3 research outputs found
Sexual Dysfunction in Urogynaecology
__abstract__
This thesis is dedicated to enhance understanding of sexual dysfunction in the field of urogynaecology,
focussing on the prevalence of sexual problems in urogynaecology clinics, the
clinical attention of the urogynaecologist to female sexual dyfunction, the impact of POP,
SUI and pelvic floor surgery on the sexual functioning of the female patient, as well as the
impact on the sexual functioning of her partner
Postpartum sexual function; the importance of the levator ani muscle
Introduction and hypothesis Pelvic floor muscle function plays an important role in female sexual functioning. Smaller genital
hiatal dimensions have been associated with sexual dysfunction, mainly dyspareunia. On the other hand, trauma of the levator ani
muscle sustained during childbirth is associated with increased genital hiatus, which potentially can affect sexual functioning by
causing vaginal laxity. This study aims to determine the association between levator hiatal dimensions and female sexual
dysfunction after first vaginal delivery.
Methods This is a secondary analysis of a prospective observational study. Two hundred four women who had a first, spontaneous vaginal delivery at term between 2012 and 2015 were recruited at a minimum of 6 months postpartum. Thirteen pregnant
women were excluded. We analyzed the association of total PISQ-12 score, as well as individual sexual complaints (desire,
arousal, orgasm and dyspareunia), with levator hiatal dimensions at rest, with maximum Valsalva and during pelvic floor muscle
contraction as measured by 4D transperineal ultrasound. Statistical analysis was performed using linear regression analysis and
Mann-Whitney U test.
Results One hundred ninety-one women were evaluated at a median of 11 months postpartum. There was no significant
as
Retinal vessel diameters and risk of impaired fasting glucose or diabetes: the Rotterdam study
The association between a smaller retinal arteriolar-to-venular ratio (AVR) and incident diabetes may be due to arteriolar narrowing, venular dilatation, or both. We investigated associations between baseline vessel diameters and incident impaired fasting glucose or diabetes in a population-based cohort (aged > or =55 years). Baseline retinal vessel diameters (1990-1993) were measured on digitized images of 2,309 subjects with a normal glucose tolerance test (postload glucose or =7.0 mmol/l and/or antidiabetic medication use. Odds ratios (ORs) per SD increase in venular diameters were 1.13 (95% CI 1.00-1.29) for impaired fasting glucose and 1.09 (0.90-1.33) for diabetes. ORs per SD decrease in arteriolar diameters were 1.12 (0.98-1.27) and 1.08 (0.89-1.31) and per SD decrease in AVR were 1.29 (1.13-1.46) and 1.19 (0.98-1.45). After adjustment for cardiovascular risk factors, the associations were unaltered for venules and disappeared for arterioles. After stratification on age, associations between venular dilatation and impaired fasting glucose (1.23 [1.02-1.47]) or diabetes (1.18 [0.89-1.56]) were mainly present in participants aged <70 years. In conclusion, in our study, the risk of impaired fasting glucose and diabetes with AVR was explained by venular dilatation rather than arteriolar narrowing, warranting more focus on the causes of this dilatation