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Marie Ellstrom Engh - One of the best experts on this subject based on the ideXlab platform.
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an intra and interrater reliability and agreement study of vaginal Resting Pressure pelvic floor muscle strength and muscular endurance using a manometer
International Urogynecology Journal, 2017Co-Authors: Merete Kolberg Tennfjord, Marie Ellstrom EnghAbstract:Introduction and hypothesis Manometry is commonly used to assess pelvic floor muscle (PFM) function. Aims of the study were to assess intra- and interrater reliability and agreement of vaginal Resting Pressure, PFM strength, and muscular endurance using a high-precision Pressure transducer.
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does episiotomy influence vaginal Resting Pressure pelvic floor muscle strength and endurance and prevalence of urinary incontinence 6 weeks postpartum
Neurourology and Urodynamics, 2017Co-Authors: Gunvor Hilde, Merete Kolberg Tennfjord, Marie Ellstrom EnghAbstract:Aims The aim of the present study was to compare vaginal Resting Pressure (VRP), pelvic floor muscle (PFM) strength and endurance, and prevalence of urinary incontinence (UI) at 6 weeks postpartum, in women with and without lateral or mediolateral episiotomy. Methods Two hundred and thirty-eight nulliparous pregnant women, mean age 28.5 years (SD 4.2) and pre-pregnancy BMI 23.8 (SD 4.0) participated in the study. Lateral or mediolateral episiotomy was only performed for indications such as fetal distress or imminent risk of severe perineal tear. At 6 weeks postpartum, a vaginal balloon connected to a high precision Pressure transducer was used to measure VRP (cm H2O), PFM strength (cm H2O), and endurance (cm H2O sec). All women completed the International Classification of Urinary Incontinence Short Form (ICIQ-UI-SF) by means of an electronic questionnaire. Results No statistically significant differences were found in VRP (mean difference 0.0 cm H2O, 95%CI: −2.1 to 2.1), PFM strength (mean difference 1.3 cm H2O, 95%CI: −1.9 to 4.6), or PFM endurance (mean difference 12.1 cm H2O sec, 95%CI: −11.0 to 35.1) between women with or without episiotomy. No significant differences were found in prevalence of UI (37.5% vs. 46.6%) or SUI (23.6% vs. 35.6%), between women with or without episiotomy, respectively. Conclusions PFM function and/or prevalence of post-partum UI were not affected by a lateral or mediolateral episiotomy. Neurourol. Urodynam. © 2016 Wiley Periodicals, Inc.
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are pelvic floor muscle thickness and size of levator hiatus associated with pelvic floor muscle strength endurance and vaginal Resting Pressure in women with pelvic organ prolapse stages i iii a cross sectional 3d ultrasound study
Neurourology and Urodynamics, 2014Co-Authors: Ingeborg Hoff Braekken, Marie Ellstrom Engh, Memona Majida, Kari BoAbstract:Faculty Division Akershus University, University of Oslo, Oslo, NorwayAims: To investigate if pelvic floor muscle (PFM) thickness and area of levator hiatus (LH) are associated with ma-nometry measured PFM function in 109 women with pelvic organ prolapse (POP) stages I–III. Methods: In this cross-sectional study pubovisceral muscle thickness and LH area were assessed with three-dimensional transperineal ultra-sound at rest and analyzed in the axial plane. PFM function was assessed with manometry and included strength,endurance, and vaginal Resting Pressure. Relationships were investigated using univariate linear logistic regressionsmodels, Pearson product-moment correlation coefficient and hierarchical multiple regression. Results: The mean agewas 49 (SD 12). There was a significant positive moderate association between muscle thickness and PFM strength(r ¼ 0.49, P < 0.001) and endurance (r ¼ .45, P < 0.001). A moderate negative association was found between LH areaand vaginal Resting Pressure (r ¼ 0.46, P < 0.001), strength (r ¼ 0.41, P < 0.001) and endurance (r ¼ 0.40,P < 0.001). Multivariate analyses included PFM strength, endurance, vaginal Resting Pressure, age, parity, BMI andsocioeconomic status. Muscle thickness was best explained by PFM strength and LH area was best explained by vagi-nal Resting Pressure. However, PFM function explained only 20.0% and 26.4% of the variance in muscle thickness andLH area after controlling for age, parity, BMI, and socioeconomic status. Conclusion: There are moderate associa-tions between measurements using ultrasound and manometry in POP women. Thicker muscles and smaller LH wereassociated with higher strength and endurance. Smaller LH was additionally associated with higher vaginal RestingPressure. Ultrasound and manometry measure different aspects of the PFM and cannot be used interchangeably.Neurourol. Urodynam. 2013 Wiley Periodicals, Inc.Key words: manometry; morphology; ultrasound; vaginal Pressure measurements
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impact of childbirth and mode of delivery on vaginal Resting Pressure and on pelvic floor muscle strength and endurance
American Journal of Obstetrics and Gynecology, 2013Co-Authors: Gunvor Hilde, Marie Ellstrom Engh, Jette Staerjensen, Franziska Siafarikas, Ingeborg Hoff BraekkenAbstract:Objective We sought to study impact of delivery mode on vaginal Resting Pressure (VRP) and on pelvic floor muscle (PFM) strength and endurance, and whether these measurements differed in women with and without urinary incontinence. Study Design We conducted a cohort study following 277 nulliparous women from midpregnancy to 6 weeks postpartum. Manometer was used for PFM measurements; differences were analyzed by t test (within groups) and analysis of variance (between groups). Results Only VRP changed significantly (10% reduction, P = .001) after emergency cesarean section. After normal and instrumental vaginal delivery, VRP was reduced by 29% and 30%; PFM strength by 54% and 66%; and endurance by 53% and 65%, respectively. Significant differences for all PFM measures ( P P Conclusion Pronounced reductions in VRP and in PFM strength and endurance were found after vaginal delivery. Continent women were stronger than incontinent counterparts.
M H Irving - One of the best experts on this subject based on the ideXlab platform.
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effect of lateral sphincterotomy on internal anal sphincter function a computerized vector manometry study
Diseases of The Colon & Rectum, 1995Co-Authors: N Williams, N A Scott, M H IrvingAbstract:PURPOSE: This study was designed to investigate the effect of lateral sphincterotomy on internal anal sphincter function in patients with chronic anal fssure. METHODS: Using an eight-channel perfusion catheter and computerized data analysis, a prospective manometric study was performed on patients with chronic anal fissure undergoing lateral sphincterotomy (LS). RESULTS: Mean Resting Pressure (MRP) in patients with anal fissure (85.1 mmHg) was significantly higher (P=0.012) than control subjects (63.3 mmHg). One week following LS there was a significant reduction in MRP (50.0 mmHg;P=0.0014), and this was maintained when reassessed five weeks later (MRP=56.4 mmHg;P=0.0019). There was no significant difference in coefficent of variation (a measure of the degree of manometric asymmetry of the anal canal) in the control group (mean, 8.9 percent) and in patients with anal fissure (mean, 7.7 percent;P=0.43). LS created a significant increase in anal canal Resting manometric asymmetry when assessed at one (mean, 17.3 percent;P=0.0013) and six weeks (mean, 11.7 percent;P=0.027) after the procedure. CONCLUSION: LS produces a global and symmetric decrease in anal canal Resting Pressure. In addition, it produces a significant increase in manometric asymmetry of the Resting anal canal by creating a detectable segmental defect.
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effect of lateral sphincterotomy on internal anal sphincter function a computerized vector manometry study
Diseases of The Colon & Rectum, 1995Co-Authors: N Williams, N A Scott, M H IrvingAbstract:PURPOSE: This study was designed to investigate the effect of lateral sphincterotomy on internal anal sphincter function in patients with chronic anal fssure. METHODS: Using an eight-channel perfusion catheter and computerized data analysis, a prospective manometric study was performed on patients with chronic anal fissure undergoing lateral sphincterotomy (LS). RESULTS: Mean Resting Pressure (MRP) in patients with anal fissure (85.1 mmHg) was significantly higher (P=0.012) than control subjects (63.3 mmHg). One week following LS there was a significant reduction in MRP (50.0 mmHg;P=0.0014), and this was maintained when reassessed five weeks later (MRP=56.4 mmHg;P=0.0019). There was no significant difference in coefficent of variation (a measure of the degree of manometric asymmetry of the anal canal) in the control group (mean, 8.9 percent) and in patients with anal fissure (mean, 7.7 percent;P=0.43). LS created a significant increase in anal canal Resting manometric asymmetry when assessed at one (mean, 17.3 percent;P=0.0013) and six weeks (mean, 11.7 percent;P=0.027) after the procedure. CONCLUSION: LS produces a global and symmetric decrease in anal canal Resting Pressure. In addition, it produces a significant increase in manometric asymmetry of the Resting anal canal by creating a detectable segmental defect.
Ingeborg Hoff Braekken - One of the best experts on this subject based on the ideXlab platform.
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are pelvic floor muscle thickness and size of levator hiatus associated with pelvic floor muscle strength endurance and vaginal Resting Pressure in women with pelvic organ prolapse stages i iii a cross sectional 3d ultrasound study
Neurourology and Urodynamics, 2014Co-Authors: Ingeborg Hoff Braekken, Marie Ellstrom Engh, Memona Majida, Kari BoAbstract:Faculty Division Akershus University, University of Oslo, Oslo, NorwayAims: To investigate if pelvic floor muscle (PFM) thickness and area of levator hiatus (LH) are associated with ma-nometry measured PFM function in 109 women with pelvic organ prolapse (POP) stages I–III. Methods: In this cross-sectional study pubovisceral muscle thickness and LH area were assessed with three-dimensional transperineal ultra-sound at rest and analyzed in the axial plane. PFM function was assessed with manometry and included strength,endurance, and vaginal Resting Pressure. Relationships were investigated using univariate linear logistic regressionsmodels, Pearson product-moment correlation coefficient and hierarchical multiple regression. Results: The mean agewas 49 (SD 12). There was a significant positive moderate association between muscle thickness and PFM strength(r ¼ 0.49, P < 0.001) and endurance (r ¼ .45, P < 0.001). A moderate negative association was found between LH areaand vaginal Resting Pressure (r ¼ 0.46, P < 0.001), strength (r ¼ 0.41, P < 0.001) and endurance (r ¼ 0.40,P < 0.001). Multivariate analyses included PFM strength, endurance, vaginal Resting Pressure, age, parity, BMI andsocioeconomic status. Muscle thickness was best explained by PFM strength and LH area was best explained by vagi-nal Resting Pressure. However, PFM function explained only 20.0% and 26.4% of the variance in muscle thickness andLH area after controlling for age, parity, BMI, and socioeconomic status. Conclusion: There are moderate associa-tions between measurements using ultrasound and manometry in POP women. Thicker muscles and smaller LH wereassociated with higher strength and endurance. Smaller LH was additionally associated with higher vaginal RestingPressure. Ultrasound and manometry measure different aspects of the PFM and cannot be used interchangeably.Neurourol. Urodynam. 2013 Wiley Periodicals, Inc.Key words: manometry; morphology; ultrasound; vaginal Pressure measurements
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impact of childbirth and mode of delivery on vaginal Resting Pressure and on pelvic floor muscle strength and endurance
American Journal of Obstetrics and Gynecology, 2013Co-Authors: Gunvor Hilde, Marie Ellstrom Engh, Jette Staerjensen, Franziska Siafarikas, Ingeborg Hoff BraekkenAbstract:Objective We sought to study impact of delivery mode on vaginal Resting Pressure (VRP) and on pelvic floor muscle (PFM) strength and endurance, and whether these measurements differed in women with and without urinary incontinence. Study Design We conducted a cohort study following 277 nulliparous women from midpregnancy to 6 weeks postpartum. Manometer was used for PFM measurements; differences were analyzed by t test (within groups) and analysis of variance (between groups). Results Only VRP changed significantly (10% reduction, P = .001) after emergency cesarean section. After normal and instrumental vaginal delivery, VRP was reduced by 29% and 30%; PFM strength by 54% and 66%; and endurance by 53% and 65%, respectively. Significant differences for all PFM measures ( P P Conclusion Pronounced reductions in VRP and in PFM strength and endurance were found after vaginal delivery. Continent women were stronger than incontinent counterparts.
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the association between pelvic floor muscle function and pelvic girdle pain a matched case control 3d ultrasound study
Manual Therapy, 2012Co-Authors: Britt Stuge, Kaja Saetre, Ingeborg Hoff BraekkenAbstract:There is uncertainty regarding the association between the function of the pelvic floor muscles (PFM) and pelvic girdle pain (PGP), and whether exercises to strengthen the PFM should be recommended for patients with PGP. This one-to-one matched case-control study examined whether there is any difference in voluntary PFM function between women with and without clinically diagnosed PGP. PFM function was assessed by manometry and three-dimensional ultrasound. Images were saved anonymously and analyses were performed offline by one investigator. A special Cox regression model was used to fit a conditional logistic regression procedure for one-to-one matched case-control studies. Forty-nine pairs of women were successfully matched according to age and parity. The study showed no difference in voluntary PFM function measured by palpation, manometry or ultrasound. The size of the levator hiatus area, together with BMI, was significantly associated with PGP. Women with PGP had statistically significantly smaller levator hiatus areas and a tendency for higher vaginal Resting Pressure compared to the control group. A significantly smaller levator hiatus and a tendency for higher vaginal Resting Pressure may indicate increased activity of the PFM. Hence, no evidence was found to recommend strengthening exercises for the PFM in patients with PGP. It is important to note that in this study we examined only voluntary contractions and not an automatic response of the PFM to a functional activity.
Kari Bo - One of the best experts on this subject based on the ideXlab platform.
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are pelvic floor muscle thickness and size of levator hiatus associated with pelvic floor muscle strength endurance and vaginal Resting Pressure in women with pelvic organ prolapse stages i iii a cross sectional 3d ultrasound study
Neurourology and Urodynamics, 2014Co-Authors: Ingeborg Hoff Braekken, Marie Ellstrom Engh, Memona Majida, Kari BoAbstract:Faculty Division Akershus University, University of Oslo, Oslo, NorwayAims: To investigate if pelvic floor muscle (PFM) thickness and area of levator hiatus (LH) are associated with ma-nometry measured PFM function in 109 women with pelvic organ prolapse (POP) stages I–III. Methods: In this cross-sectional study pubovisceral muscle thickness and LH area were assessed with three-dimensional transperineal ultra-sound at rest and analyzed in the axial plane. PFM function was assessed with manometry and included strength,endurance, and vaginal Resting Pressure. Relationships were investigated using univariate linear logistic regressionsmodels, Pearson product-moment correlation coefficient and hierarchical multiple regression. Results: The mean agewas 49 (SD 12). There was a significant positive moderate association between muscle thickness and PFM strength(r ¼ 0.49, P < 0.001) and endurance (r ¼ .45, P < 0.001). A moderate negative association was found between LH areaand vaginal Resting Pressure (r ¼ 0.46, P < 0.001), strength (r ¼ 0.41, P < 0.001) and endurance (r ¼ 0.40,P < 0.001). Multivariate analyses included PFM strength, endurance, vaginal Resting Pressure, age, parity, BMI andsocioeconomic status. Muscle thickness was best explained by PFM strength and LH area was best explained by vagi-nal Resting Pressure. However, PFM function explained only 20.0% and 26.4% of the variance in muscle thickness andLH area after controlling for age, parity, BMI, and socioeconomic status. Conclusion: There are moderate associa-tions between measurements using ultrasound and manometry in POP women. Thicker muscles and smaller LH wereassociated with higher strength and endurance. Smaller LH was additionally associated with higher vaginal RestingPressure. Ultrasound and manometry measure different aspects of the PFM and cannot be used interchangeably.Neurourol. Urodynam. 2013 Wiley Periodicals, Inc.Key words: manometry; morphology; ultrasound; vaginal Pressure measurements
Steven R. Demeester - One of the best experts on this subject based on the ideXlab platform.
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The impact of gastric distension on the lower esophageal sphincter and its exposure to acid gastric juice.
Annals of surgery, 2010Co-Authors: Shahin Ayazi, Anand P. Tamhankar, Steven R. Demeester, Joerg Zehetner, John C. Lipham, Jeffrey A. Hagen, Tom R. DemeesterAbstract:Background and Aims:The lower esophageal sphincter (LES) in patients with gastroesophageal reflux disease often has a low Resting Pressure and a short abdominal length. The mechanism by which this occurs is unknown. We hypothesize that gastric distension causes progressive effacement of the abdomina
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the value of high resolution manometry in the assessment of the Resting characteristics of the lower esophageal sphincter
Journal of Gastrointestinal Surgery, 2009Co-Authors: Shahin Ayazi, Joerg Zehetner, John C. Lipham, Jeffrey A. Hagen, Arzu Oezcelik, Emmanuele Abate, Helen J. Sohn, Farzaneh Banki, Oliver N Ross, Steven R. DemeesterAbstract:Introduction High-resolution manometry (HRM) is faster and easier to perform than conventional water perfused manometry. There is general acceptance of its usefulness in evaluating upper esophageal sphincter and esophageal body. There has been less emphasis on the use of HRM to evaluate the lower esophageal sphincter (LES) Resting Pressure and length, both factors important in LES barrier function. The aim of this study was to compare the Resting characteristics of the LES determined by HRM and conventional manometry in the same patients.
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the value of high resolution manometry in the assessment of the Resting characteristics of the lower esophageal sphincter
Journal of Gastrointestinal Surgery, 2009Co-Authors: Shahin Ayazi, Joerg Zehetner, John C. Lipham, Jeffrey A. Hagen, Arzu Oezcelik, Emmanuele Abate, Helen J. Sohn, Farzaneh Banki, Oliver N Ross, Steven R. DemeesterAbstract:High-resolution manometry (HRM) is faster and easier to perform than conventional water perfused manometry. There is general acceptance of its usefulness in evaluating upper esophageal sphincter and esophageal body. There has been less emphasis on the use of HRM to evaluate the lower esophageal sphincter (LES) Resting Pressure and length, both factors important in LES barrier function. The aim of this study was to compare the Resting characteristics of the LES determined by HRM and conventional manometry in the same patients. We performed both HRM and conventional manometry including a slow motorized pull-through technique in 55 patients with foregut symptoms. The characteristics of the LES analyzed were: Resting Pressure, total length, and abdominal length. Four available modes of HRM analysis were used to assess Resting characteristics of the LES: spatiotemporal mode using both abrupt color change and isobaric contour, line tracing, and Pressure profile. The values obtained from these four HRM modes were then compared to the conventional manometry measurements. High-resolution manometry and conventional manometry did not differ in their measurement of LES Resting Pressure. LES overall and abdominal length were consistently overestimated by HRM. A variability up to 4 cm in overall length was observed and was greatest in patients with hiatal hernia (1.8 vs. 0.9 cm, p = 0.027). The current construction of the catheter and software analysis used in high-resolution manometry do not allow precise measurement of LES length. Errors in the identification of the upper border of the sphincter may compromise accurate positioning of a pH probe.
