Avaliação dos sintomas de desconforto pélvico em mulheres com e sem histerectomia

Abstract

Introduction: The pelvic floor (PF) is composed of muscles, fascia, and ligaments that provide support to the lower part of the abdominopelvic cavity. Multifactorial etiological factors can cause damage to these structures, resulting in pelvic floor dysfunction (PFD). Hysterectomy treats a variety of gynecological conditions and is indicated when conservative treatments fail. It can be considered a predisposing factor for PFD, since the removal of the uterus modifies the anatomy, altering the biomechanics of the region. Objective: To investigate whether there are differences in symptoms of pelvic discomfort between women who underwent hysterectomy and those who did not undergo this surgery. Methodology: Cross-sectional study, part of a clinical trial. Sixty-eight women were included by convenience, divided into two groups: Group with hysterectomy (GCH, n=34), and Group without hysterectomy (GSH, n=34). During the evaluation, the patients answered an anamnesis, the Pelvic Floor Distress Inventory (PFDI-20) questionnaire and the physical examination of manual muscle strength testing of the Pelvic Floor Muscles (PFM). Approved by the ethics and research committee under opinion no. 6,260,927 and Certificate of Presentation of Ethical Appreciation (CAAE): 5750322.2.0000.0253. The Kolmogorov-Smirnov test was used to assess the normality of the data. Median and quartiles 25 and 75 for continuous variables, absolute frequencies and percentages for categorical variables. The differences between the groups were assessed by the Mann-Whitney and chi-square tests. Results: The sociodemographic and anthropometric data had no statistically significant differences. Gynecological, obstetric and urinary variables showed differences only in the number of vaginal deliveries (p=0.04), oophorectomy (p=0.00) and nocturnal urinary frequency (p=0.00). The analysis of PFM muscle strength was significant between the groups (p=0.008), as was the PFDI-20 (p=0.024). Regarding anorectal problems and POP, both presented positive results, with significant differences between the groups. However, for urinary problems, this same result was not observed. Conclusion: The results obtained in this study provide a solid basis for future investigations, mainly because the sample size was small so that definitive conclusions can be drawn, and studies with a larger number of participants are necessary to obtain more conclusive results