EC Gynaecology

Objective: To investigate the differences of pelvic floor surface electromyography (sEMG) parameters between perimenopausal women with pelvic organ prolapse (POP), stress urinary incontinence (SUI), and mixed POP and SUI pelvic floor dysfunction.

Methods: All women seeking treatment for perimenopausal pelvic floor dysfunction at our institution between April 2021 and March 2023 were invited to participate in the study and signed an informed consent form. Pelvic floor sEMG parameters were obtained by Glazer assessment using the Melander instrument (MLD A2 Deluxe). Pelvic floor sEMG parameters were compared between the three groups of patients with POP, SUI, and mixed POP with SUI. Differences in pelvic floor sEMG parameters between the three groups were compared using unordered multivariate logistic regression modeling to control for potential confounding factors.

Results: A total of 237 participants were included in this study, 92, 95, and 50 in the POP, SUI, and POP+SUI groups respectively. The median, P25, and P75 for fast muscle phase peak value, slow muscle phase mean, slow muscle phase variation, slow muscle phase rise time, and slow muscle phase recovery time in all participants were 33.70 (24.05, 46.99), 21.06 (13.35, 28.84), 0.27 (0.20, 0.34), 0.41 (0.27, 0.65) and 0.88 (0.62, 1.55) respectively, with a statistically significant difference in distribution between the three groups (p < 0.05). The total assessment score was closely correlated with the fast muscle score, the slow muscle score, and the slow muscle mean, with correlation coefficients ρ of 0.839, 0.822, and 0.805, respectively. Multivariate logistic regression analyses showed that the mean value of the anterior resting potential was significantly higher in the SUI group than in the POP group (P < 0.05), whereas the SUI+POP group had similar levels of pelvic floor sEMG parameters as the other two groups (P > 0.05).

Conclusion: The mean value of the anterior resting potential is higher in patients with SUI than in those with POP. Patients with SUI may be candidates for treatment of perimenopausal pelvic floor dysfunction with a reduction of the anterior resting potential.

Keywords: Perimenopause; Pelvic Floor Dysfunction; Pelvic Organ Prolapse; Stress Urinary Incontinence; Pelvic Floor Surface Electromyography

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