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Int Urogynecol J. 2013 Oct;24(10):1687-93. doi: 10.1007/s00192-013-2089-8. Epub 2013 Apr 11.

Levator myalgia: why bother?

Author information

1
Oregon Health and Science University, 3181 Sam Jackson Park Road, Portland, OR, Mail Code L466, 97239, USA, adamske@ohsu.edu.

Abstract

INTRODUCTION AND HYPOTHESIS:

We report the prevalence of levator myalgia (LM) and describe symptom bother and comorbidities associated with this examination finding.

METHODS:

We performed a cross-sectional study of patients referred to urogynecology practices: a private practice (COMM) and a tertiary university-based practice (UNIV). We identified within our population a subset of patients with LM and a reference group without LM. The primary outcome was to report the prevalence of LM within a urogynecology referral population. Our secondary outcomes include mean Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) scores, medication use, medical co-morbidities, and presence of vulvodynia.

RESULTS:

The prevalence of LM was 24% at the UNIV detected on 5,618 examinations and 9% at the COMM based on 946 examinations. Women with LM were significantly younger: mean age 56.8 years vs 65.5 (p < 0.001). There was no difference in mean parity (2.3), BMI (28.2 kg/m(2)), and race (94% white). Patients with LM reported significantly higher mean symptom bother scores (PFDI, PFIQ; p = <0. 001) related to prolapse, defecatory dysfunction, and urinary symptoms. Women with LM were more likely to report a diagnosis of fibromyalgia (OR 4.4 [1.7, 11.0]), depression (OR 1.8 [1.2, 2.7]), a history of sexual abuse (OR 2.4 [1.3, 4.7]), and use narcotic pain medications (OR 2.5 [1.2, 5.2]).

CONCLUSIONS:

Levator myalgia is a prevalent condition in urogynecology practice, and is associated with approximately 50% greater bother in urinary, defecatory, and prolapse symptoms.

PMID:
23575699
DOI:
10.1007/s00192-013-2089-8
[Indexed for MEDLINE]

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