4.2 Article

Comparisons of Electromyography and Digital Palpation Measurement of Pelvic Floor Muscle Strength in Postpartum Women with Stress Urinary Incontinence and Asymptomatic Parturients: A Cross-Sectional Study

Journal

GYNECOLOGIC AND OBSTETRIC INVESTIGATION
Volume 84, Issue 6, Pages 599-605

Publisher

KARGER
DOI: 10.1159/000501825

Keywords

Postpartum stress urinary incontinence; Electromyography; Glazer protocol; Digital palpation; Pelvic floor muscle

Funding

  1. Zhejiang Provincial Project of Medical and Health Technology Achievements [2017PY004]
  2. Key Research Project of Traditional Chinese Medicine in Zhejiang Province [2018ZZ017]
  3. Project of Zhejiang Public Welfare Technology Application Research Program [2017C33073]
  4. Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, PR China/Women's Reproductive Health Key Laboratory of Zhejiang Province/Uterine Tumors Research Center of Zhejiang Province [ZDFY2017-RG/RH-006]

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Aims: Early evaluation of pelvic floor muscle (PFM) in postpartum women is important for the treatment of stress urinary incontinence (SUI). Digital vaginal palpation and electromyography (EMG) evaluation based on Glazer protocol are widely used for the assessment of PFM. However, the correlation among digital palpation, EMG, and morbidity of postpartum SUI is still unclear. This study aims to investigate the relationship between postpartum SUI and PFM examinations. Methods: This hospital-based cross-sectional study included 1,380 parturients during September 2016 to January 2018. We collected the clinical characteristics, PFM strength, and EMG variables of parturients 6-8 weeks after birth. Then the correlation among the results of EMG, digital palpation, and the occurrence of SUI was analyzed. Results: There is no significant difference in digital palpation scores of PFM strength between SUI and non-SUI parturients. The EMG values were closely related to SUI: the multivariate logistic regression revealed that the most reliable evaluation indicators of postpartum SUI were pelvic floor contractile amplitude of endurance contraction (B = 0.021, p = 0.019) and pretest resting baseline (B = 0.056, p = 0.019). Correlation analysis demonstrated that the contraction variables of EMG had a significant correlation with the digital palpation PFM strength in postpartum women (r = 0.467-0.545, p < 0.001). Conclusion: The EMG proved to be reliable in assessing the PFM function in postpartum women. The decreased PFM activity, according to EMG, was correlated with postpartum SUI. Although digital palpation scores were positively correlated with EMG results, no correlation was observed with SUI incidence.

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