Interpretation
pelvic floor dysfunction, pelvic floor muscle, pelvic floor complaints, anterior wall prolapse, vaginal atrophy, pelvic organ prolapse
STRESS URINARY INCONTINENCE, UTERUS, VAGINAL ATROPHY
Several theories about the cause of the increased risk of POP after hysterectomy have been described. The most important one is that by removing the uterus, supporting ligaments are harmed, which lead to more laxity in the pelvic floor [But about PFS after hysterectomy, regardless of POP, not much has been published. There is a hypothesis that due to ligation of the uterine artery, women are more prone to vaginal atrophy. The combination of increased laxity and vaginal atrophy after hysterectomy, and the attempt to (over)compensate by pelvic floor muscle tension, can lead to a variety of PFS [In our results section, we decided to show both the absolute PFDI-scores per POP category and the dichotomous variant differentiating between none/mild and moderate/severe symptoms. It is important to point out that you can have a high PFDI-20 score without experiencing moderate or severe symptoms. The PFDI-20 survey was originally designed as a tool to evaluate treatment success, comparing scores before and after treatment [In our cohort, 47% of women had one or more moderate/severe pelvic floor symptom. Most frequently reported symptoms were uncontrollable flatus, urinary frequency and stress urinary incontinence. In other studies, researching random samples, these symptoms occur frequently as well [We have shown that PFS are very common regardless of whether pelvic organ prolapse is present. For women without POP, 39% had at least one clinically relevant PFS. Sixteen percent (1 out of 6) had a POPDI complaint. A noteworthy finding is shown in Fig. We found a significant correlation between women with an anterior wall prolapse and urinary symptoms, consistent with the findings of Slieker et al. [POP is more common after hysterectomy, but we wonder if pelvic floor complaints are too. Unfortunately, PFDI-data for women who did not seek medical attention for pelvic floor dysfunction is scarcely available in literature. Utomo [PFS can lead to impairment in physical, social and daily activities, and be a real burden for women [