Giagio et al evaluate female athletes for pelvic floor dysfunction. They used a 2-step process with an initial screen and a follow-up questionnaire to triage patients. The authors are from University of Bologna, University of Genoa, Vrije Universiteit Amsterdam and Azienda Ospedale Universita Padova in Italy and The Netherlands.
Patient selection: female athlete
Risk factors for pelvic flood dysfunction:
(1) body mass index (BMI < 18.5 or > 30 kg per sq m
(2) childbirth
(3) vaginal delivery of childbirth
(4) diabetes mellitus
(5) connective tissue disease
(6) hypermobility syndrome
(7) eating disorder
(8) relative energy deficiency in sport
(9) musculoskeletal disorder (back pain, hip pain, etc)
(10) therapy with diuretics, ACE inhibitor, psychotropic drug
(11) menopause
(12) hormonal therapy, estrogen deficiency state
(13) irregular menstrual cycle
(14) constipation
(15) nerve, muscle damage or tissue disruption of the pelvic floor
(16) pelvic surgery and/or radiation
(17) history of urinary tract infection
(18) family history of urinary incontinence
(19) family history of pelvic organ prolapse
(20) years of training or sports >= 9 years
(21) age at onset of training < 14 years
(22) training hours per day >= 2 hours
(23) training hours per week >= 8 hours
(24) training days per week >= 4 days
(25) high-level sports ranking (elite)
(26) engaged in medium impact sports
(27) engaged in high impact sports (volleyball, basketball, gymnastics, powerlifting)
|
Response
|
Points
|
|
no
|
0
|
|
yes
|
1
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: depends how you count (the paper says 28; however, only 1 of the BMI questions applies; some of the other items may overlap; will use 27 in the implementation)
• If the score is >= 14 then the patient is referred to a pelvic floor dysfunction specialist.
• If the score is < 14 then the patient's health should be monitored by a multiisciplinary team.
