(065) ASSOCIATION BETWEEN LEVATOR ANI MUSCLE AVULSION INJURY AND SEXUAL FUNCTION IN PAROUS WOMEN
Notice bibliographique
Résumé
Abstract Introduction Childbirth is a major risk factor for levator ani muscle (LAM) trauma. In 21%-36% of women, stretching of the LAM leads to an avulsion injury, which is the detachment of the LAM from its insertion points on the pubic symphysis. LAM avulsion injury has been found to be significantly associated with important consequences such as higher rates and greater severity of stress urinary incontinence and pelvic organ prolapse. However, little is known about the impact of this obstetrical injury on sexual function. Objective This study aimed to examine the association between LAM avulsion injury and sexual function in parous women. Methods This multicenter prospective study involved 322 primiparous and multiparous women aged 18 to 45 years. Participants underwent a 3D/4D transperineal assessment, ≥ 3-month after delivery with a physiotherapist experienced in assessing LAM injury. The avulsion diagnosis was confirmed by two offline reviewers blinded to the patient’s clinical data following a validated protocol. A third reviewer was involved in case of discrepancy. Sexual function was measured with the Female Sexual Function Index (FSFI) questionnaire. Multiple linear regressions were computed to examine the association between avulsion injury and sexual function while controlling for potentially confounding variables (maternal age, time since last childbirth, stage of perineal tears 0-4, use of hormonal contraception, breastfeeding, urinary incontinence assessed with the International Consultation Incontinence Questionnaire – Urinary Incontinence (ICIQ-IU-SF), and pelvic organ prolapse evaluated with the Pelvic Organ Prolapse Symptom Score (POPSS). Results Of the 322 women who completed the study, 194 had an intact LAM, 77 had a unilateral avulsion, and 51 had a bilateral avulsion. Participants had a median parity of 2 (IQR 2-3) as well as a median of 4.4 (IQR 1.7-9.4) years since last childbirth. Avulsion was significantly associated with lower sexual function (β = -0.143, p = 0.011) as measured by the FSFI total score. Further analyses of the FSFI domains revealed that avulsion was also significantly associated with lower arousal (β = -0.160, p = 0.004), decreased lubrication (β = -0.128, p = 0.023) and lower orgasm (β = -0.146, p = 0.010). Conclusions The findings of this study support the role of LAM avulsion in sexual dysfunction. LAM avulsion was associated with poorer sexual function overall and more specifically, lower arousal, lubrication, and orgasm. Given the impact of LAM avulsion on sexual function, women diagnosed with this obstetrical injury should be screened for sexual dysfunction and offered appropriate treatment and counselling. Further research is needed to explore effective interventions and support for sexual dysfunctions in women sustaining this injury. Disclosure No.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».