult women. No studies have focused on the effect of adolescence rape on sexual functioning.
  
  
  OBJECTIVE
  To investigate the effect of rape on sexual problems and on pelvic floor problems, as well as the mediating role of pelvic floor problems on sexual problems, in a homogenous group of victims of adolescence rape without a history of childhood sexual, physical, and/or emotional abuse.
  
  
  METHODS
  Sexual functioning and pelvic floor functioning were assessed using self-report questionnaires.
  
  
  METHODS
  In this cross-sectional study, a group of 89 young women aged 18-25 years who were victimized by rape in adolescence was compared with a group of 114 nonvictimized controls. The rape victims were treated for posttraumatic stress disorder (PTSD) 3 years prior to participation in the study.
  
  
  RESULTS
  Three years posttreatment, rape victims were 2.4 times more likely to have a sexual dysfunction (lubrication problems and pain) and 2.7 times more likely to have pelvic floor dysfunction (symptoms of provoked vulvodynia, general stress, lower urinary tract, and irritable bowel syndrome) than nonvictimized controls. The relationship between rape and sexual problems was partially mediated by the presence of pelvic floor problems. Rape victims and controls did not differ with regard to sexual activities.
  
  
  CONCLUSIONS
  Rape victims suffer significantly more from sexual dysfunction and pelvic floor dysfunction when compared with nontraumatized controls, despite the provision of treatment for PTSD. Possibly, physical manifestations of PTSD have been left unaddressed in treatment. Future treatment protocols should consider incorporating (physical or psychological) treatment strategies for sexual dysfunction and/or pelvic floor dysfunction into trauma exposure treatments.
authors.affiliation: National Psychotrauma Centre for Children and Youth, University Medical Centre, Utrecht, The Netherlands.
authors.forename: Riemke
authors.initials: R
authors.lastname: Postma
authors.forename: Iva
authors.initials: I
authors.lastname: Bicanic
authors.forename: Huub
authors.initials: H
authors.lastname: van der Vaart
authors.forename: Ellen
authors.initials: E
authors.lastname: Laan
mesh_terms: D000293:Adolescent; D000328:Adult; D019548:Crime Victims / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017773:Pelvic Floor / Q000503:physiopathology*; D011902:Rape / Q000523:psychology*; D012735:Sexual Dysfunction, Physiological; D020018:Sexual Dysfunctions, Psychological; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy; D055815:Young Adult
keywords: Adolescent; High-Tone Pelvic Floor Dysfunction; Pelvic Floor Problems; Rape; Sexual Assault; Sexual Problems