Intraabdominal pressure with pelvic floor dysfunction: do postoperative restrictions make sense?

OBJECTIVE

To quantify and compare intraabdominal pressures (IAPs) in women with pelvic floor dysfunction during standard activities.

STUDY

DESIGN

Eligible subjects were women with pelvic organ prolapse and/or urinary incontinence presenting for urodynamic evaluation. IAPs were recorded for the following tasks: (1) standing up from a chair, (2) coughing, (3) lifting 10 lb (4.54 kg), (4) lifting 20 ;b (9.07 kg), and (5) pushing 20 lb (9.07 kg). Net pressures were compared by activity, age, and body mass index (BMI).

RESULTS

We enrolled 147 subjects. The mean net IAPs generated were as follows: pushing 20 lb (11.6 cm H2O), lifting 10 lb (11.9 cm H2O), lifting 20 lb (19.6 cm H2O), standing up (36.8 cm H2O), and coughing (80.4 cm H2O). Coughing and standing up generated significantly more pressure than lifting either 10 or 20 lb (p < 0.001). IAPs were significantly lower for standing up in patients > or = 70 years old (p = 0.01) but otherwise did not vary by age. Obese subjects (BMI > or = 30.0) generated significantly more pressure than did normal-weight subjects (BMI 18.5-24.9) during all activities.

CONCLUSION

Common activities such as standing up and coughing generate significantly more IAP than lifting up to 20 lb. This may have implications for postoperative restrictions in patients with pelvic floor dysfunction.