Anatomical and functional characteristics of the pelvic floor in women of various age groups

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Abstract

Objective: To evaluate the anatomical and functional characteristics of the pelvic floor in women of different age groups.

Materials and methods: This study was conducted at the Military Medical Academy and included 1,546 women who were divided into three age groups. Anatomical characteristics were assessed using the POP-Q system and transperineal ultrasound examinations. Functional characteristics were analyzed with the PERFECT system, and the PFDI-20 and SF-36 questionnaires were utilized. In addition, the Female Sexual Function Index was evaluated.

Results: The study revealed that women in the second group experienced age-related shifts in the locations of points Aa and Ba, along with a statistically significant increase in the angle of urethral inclination and bladder neck displacement (p=0.01). Women in group 3 showed a significant decrease in strength, endurance, and muscle contractions (p=0.001). The PFDI-20 questionnaire results indicated an increase in the severity of pelvic dysfunction symptoms, rising from 9.4 points in group 1 to 144.8 points in group 3 (p=0.001). The increase in prolapse symptoms and severity of pelvic dysfunction correlated with a decrease in both the physical (ρ=-0.56, p=0.001) and psychological components of health (ρ=-0.60, p=0.001).

Conclusion: This study demonstrated that anatomical and functional changes in most women begin long before menopause onset. The data obtained can be used to develop individualized prevention and treatment measures.

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About the authors

Alexander A. Bezmenko

S.M. Kirov Military Medical Academy, Ministry of Defense of the Russian Federation

Email: bezmenko@yandex.ru
ORCID iD: 0000-0003-2837-1260

PhD, Head of the Department of Obstetrics and Gynecology

Russian Federation, 6g, Ac. Lebedev str., St. Petersburg, 194044

Igor S. Zakharov

S.M. Kirov Military Medical Academy, Ministry of Defense of the Russian Federation

Author for correspondence.
Email: isza@mail.ru
ORCID iD: 0000-0001-6167-2968

Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology

Russian Federation, 6g, Ac. Lebedev str., St. Petersburg, 194044

Vitaly F. Bezhenar

Pavlov First St. Petersburg State Medical University, Ministry of Health of Russia

Email: bez-vitaly@yandex.ru
ORCID iD: 0000-0002-7807-4929

Professor, Head of the Department of Obstetrics, Gynecology and Neonatology

Russian Federation, 6-8 Lva Tolstogo str, St. Petersburg, 197022

Anna S. Staroverova

S.M. Kirov Military Medical Academy, Ministry of Defense of the Russian Federation

Email: staroverova.anna85@mail.ru
ORCID iD: 0000-0003-0916-4012

Head of the Obstetric (Observation) Department of the Clinic of Obstetrics and Gynecology

Russian Federation, 6g Acad. Lebedev str., St. Petersburg, 194044

Elina A. Bagramyan

S.M. Kirov Military Medical Academy, Ministry of Defense of the Russian Federation

Email: elin.bagramian@yandex.ru
ORCID iD: 0009-0009-8650-2426

Resident at the Clinic of Obstetrics and Gynecology

Russian Federation, 6g Acad. Lebedev str., St. Petersburg, 194044

Olga A. Ivanova

S.M. Kirov Military Medical Academy, Ministry of Defense of the Russian Federation

Email: oa_ivanova_63@mail.ru
ORCID iD: 0009-0007-7125-4736

Physician at the Ultrasound Diagnostics Department

Russian Federation, 6g Acad. Lebedev str., St. Petersburg, 194044

Margarita V. Kapitanova

S.M. Kirov Military Medical Academy, Ministry of Defense of the Russian Federation

Email: lysya08@mail.ru
ORCID iD: 0009-0005-7331-4099

Physician at the Ultrasound Diagnostics Department

Russian Federation, 6g Acad. Lebedev str., St. Petersburg, 194044

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Supplementary files

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2. Fig. 1. Ultrasound determination of the anterior urethral angle (a, urethral inclination angle)

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3. Fig. 2. Age dynamics of symptoms of POP and disorders of bladder and bowel function based on the PFDI-20 questionnaire

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