Pelvic floor myofascial pain in patients with symptoms of urinary tract infection
Objective To correlate lower urinary tract symptoms typically associated with a urinary tract infection (UTI) with physical examination findings of pelvic floor myofascial pain (PFMP). Methods This retrospective review included all new patients presenting to a urogynecology clinic between August 2 a...
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| Veröffentlicht in: | International journal of gynecology and obstetrics 2019-05, Vol.145 (2), p.205-211 |
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| container_title | International journal of gynecology and obstetrics |
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| creator | Wolff, Birte J. Joyce, Cara J. Brincat, Cynthia A. Mueller, Elizabeth R. Fitzgerald, Colleen M. |
| description | Objective
To correlate lower urinary tract symptoms typically associated with a urinary tract infection (UTI) with physical examination findings of pelvic floor myofascial pain (PFMP).
Methods
This retrospective review included all new patients presenting to a urogynecology clinic between August 2 and December 19, 2016. Patients completed validated questionnaires, had a catheterized urine specimen, and underwent pelvic examination. Associations between demographics, symptoms, urine culture, and PFMP were analyzed.
Results
We included 250 patients with urinary frequency (n=160, 64.0%), urgency (n=155, 62.0%), urgency incontinence (n=140, 56.0%), pelvic pain (n=43, 17.2%), and dysuria (n=25, 10.0%). PFMP was detected in 125 (50.0%) patients and culture‐proven UTI in 15 (6.0%) patients. Demographics associated with PFMP were lower prolapse stage (P |
| doi_str_mv | 10.1002/ijgo.12784 |
| format | Article |
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To correlate lower urinary tract symptoms typically associated with a urinary tract infection (UTI) with physical examination findings of pelvic floor myofascial pain (PFMP).
Methods
This retrospective review included all new patients presenting to a urogynecology clinic between August 2 and December 19, 2016. Patients completed validated questionnaires, had a catheterized urine specimen, and underwent pelvic examination. Associations between demographics, symptoms, urine culture, and PFMP were analyzed.
Results
We included 250 patients with urinary frequency (n=160, 64.0%), urgency (n=155, 62.0%), urgency incontinence (n=140, 56.0%), pelvic pain (n=43, 17.2%), and dysuria (n=25, 10.0%). PFMP was detected in 125 (50.0%) patients and culture‐proven UTI in 15 (6.0%) patients. Demographics associated with PFMP were lower prolapse stage (P<0.001), age younger than 50 years (P<0.001), lower parity (P=0.028), and non‐white ethnicity (P=0.003). Symptoms associated with PFMP were dysuria (adjusted odds ratio 4.13, 95% confidence interval 1.08–15.78), urgency/frequency (2.72, 1.47–5.04), and patient‐reported pelvic pain (2.57, 1.08–6.12). These symptoms were independent predictors in multivariable logistic regression analysis.
Conclusions
Most patients had symptoms associated with UTI; however, culture‐confirmed diagnosis was infrequent and PFMT was diagnosed in half of participants. Clinicians treating women with these symptoms are advised to examine the pelvic floor muscles.
Urinary urgency or dysuria in women may be due to pelvic floor myofascial pain rather than urinary tract infection, and hence focused examination is advised.</description><identifier>ISSN: 0020-7292</identifier><identifier>EISSN: 1879-3479</identifier><identifier>DOI: 10.1002/ijgo.12784</identifier><identifier>PMID: 30758844</identifier><language>eng</language><publisher>United States</publisher><subject>Dysuria ; Female ; Lower urinary tract symptoms ; Myofascial pain ; Pelvic floor ; Pelvic pain ; Urinary tract infection ; Urinary urgency</subject><ispartof>International journal of gynecology and obstetrics, 2019-05, Vol.145 (2), p.205-211</ispartof><rights>2019 International Federation of Gynecology and Obstetrics</rights><rights>2019 International Federation of Gynecology and Obstetrics.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3294-cae3890211ad74f1d40c0199e5cf5a64c14d5204c8cfb48a9ce53ca438fa652d3</citedby><cites>FETCH-LOGICAL-c3294-cae3890211ad74f1d40c0199e5cf5a64c14d5204c8cfb48a9ce53ca438fa652d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fijgo.12784$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fijgo.12784$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30758844$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wolff, Birte J.</creatorcontrib><creatorcontrib>Joyce, Cara J.</creatorcontrib><creatorcontrib>Brincat, Cynthia A.</creatorcontrib><creatorcontrib>Mueller, Elizabeth R.</creatorcontrib><creatorcontrib>Fitzgerald, Colleen M.</creatorcontrib><title>Pelvic floor myofascial pain in patients with symptoms of urinary tract infection</title><title>International journal of gynecology and obstetrics</title><addtitle>Int J Gynaecol Obstet</addtitle><description>Objective
To correlate lower urinary tract symptoms typically associated with a urinary tract infection (UTI) with physical examination findings of pelvic floor myofascial pain (PFMP).
Methods
This retrospective review included all new patients presenting to a urogynecology clinic between August 2 and December 19, 2016. Patients completed validated questionnaires, had a catheterized urine specimen, and underwent pelvic examination. Associations between demographics, symptoms, urine culture, and PFMP were analyzed.
Results
We included 250 patients with urinary frequency (n=160, 64.0%), urgency (n=155, 62.0%), urgency incontinence (n=140, 56.0%), pelvic pain (n=43, 17.2%), and dysuria (n=25, 10.0%). PFMP was detected in 125 (50.0%) patients and culture‐proven UTI in 15 (6.0%) patients. Demographics associated with PFMP were lower prolapse stage (P<0.001), age younger than 50 years (P<0.001), lower parity (P=0.028), and non‐white ethnicity (P=0.003). Symptoms associated with PFMP were dysuria (adjusted odds ratio 4.13, 95% confidence interval 1.08–15.78), urgency/frequency (2.72, 1.47–5.04), and patient‐reported pelvic pain (2.57, 1.08–6.12). These symptoms were independent predictors in multivariable logistic regression analysis.
Conclusions
Most patients had symptoms associated with UTI; however, culture‐confirmed diagnosis was infrequent and PFMT was diagnosed in half of participants. Clinicians treating women with these symptoms are advised to examine the pelvic floor muscles.
Urinary urgency or dysuria in women may be due to pelvic floor myofascial pain rather than urinary tract infection, and hence focused examination is advised.</description><subject>Dysuria</subject><subject>Female</subject><subject>Lower urinary tract symptoms</subject><subject>Myofascial pain</subject><subject>Pelvic floor</subject><subject>Pelvic pain</subject><subject>Urinary tract infection</subject><subject>Urinary urgency</subject><issn>0020-7292</issn><issn>1879-3479</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kEFLwzAUgIMobk4v_gDJUYTOvDRdk6MMnZPBFPRcsjTRjLapTerov7ez06Pw4B3ex8fjQ-gSyBQIobd2--6mQFPOjtAYeCqimKXiGI37I4lSKugInXm_JYRACnCKRjFJE84ZG6OXZ118WYVN4VyDy84Z6ZWVBa6lrXA_tQxWV8HjnQ0f2HdlHVzpsTO4bWwlmw6HRqrQo0arYF11jk6MLLy-OOwJenu4f50_Rqv1Yjm_W0UqpoJFSuqYC0IBZJ4yAzkjioAQOlEmkTOmgOUJJUxxZTaMS6F0EivJYm7kLKF5PEHXg7du3GerfchK65UuCllp1_qMAueJiBlAj94MqGqc9402Wd3Ysv89A5LtE2b7hNlPwh6-OnjbTanzP_S3WQ_AAOxsobt_VNnyabEepN8j6XzO</recordid><startdate>201905</startdate><enddate>201905</enddate><creator>Wolff, Birte J.</creator><creator>Joyce, Cara J.</creator><creator>Brincat, Cynthia A.</creator><creator>Mueller, Elizabeth R.</creator><creator>Fitzgerald, Colleen M.</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201905</creationdate><title>Pelvic floor myofascial pain in patients with symptoms of urinary tract infection</title><author>Wolff, Birte J. ; Joyce, Cara J. ; Brincat, Cynthia A. ; Mueller, Elizabeth R. ; Fitzgerald, Colleen M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3294-cae3890211ad74f1d40c0199e5cf5a64c14d5204c8cfb48a9ce53ca438fa652d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Dysuria</topic><topic>Female</topic><topic>Lower urinary tract symptoms</topic><topic>Myofascial pain</topic><topic>Pelvic floor</topic><topic>Pelvic pain</topic><topic>Urinary tract infection</topic><topic>Urinary urgency</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wolff, Birte J.</creatorcontrib><creatorcontrib>Joyce, Cara J.</creatorcontrib><creatorcontrib>Brincat, Cynthia A.</creatorcontrib><creatorcontrib>Mueller, Elizabeth R.</creatorcontrib><creatorcontrib>Fitzgerald, Colleen M.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of gynecology and obstetrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wolff, Birte J.</au><au>Joyce, Cara J.</au><au>Brincat, Cynthia A.</au><au>Mueller, Elizabeth R.</au><au>Fitzgerald, Colleen M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pelvic floor myofascial pain in patients with symptoms of urinary tract infection</atitle><jtitle>International journal of gynecology and obstetrics</jtitle><addtitle>Int J Gynaecol Obstet</addtitle><date>2019-05</date><risdate>2019</risdate><volume>145</volume><issue>2</issue><spage>205</spage><epage>211</epage><pages>205-211</pages><issn>0020-7292</issn><eissn>1879-3479</eissn><abstract>Objective
To correlate lower urinary tract symptoms typically associated with a urinary tract infection (UTI) with physical examination findings of pelvic floor myofascial pain (PFMP).
Methods
This retrospective review included all new patients presenting to a urogynecology clinic between August 2 and December 19, 2016. Patients completed validated questionnaires, had a catheterized urine specimen, and underwent pelvic examination. Associations between demographics, symptoms, urine culture, and PFMP were analyzed.
Results
We included 250 patients with urinary frequency (n=160, 64.0%), urgency (n=155, 62.0%), urgency incontinence (n=140, 56.0%), pelvic pain (n=43, 17.2%), and dysuria (n=25, 10.0%). PFMP was detected in 125 (50.0%) patients and culture‐proven UTI in 15 (6.0%) patients. Demographics associated with PFMP were lower prolapse stage (P<0.001), age younger than 50 years (P<0.001), lower parity (P=0.028), and non‐white ethnicity (P=0.003). Symptoms associated with PFMP were dysuria (adjusted odds ratio 4.13, 95% confidence interval 1.08–15.78), urgency/frequency (2.72, 1.47–5.04), and patient‐reported pelvic pain (2.57, 1.08–6.12). These symptoms were independent predictors in multivariable logistic regression analysis.
Conclusions
Most patients had symptoms associated with UTI; however, culture‐confirmed diagnosis was infrequent and PFMT was diagnosed in half of participants. Clinicians treating women with these symptoms are advised to examine the pelvic floor muscles.
Urinary urgency or dysuria in women may be due to pelvic floor myofascial pain rather than urinary tract infection, and hence focused examination is advised.</abstract><cop>United States</cop><pmid>30758844</pmid><doi>10.1002/ijgo.12784</doi><tpages>7</tpages></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Dysuria Female Lower urinary tract symptoms Myofascial pain Pelvic floor Pelvic pain Urinary tract infection Urinary urgency |
| title | Pelvic floor myofascial pain in patients with symptoms of urinary tract infection |
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