Damian McNamara

ATLANTA – Parental distress can prolong and worsen a child's experience after a shared traumatic event, according to a survey of 183 parents who survived the tsunami that struck Southeast Asia in 2004.

The degree of parental exposure to the tsunami did not appear to be a significant factor in the distress experienced by their offspring. However, a parental posttraumatic stress reaction to the event significantly predicted posttraumatic stress disorder (PTSD) in their child at 6 months (odds ratio, 3.89), Dr. Grete Dyb said.

“The first thing a child would do is look to the parent to see if they are scared [and think] if they run, I will run,” Dr. Dyb said at the annual meeting of the International Society for Traumatic Stress Studies.

Children whose parents hadwa low level of symptoms were resilient even if they had high exposure to an event, Dr. Dyb said.

There were approximately 4,000 Norwegians, including about 1,000 children, on vacation in Southeast Asia on Dec. 26, 2004. The tsunami killed more than 200,000 people, including 58 Norwegians adults and 26 children.

Dr. Dyb and her colleagues interviewed 183 parents about their reactions and experiences, and those of their 319 children and adolescents, 6 months after they returned to Norway.

Parents completed the Child Stress Reaction Checklist on behalf of their children. The level of symptoms was rather low in offspring at 6 months, including 22% who were nonsymptomatic, said Dr. Dyb, a researcher at the Norwegian Centre for Violence and Traumatic Studies in Oslo.

Overall, parents reported a low mean level of symptoms, although only 2% said they were nonsymptomatic.

“But we did see a dose-response between objective exposure and subjective response,” Dr. Dyb said. A total of 86 parents and 153 children were in physical danger that day; including 35 parents and 45 children caught by the rushing water. A total 27 parents and 24 children were physically injured. Another 112 parents and 162 children witnessed serious physical injuries in others.

A total of 30 parents and 62 children were separated from their families during the natural disaster.

Child objective exposure also was a predictor of PTSD (OR, 0.79). This factor contributed significantly to PTSD variance in children, Dr. Dyb said.

Sixty percent of respondents were mothers, and 52% of their children and adolescents were girls. The mean age of children was 12 years (range, 6–18 years). The study included siblings in 107 families.

A meeting attendee commented that parents might have hidden their immediate reactions to the disaster to protect their child. Dr. Dyb said that was possible, and added: “Immediate reactions in children were reported by parents, so we worried also about their capacity to report how scared their children were.”

Another attendee suggested interviewing children about their parents' reaction. “We didn't ask children about that–that we should have done,” Dr. Dyb said.

Dr. Dyb said she has another study coming out that demonstrates the child's age plays a role in development of PTSD symptoms. “We had a range of age and development in these children [in the current study]. We thought we had big sample, but we needed more power to look at the age effect.”

ATLANTA – Parental distress can prolong and worsen a child's experience after a shared traumatic event, according to a survey of 183 parents who survived the tsunami that struck Southeast Asia in 2004.

The degree of parental exposure to the tsunami did not appear to be a significant factor in the distress experienced by their offspring. However, a parental posttraumatic stress reaction to the event significantly predicted posttraumatic stress disorder (PTSD) in their child at 6 months (odds ratio, 3.89), Dr. Grete Dyb said.

“The first thing a child would do is look to the parent to see if they are scared [and think] if they run, I will run,” Dr. Dyb said at the annual meeting of the International Society for Traumatic Stress Studies.

Children whose parents hadwa low level of symptoms were resilient even if they had high exposure to an event, Dr. Dyb said.

There were approximately 4,000 Norwegians, including about 1,000 children, on vacation in Southeast Asia on Dec. 26, 2004. The tsunami killed more than 200,000 people, including 58 Norwegians adults and 26 children.

Dr. Dyb and her colleagues interviewed 183 parents about their reactions and experiences, and those of their 319 children and adolescents, 6 months after they returned to Norway.

Parents completed the Child Stress Reaction Checklist on behalf of their children. The level of symptoms was rather low in offspring at 6 months, including 22% who were nonsymptomatic, said Dr. Dyb, a researcher at the Norwegian Centre for Violence and Traumatic Studies in Oslo.

Overall, parents reported a low mean level of symptoms, although only 2% said they were nonsymptomatic.

“But we did see a dose-response between objective exposure and subjective response,” Dr. Dyb said. A total of 86 parents and 153 children were in physical danger that day; including 35 parents and 45 children caught by the rushing water. A total 27 parents and 24 children were physically injured. Another 112 parents and 162 children witnessed serious physical injuries in others.

A total of 30 parents and 62 children were separated from their families during the natural disaster.

Child objective exposure also was a predictor of PTSD (OR, 0.79). This factor contributed significantly to PTSD variance in children, Dr. Dyb said.

Sixty percent of respondents were mothers, and 52% of their children and adolescents were girls. The mean age of children was 12 years (range, 6–18 years). The study included siblings in 107 families.

A meeting attendee commented that parents might have hidden their immediate reactions to the disaster to protect their child. Dr. Dyb said that was possible, and added: “Immediate reactions in children were reported by parents, so we worried also about their capacity to report how scared their children were.”

Another attendee suggested interviewing children about their parents' reaction. “We didn't ask children about that–that we should have done,” Dr. Dyb said.

Dr. Dyb said she has another study coming out that demonstrates the child's age plays a role in development of PTSD symptoms. “We had a range of age and development in these children [in the current study]. We thought we had big sample, but we needed more power to look at the age effect.”

ATLANTA – Parental distress can prolong and worsen a child's experience after a shared traumatic event, according to a survey of 183 parents who survived the tsunami that struck Southeast Asia in 2004.

The degree of parental exposure to the tsunami did not appear to be a significant factor in the distress experienced by their offspring. However, a parental posttraumatic stress reaction to the event significantly predicted posttraumatic stress disorder (PTSD) in their child at 6 months (odds ratio, 3.89), Dr. Grete Dyb said.

“The first thing a child would do is look to the parent to see if they are scared [and think] if they run, I will run,” Dr. Dyb said at the annual meeting of the International Society for Traumatic Stress Studies.

Children whose parents hadwa low level of symptoms were resilient even if they had high exposure to an event, Dr. Dyb said.

There were approximately 4,000 Norwegians, including about 1,000 children, on vacation in Southeast Asia on Dec. 26, 2004. The tsunami killed more than 200,000 people, including 58 Norwegians adults and 26 children.

Dr. Dyb and her colleagues interviewed 183 parents about their reactions and experiences, and those of their 319 children and adolescents, 6 months after they returned to Norway.

Parents completed the Child Stress Reaction Checklist on behalf of their children. The level of symptoms was rather low in offspring at 6 months, including 22% who were nonsymptomatic, said Dr. Dyb, a researcher at the Norwegian Centre for Violence and Traumatic Studies in Oslo.

Overall, parents reported a low mean level of symptoms, although only 2% said they were nonsymptomatic.

“But we did see a dose-response between objective exposure and subjective response,” Dr. Dyb said. A total of 86 parents and 153 children were in physical danger that day; including 35 parents and 45 children caught by the rushing water. A total 27 parents and 24 children were physically injured. Another 112 parents and 162 children witnessed serious physical injuries in others.

A total of 30 parents and 62 children were separated from their families during the natural disaster.

Child objective exposure also was a predictor of PTSD (OR, 0.79). This factor contributed significantly to PTSD variance in children, Dr. Dyb said.

Sixty percent of respondents were mothers, and 52% of their children and adolescents were girls. The mean age of children was 12 years (range, 6–18 years). The study included siblings in 107 families.

A meeting attendee commented that parents might have hidden their immediate reactions to the disaster to protect their child. Dr. Dyb said that was possible, and added: “Immediate reactions in children were reported by parents, so we worried also about their capacity to report how scared their children were.”

Another attendee suggested interviewing children about their parents' reaction. “We didn't ask children about that–that we should have done,” Dr. Dyb said.

Dr. Dyb said she has another study coming out that demonstrates the child's age plays a role in development of PTSD symptoms. “We had a range of age and development in these children [in the current study]. We thought we had big sample, but we needed more power to look at the age effect.”

ATLANTA – A single, traumatic injury is associated with more psychiatric diagnoses and more psychotropic medication prescriptions among children and adolescents than among those uninjured, according to a prospective, cohort study.

Researchers studied 20,507 patients aged 10–19 years who were treated at Group Health, a large health maintenance organization based in Seattle. Dr. Doug Zatzick and his associate studied the 6,116 teenagers (30%) who experienced a single traumatic injury in the index year of 2001 and looked for mental health diagnoses and psychotropic prescriptions in these patients for 2002, 2003, or 2004. They compared these factors with the group of 14,391 teens (70%)who were not injured.

“Yes, a single event in 2001 was associated with increased risk for a broad range of psychopathology,” Dr. Zatzick said at the annual meeting of the International Society for Trauma Stress Studies.

Injury during the index year was significantly and independently associated with an increased likelihood of any psychiatric diagnosis (odds ratio, 1.23) in this population-based study, said Dr. Zatzick, of the psychiatry and behavioral science departments at the University of Washington, Seattle. Dr. Zatzick conducted the study with Dr. David Grossman a pediatrician at the Group Health Research Center in Seattle.

Specifically, they found that a significantly higher percentage of injured children had an anxiety diagnosis in 2002, 6.5%, compared with 4.8% of the noninjured group. A total 6.2% of the injured adolescents were subsequently diagnosed with a disruptive behavior disorder, compared with 4.6% of their noninjured peers.

A secondary aim of the study was to look at prevalence of traumatic brain injury (TBI). Of the 30% of the kids who were injured, “only 1% had a traumatic-brain related injury, so it's not that common,” Dr. Zatzick said.

A greater percentage of the injured group (15%) received a prescription for a psychotropic medication, compared with the noninjured group (9%). There was an increased odds ratio of 1.35 for psychotropic drug use by the injured teenagers.

A total of 72% of the injured group versus 49% of the noninjured in 2001 reported a history of previous injury. Some adolescents presented with a cumulative trauma burden.

“We randomly approach injured adolescents on our trauma ward. About 40% have four or more lifetime trauma [events] when they present, and so do about 50% of their parents–a common story at level 1 trauma centers,” said Dr. Zatzick, a self-described “front-line, trauma center clinician” at Harborview Injury Prevention and Research Center in Seattle. He is director of Attending Consult Services at Harborview.

Misclassification bias of psychiatric diagnosis is a potential limitation of the study, Dr. Zatzick said. Increased injury visits associated with increased diagnoses are also a possibility, “but we don't think that is happening.”

Vitals

Major Finding: Injured children and adolescents were more likely to have an anxiety diagnosis (OR, 1.19) or an acute stress disorder (OR, 1.21), compared with the noninjured adolescents.

Source of Data: A prospective, cohort study of 20,507 patients aged 10–19 years.

Disclosures: Dr. Zatzick and Dr. Grossman had no relevant disclosures.

ATLANTA – A single, traumatic injury is associated with more psychiatric diagnoses and more psychotropic medication prescriptions among children and adolescents than among those uninjured, according to a prospective, cohort study.

Researchers studied 20,507 patients aged 10–19 years who were treated at Group Health, a large health maintenance organization based in Seattle. Dr. Doug Zatzick and his associate studied the 6,116 teenagers (30%) who experienced a single traumatic injury in the index year of 2001 and looked for mental health diagnoses and psychotropic prescriptions in these patients for 2002, 2003, or 2004. They compared these factors with the group of 14,391 teens (70%)who were not injured.

“Yes, a single event in 2001 was associated with increased risk for a broad range of psychopathology,” Dr. Zatzick said at the annual meeting of the International Society for Trauma Stress Studies.

Injury during the index year was significantly and independently associated with an increased likelihood of any psychiatric diagnosis (odds ratio, 1.23) in this population-based study, said Dr. Zatzick, of the psychiatry and behavioral science departments at the University of Washington, Seattle. Dr. Zatzick conducted the study with Dr. David Grossman a pediatrician at the Group Health Research Center in Seattle.

Specifically, they found that a significantly higher percentage of injured children had an anxiety diagnosis in 2002, 6.5%, compared with 4.8% of the noninjured group. A total 6.2% of the injured adolescents were subsequently diagnosed with a disruptive behavior disorder, compared with 4.6% of their noninjured peers.

A secondary aim of the study was to look at prevalence of traumatic brain injury (TBI). Of the 30% of the kids who were injured, “only 1% had a traumatic-brain related injury, so it's not that common,” Dr. Zatzick said.

A greater percentage of the injured group (15%) received a prescription for a psychotropic medication, compared with the noninjured group (9%). There was an increased odds ratio of 1.35 for psychotropic drug use by the injured teenagers.

A total of 72% of the injured group versus 49% of the noninjured in 2001 reported a history of previous injury. Some adolescents presented with a cumulative trauma burden.

“We randomly approach injured adolescents on our trauma ward. About 40% have four or more lifetime trauma [events] when they present, and so do about 50% of their parents–a common story at level 1 trauma centers,” said Dr. Zatzick, a self-described “front-line, trauma center clinician” at Harborview Injury Prevention and Research Center in Seattle. He is director of Attending Consult Services at Harborview.

Misclassification bias of psychiatric diagnosis is a potential limitation of the study, Dr. Zatzick said. Increased injury visits associated with increased diagnoses are also a possibility, “but we don't think that is happening.”

Vitals

Major Finding: Injured children and adolescents were more likely to have an anxiety diagnosis (OR, 1.19) or an acute stress disorder (OR, 1.21), compared with the noninjured adolescents.

Source of Data: A prospective, cohort study of 20,507 patients aged 10–19 years.

Disclosures: Dr. Zatzick and Dr. Grossman had no relevant disclosures.

ATLANTA – A single, traumatic injury is associated with more psychiatric diagnoses and more psychotropic medication prescriptions among children and adolescents than among those uninjured, according to a prospective, cohort study.

Researchers studied 20,507 patients aged 10–19 years who were treated at Group Health, a large health maintenance organization based in Seattle. Dr. Doug Zatzick and his associate studied the 6,116 teenagers (30%) who experienced a single traumatic injury in the index year of 2001 and looked for mental health diagnoses and psychotropic prescriptions in these patients for 2002, 2003, or 2004. They compared these factors with the group of 14,391 teens (70%)who were not injured.

“Yes, a single event in 2001 was associated with increased risk for a broad range of psychopathology,” Dr. Zatzick said at the annual meeting of the International Society for Trauma Stress Studies.

Injury during the index year was significantly and independently associated with an increased likelihood of any psychiatric diagnosis (odds ratio, 1.23) in this population-based study, said Dr. Zatzick, of the psychiatry and behavioral science departments at the University of Washington, Seattle. Dr. Zatzick conducted the study with Dr. David Grossman a pediatrician at the Group Health Research Center in Seattle.

Specifically, they found that a significantly higher percentage of injured children had an anxiety diagnosis in 2002, 6.5%, compared with 4.8% of the noninjured group. A total 6.2% of the injured adolescents were subsequently diagnosed with a disruptive behavior disorder, compared with 4.6% of their noninjured peers.

A secondary aim of the study was to look at prevalence of traumatic brain injury (TBI). Of the 30% of the kids who were injured, “only 1% had a traumatic-brain related injury, so it's not that common,” Dr. Zatzick said.

A greater percentage of the injured group (15%) received a prescription for a psychotropic medication, compared with the noninjured group (9%). There was an increased odds ratio of 1.35 for psychotropic drug use by the injured teenagers.

A total of 72% of the injured group versus 49% of the noninjured in 2001 reported a history of previous injury. Some adolescents presented with a cumulative trauma burden.

“We randomly approach injured adolescents on our trauma ward. About 40% have four or more lifetime trauma [events] when they present, and so do about 50% of their parents–a common story at level 1 trauma centers,” said Dr. Zatzick, a self-described “front-line, trauma center clinician” at Harborview Injury Prevention and Research Center in Seattle. He is director of Attending Consult Services at Harborview.

Misclassification bias of psychiatric diagnosis is a potential limitation of the study, Dr. Zatzick said. Increased injury visits associated with increased diagnoses are also a possibility, “but we don't think that is happening.”

Vitals

Major Finding: Injured children and adolescents were more likely to have an anxiety diagnosis (OR, 1.19) or an acute stress disorder (OR, 1.21), compared with the noninjured adolescents.

Source of Data: A prospective, cohort study of 20,507 patients aged 10–19 years.

Disclosures: Dr. Zatzick and Dr. Grossman had no relevant disclosures.

CHICAGO — Multidetector computed tomography can identify the site and etiology of gastrointestinal perforations correctly in a high percentage of patients with acute abdominal pain who present to an emergency department, according to a prospective study.

This imaging technique can help surgeons make crucial and timely decisions about surgery or other therapeutic options in these acute patients, Dr. Leopoldo D. Salvatierra Arrieta said during the annual clinical congress of the American College of Surgeons.

To assess the accuracy of multidetector computed tomography (MDCT) in this setting, Dr. Arrieta and his colleagues prospectively studied 121 patients presenting with acute abdominal pain between April 2007 and January 2009 at La Paz University Hospital in Madrid. The research was designated a Poster of Exceptional Merit at the meeting.

Two radiologists blinded to the subsequent surgical findings used MDCT independently of one another and reached a consensus on the perforation site in 96 of 121 cases (79%). Surgery later revealed that MCDT correctly predicted the site in 80 of these 96 cases (83%).

Of the remaining 25 patients, 12 had an indeterminate perforation site, 10 did not have a GI perforation (verified by surgery), and 3 declined surgery.

The large bowel, stomach, and small bowel were the most common sites for GI tract perforations identified with MDCT. The mean patient age was 63 years (range, 15–97 years), and the study included 58 men and 63 women.

The strongest predictors of the perforation site on MDCT were bowel wall defect, concentration of extraluminal air bubbles, and segmental bowel wall thickening, Dr. Arrieta said.

Surgeons identified more perforation sites, a total of 108, compared with the radiologists using MDCT. Surgeons found 30 perforations in the descending colon and sigmoid, 25 in the stomach or duodenum, 21 in the small bowel, 10 in the cecum or ascending colon, 5 in the rectum, and 1 transverse colon perforation; the series also included 16 patients with an acute perforated appendix.

The radiologists also evaluated MDCT scans for information on the etiology of the perforation and correctly identified the cause in 71 patients. Inflammation was the most common etiology, followed by tumor and peptic ulcer. Ischemia, foreign bodies, and trauma were other causes of the perforations.

The radiologists analyzed axial and multiplanar images. They specifically looked for contrast extravasation, bowel wall focal defects, extraluminal air-free fluid, and any inflammatory changes, including segmental bowel wall thickening, perivisceral fat stranding, or abscess. Segmental thickening of the bowel wall, fat stranding, and abscess were the most important MDCT signs in perforations associated with inflammatory causes. For patients with neoplastic perforations, segmental thickening and free air were the most frequent MDCT findings.

Dr. Arrieta and his associates chose MDCT because the modality has an overall accuracy of 82%-90% for predicting the site of GI tract perforation in published studies (Am. J. Roentgenol. 2006;187:1179–83). With sensitivities of 69%-95% and specificities of 95%-100% for diagnosis of bowel blunt trauma and mesenteric injuries, CT scanning and MDCT have emerged as the primary diagnostic imaging modalities for patients presenting with abdominal or pelvic pain, he added (Radiographics 2006;26:1119–31).

“Accurate preoperative diagnosis is helpful,” Dr. Arrieta said, and MDCT is “the most valuable technique for identifying the presence, site, and cause of GI tract perforation.”

Dr. Arrieta had nothing to disclose.

CHICAGO — Multidetector computed tomography can identify the site and etiology of gastrointestinal perforations correctly in a high percentage of patients with acute abdominal pain who present to an emergency department, according to a prospective study.

This imaging technique can help surgeons make crucial and timely decisions about surgery or other therapeutic options in these acute patients, Dr. Leopoldo D. Salvatierra Arrieta said during the annual clinical congress of the American College of Surgeons.

To assess the accuracy of multidetector computed tomography (MDCT) in this setting, Dr. Arrieta and his colleagues prospectively studied 121 patients presenting with acute abdominal pain between April 2007 and January 2009 at La Paz University Hospital in Madrid. The research was designated a Poster of Exceptional Merit at the meeting.

Two radiologists blinded to the subsequent surgical findings used MDCT independently of one another and reached a consensus on the perforation site in 96 of 121 cases (79%). Surgery later revealed that MCDT correctly predicted the site in 80 of these 96 cases (83%).

Of the remaining 25 patients, 12 had an indeterminate perforation site, 10 did not have a GI perforation (verified by surgery), and 3 declined surgery.

The large bowel, stomach, and small bowel were the most common sites for GI tract perforations identified with MDCT. The mean patient age was 63 years (range, 15–97 years), and the study included 58 men and 63 women.

The strongest predictors of the perforation site on MDCT were bowel wall defect, concentration of extraluminal air bubbles, and segmental bowel wall thickening, Dr. Arrieta said.

Surgeons identified more perforation sites, a total of 108, compared with the radiologists using MDCT. Surgeons found 30 perforations in the descending colon and sigmoid, 25 in the stomach or duodenum, 21 in the small bowel, 10 in the cecum or ascending colon, 5 in the rectum, and 1 transverse colon perforation; the series also included 16 patients with an acute perforated appendix.

The radiologists also evaluated MDCT scans for information on the etiology of the perforation and correctly identified the cause in 71 patients. Inflammation was the most common etiology, followed by tumor and peptic ulcer. Ischemia, foreign bodies, and trauma were other causes of the perforations.

The radiologists analyzed axial and multiplanar images. They specifically looked for contrast extravasation, bowel wall focal defects, extraluminal air-free fluid, and any inflammatory changes, including segmental bowel wall thickening, perivisceral fat stranding, or abscess. Segmental thickening of the bowel wall, fat stranding, and abscess were the most important MDCT signs in perforations associated with inflammatory causes. For patients with neoplastic perforations, segmental thickening and free air were the most frequent MDCT findings.

Dr. Arrieta and his associates chose MDCT because the modality has an overall accuracy of 82%-90% for predicting the site of GI tract perforation in published studies (Am. J. Roentgenol. 2006;187:1179–83). With sensitivities of 69%-95% and specificities of 95%-100% for diagnosis of bowel blunt trauma and mesenteric injuries, CT scanning and MDCT have emerged as the primary diagnostic imaging modalities for patients presenting with abdominal or pelvic pain, he added (Radiographics 2006;26:1119–31).

“Accurate preoperative diagnosis is helpful,” Dr. Arrieta said, and MDCT is “the most valuable technique for identifying the presence, site, and cause of GI tract perforation.”

Dr. Arrieta had nothing to disclose.

CHICAGO — Multidetector computed tomography can identify the site and etiology of gastrointestinal perforations correctly in a high percentage of patients with acute abdominal pain who present to an emergency department, according to a prospective study.

This imaging technique can help surgeons make crucial and timely decisions about surgery or other therapeutic options in these acute patients, Dr. Leopoldo D. Salvatierra Arrieta said during the annual clinical congress of the American College of Surgeons.

To assess the accuracy of multidetector computed tomography (MDCT) in this setting, Dr. Arrieta and his colleagues prospectively studied 121 patients presenting with acute abdominal pain between April 2007 and January 2009 at La Paz University Hospital in Madrid. The research was designated a Poster of Exceptional Merit at the meeting.

Two radiologists blinded to the subsequent surgical findings used MDCT independently of one another and reached a consensus on the perforation site in 96 of 121 cases (79%). Surgery later revealed that MCDT correctly predicted the site in 80 of these 96 cases (83%).

Of the remaining 25 patients, 12 had an indeterminate perforation site, 10 did not have a GI perforation (verified by surgery), and 3 declined surgery.

The large bowel, stomach, and small bowel were the most common sites for GI tract perforations identified with MDCT. The mean patient age was 63 years (range, 15–97 years), and the study included 58 men and 63 women.

The strongest predictors of the perforation site on MDCT were bowel wall defect, concentration of extraluminal air bubbles, and segmental bowel wall thickening, Dr. Arrieta said.

Surgeons identified more perforation sites, a total of 108, compared with the radiologists using MDCT. Surgeons found 30 perforations in the descending colon and sigmoid, 25 in the stomach or duodenum, 21 in the small bowel, 10 in the cecum or ascending colon, 5 in the rectum, and 1 transverse colon perforation; the series also included 16 patients with an acute perforated appendix.

The radiologists also evaluated MDCT scans for information on the etiology of the perforation and correctly identified the cause in 71 patients. Inflammation was the most common etiology, followed by tumor and peptic ulcer. Ischemia, foreign bodies, and trauma were other causes of the perforations.

The radiologists analyzed axial and multiplanar images. They specifically looked for contrast extravasation, bowel wall focal defects, extraluminal air-free fluid, and any inflammatory changes, including segmental bowel wall thickening, perivisceral fat stranding, or abscess. Segmental thickening of the bowel wall, fat stranding, and abscess were the most important MDCT signs in perforations associated with inflammatory causes. For patients with neoplastic perforations, segmental thickening and free air were the most frequent MDCT findings.

Dr. Arrieta and his associates chose MDCT because the modality has an overall accuracy of 82%-90% for predicting the site of GI tract perforation in published studies (Am. J. Roentgenol. 2006;187:1179–83). With sensitivities of 69%-95% and specificities of 95%-100% for diagnosis of bowel blunt trauma and mesenteric injuries, CT scanning and MDCT have emerged as the primary diagnostic imaging modalities for patients presenting with abdominal or pelvic pain, he added (Radiographics 2006;26:1119–31).

“Accurate preoperative diagnosis is helpful,” Dr. Arrieta said, and MDCT is “the most valuable technique for identifying the presence, site, and cause of GI tract perforation.”

Dr. Arrieta had nothing to disclose.

CHICAGO — Controlling preoperative wound infections prior to repair of ventral hernias might reduce the risk of severe adverse outcomes, according to an analysis based on records from the American College of Surgeons' National Surgical Quality Improvement Program.

Of note, 21% of patients who had severe adverse outcomes within 30 days of ventral hernia surgery had a deep-incision infection. A total of 37% were diagnosed with sepsis, and more than 50% had to return to the operating room.

The findings suggest that preoperative infection control could be beneficial, said Dr. Brook V. Nelson, a surgical fellow at St. Luke's Hospital and the University of Missouri–Kansas City. Some “risks for severe adverse outcomes can be predicted at the time we are making the operative decision” in ventral hernia patients, Dr. Nelson said at the annual clinical congress of the American College of Surgeons.

The multivariate logistic regression analysis by Dr. Nelson and her colleagues indicated that three preoperative risk factors—high body mass index, dependent functional status, and active wound infection—are associated with an increased risk of severe adverse outcomes.

They analyzed the records of 14,883 patients who underwent ventral hernia repair from 2005 to 2007 and were included in the National Surgical Quality Improvement Program database. Severe adverse outcomes occurred within 30 days in 1,106 (7%). A total of 16% of patients with severe adverse outcomes underwent emergency procedures versus 6% of patients without severe adverse outcomes.

In addition to wound infection, preoperative BMI greater than 35 kg/m

Cessation of cigarette smoking, pulmonary optimization, and delay of surgery for patients with wound infections also are potentially useful interventions identified by the study, Dr. Nelson said.

Patients with severe adverse outcomes were slightly older, with a mean age of 58 years compared with 56 years. Chronic obstructive pulmonary disease, recurrent hernia, and complex surgical repairs also conveyed increased risk, she added.

Dr. Nelson said she had no relevant disclosures.

CHICAGO — Controlling preoperative wound infections prior to repair of ventral hernias might reduce the risk of severe adverse outcomes, according to an analysis based on records from the American College of Surgeons' National Surgical Quality Improvement Program.

Of note, 21% of patients who had severe adverse outcomes within 30 days of ventral hernia surgery had a deep-incision infection. A total of 37% were diagnosed with sepsis, and more than 50% had to return to the operating room.

The findings suggest that preoperative infection control could be beneficial, said Dr. Brook V. Nelson, a surgical fellow at St. Luke's Hospital and the University of Missouri–Kansas City. Some “risks for severe adverse outcomes can be predicted at the time we are making the operative decision” in ventral hernia patients, Dr. Nelson said at the annual clinical congress of the American College of Surgeons.

The multivariate logistic regression analysis by Dr. Nelson and her colleagues indicated that three preoperative risk factors—high body mass index, dependent functional status, and active wound infection—are associated with an increased risk of severe adverse outcomes.

They analyzed the records of 14,883 patients who underwent ventral hernia repair from 2005 to 2007 and were included in the National Surgical Quality Improvement Program database. Severe adverse outcomes occurred within 30 days in 1,106 (7%). A total of 16% of patients with severe adverse outcomes underwent emergency procedures versus 6% of patients without severe adverse outcomes.

In addition to wound infection, preoperative BMI greater than 35 kg/m

Cessation of cigarette smoking, pulmonary optimization, and delay of surgery for patients with wound infections also are potentially useful interventions identified by the study, Dr. Nelson said.

Patients with severe adverse outcomes were slightly older, with a mean age of 58 years compared with 56 years. Chronic obstructive pulmonary disease, recurrent hernia, and complex surgical repairs also conveyed increased risk, she added.

Dr. Nelson said she had no relevant disclosures.

CHICAGO — Controlling preoperative wound infections prior to repair of ventral hernias might reduce the risk of severe adverse outcomes, according to an analysis based on records from the American College of Surgeons' National Surgical Quality Improvement Program.

Of note, 21% of patients who had severe adverse outcomes within 30 days of ventral hernia surgery had a deep-incision infection. A total of 37% were diagnosed with sepsis, and more than 50% had to return to the operating room.

The findings suggest that preoperative infection control could be beneficial, said Dr. Brook V. Nelson, a surgical fellow at St. Luke's Hospital and the University of Missouri–Kansas City. Some “risks for severe adverse outcomes can be predicted at the time we are making the operative decision” in ventral hernia patients, Dr. Nelson said at the annual clinical congress of the American College of Surgeons.

The multivariate logistic regression analysis by Dr. Nelson and her colleagues indicated that three preoperative risk factors—high body mass index, dependent functional status, and active wound infection—are associated with an increased risk of severe adverse outcomes.

They analyzed the records of 14,883 patients who underwent ventral hernia repair from 2005 to 2007 and were included in the National Surgical Quality Improvement Program database. Severe adverse outcomes occurred within 30 days in 1,106 (7%). A total of 16% of patients with severe adverse outcomes underwent emergency procedures versus 6% of patients without severe adverse outcomes.

In addition to wound infection, preoperative BMI greater than 35 kg/m

Cessation of cigarette smoking, pulmonary optimization, and delay of surgery for patients with wound infections also are potentially useful interventions identified by the study, Dr. Nelson said.

Patients with severe adverse outcomes were slightly older, with a mean age of 58 years compared with 56 years. Chronic obstructive pulmonary disease, recurrent hernia, and complex surgical repairs also conveyed increased risk, she added.

Dr. Nelson said she had no relevant disclosures.

CHICAGO — One in four elderly patients discharged to an institution after undergoing elective surgery died within 6 months, investigators found in a study designed to identify the incidence of and risk factors for postoperative admission to a skilled nursing center, rehabilitation center, or nursing home.

Although 30-day postoperative mortality for the 167 patients was similar (2% of the transferred patients versus 3% of those discharged to home), the 24% 6-month mortality rate among institutionalized patients was significantly greater than the 5% rate for those discharged, Dr. Arek J. Wiktor said at the annual clinical congress of the American College of Surgeons.

“Elderly patients often have functional decline following major surgery. But there is a lack of outcomes [information] on those who require postdischarge care,” Dr. Wiktor said.

He and his associate, Dr. Thomas N. Robinson, both with the University of Colorado at Denver, studied surgical patients aged 50 years and older (mean age, 63). Most (96%) were men.

A total 29 of the 167 patients (17%) required postoperative institutionalization, and there was a significant difference in institutionalization rates between those aged 70 years or older and younger patients, Dr. Wiktor said.

Operative time and blood loss did not differ significantly between patients transferred to a facility and those discharged to home. Mean operative times were 298 minutes in the facility group vs. 276 minutes in the discharge group, and mean blood loss was 561 mL versus 603 mL, respectively.

Identification of risk factors for institutionalization was a secondary aim of the study. Patients admitted to a facility after surgery were older (mean age of 70 years versus 64 years), had a longer ICU stay (11 days versus 6 days), and had a longer overall hospital stay (20 days versus 9 days) than those discharged to home.

“Preoperative markers of frailty strongly correlated with institutionalization,” Dr. Wiktor said. Preoperative cognitive function was assessed on the basis of the Mini-Cognitive Examination. The admitted patients had a mean score of 2.6 versus 4.0 in those ultimately discharged to home, a significant difference. Similarly, the mean preoperative function score was 88.5 in admitted patients versus 97.4 in those discharged to home, as measured on the Barthel Index scale. The researchers also found a significant difference in comorbidities on the Charlson Index: 4.9 in the admitted group versus 2.6 in the discharged group.

Dr. Martin A. Makary, a study discussant, asked why the investigators chose to assess patients 50 years and older for an “elderly” study.

Dr. Wiktor replied, “That is why we chose such a wide age group and started at 50. We didn't want to short-change ourselves if we saw a trend earlier versus later.”

Could the age disparity be explained by older patients undergoing more complex procedures? asked Dr. Makary, the Mark Ravitch Chair of Gastrointestinal Surgery and director of the Johns Hopkins Center for Surgical Outcomes in Baltimore.

Complexity was not likely a factor, Dr. Wiktor replied, because the investigators anticipated that all participants would be admitted to critical care after their elective surgery.

“Surprising to me was that four out of five of your elderly patients went home after major surgery,” said Dr. Hasan Badre Alam, a comoderator of the session. He commented that none of the risk factors identified are modifiable.

“It would be useful to identify risk factors that distinguish the 24% who are going to die [by 6 months] versus the 76% who will not,” said Dr. Alam, a staff surgeon at Massachusetts General Hospital, Boston.

“That is why this research is so interesting and sometimes frustrating,” Dr. Wiktor replied. “Patients come with comorbidities, and sometimes there is little you can do. But having a frank discussion with these patients before surgery may lead to them making small changes.”

My Take

Stratify Risks to Improve Outcomes

Modifiable risk factors for poor surgical outcome would be nice to have, but there would also be tremendous value in just being able to risk-stratify elderly patients preoperatively for a higher-quality informed consent discussion.

It has already been established that patients with dementia who undergo surgery do not fare as well postoperatively as patients without dementia. In this study, cognitive dysfunction is also linked to poor outcomes.

The more precisely we can stratify risk, the better we will be able to identify target groups for interventional studies that may be able to improve outcomes.

FRANK MICHOTA, M.D., is the Director of Academic Affairs in the Department of Hospital Medicine at the Cleveland Clinic. He reports no relevant conflicts of interest.

CHICAGO — One in four elderly patients discharged to an institution after undergoing elective surgery died within 6 months, investigators found in a study designed to identify the incidence of and risk factors for postoperative admission to a skilled nursing center, rehabilitation center, or nursing home.

Although 30-day postoperative mortality for the 167 patients was similar (2% of the transferred patients versus 3% of those discharged to home), the 24% 6-month mortality rate among institutionalized patients was significantly greater than the 5% rate for those discharged, Dr. Arek J. Wiktor said at the annual clinical congress of the American College of Surgeons.

“Elderly patients often have functional decline following major surgery. But there is a lack of outcomes [information] on those who require postdischarge care,” Dr. Wiktor said.

He and his associate, Dr. Thomas N. Robinson, both with the University of Colorado at Denver, studied surgical patients aged 50 years and older (mean age, 63). Most (96%) were men.

A total 29 of the 167 patients (17%) required postoperative institutionalization, and there was a significant difference in institutionalization rates between those aged 70 years or older and younger patients, Dr. Wiktor said.

Operative time and blood loss did not differ significantly between patients transferred to a facility and those discharged to home. Mean operative times were 298 minutes in the facility group vs. 276 minutes in the discharge group, and mean blood loss was 561 mL versus 603 mL, respectively.

Identification of risk factors for institutionalization was a secondary aim of the study. Patients admitted to a facility after surgery were older (mean age of 70 years versus 64 years), had a longer ICU stay (11 days versus 6 days), and had a longer overall hospital stay (20 days versus 9 days) than those discharged to home.

“Preoperative markers of frailty strongly correlated with institutionalization,” Dr. Wiktor said. Preoperative cognitive function was assessed on the basis of the Mini-Cognitive Examination. The admitted patients had a mean score of 2.6 versus 4.0 in those ultimately discharged to home, a significant difference. Similarly, the mean preoperative function score was 88.5 in admitted patients versus 97.4 in those discharged to home, as measured on the Barthel Index scale. The researchers also found a significant difference in comorbidities on the Charlson Index: 4.9 in the admitted group versus 2.6 in the discharged group.

Dr. Martin A. Makary, a study discussant, asked why the investigators chose to assess patients 50 years and older for an “elderly” study.

Dr. Wiktor replied, “That is why we chose such a wide age group and started at 50. We didn't want to short-change ourselves if we saw a trend earlier versus later.”

Could the age disparity be explained by older patients undergoing more complex procedures? asked Dr. Makary, the Mark Ravitch Chair of Gastrointestinal Surgery and director of the Johns Hopkins Center for Surgical Outcomes in Baltimore.

Complexity was not likely a factor, Dr. Wiktor replied, because the investigators anticipated that all participants would be admitted to critical care after their elective surgery.

“Surprising to me was that four out of five of your elderly patients went home after major surgery,” said Dr. Hasan Badre Alam, a comoderator of the session. He commented that none of the risk factors identified are modifiable.

“It would be useful to identify risk factors that distinguish the 24% who are going to die [by 6 months] versus the 76% who will not,” said Dr. Alam, a staff surgeon at Massachusetts General Hospital, Boston.

“That is why this research is so interesting and sometimes frustrating,” Dr. Wiktor replied. “Patients come with comorbidities, and sometimes there is little you can do. But having a frank discussion with these patients before surgery may lead to them making small changes.”

My Take

Stratify Risks to Improve Outcomes

Modifiable risk factors for poor surgical outcome would be nice to have, but there would also be tremendous value in just being able to risk-stratify elderly patients preoperatively for a higher-quality informed consent discussion.

It has already been established that patients with dementia who undergo surgery do not fare as well postoperatively as patients without dementia. In this study, cognitive dysfunction is also linked to poor outcomes.

The more precisely we can stratify risk, the better we will be able to identify target groups for interventional studies that may be able to improve outcomes.

FRANK MICHOTA, M.D., is the Director of Academic Affairs in the Department of Hospital Medicine at the Cleveland Clinic. He reports no relevant conflicts of interest.

CHICAGO — One in four elderly patients discharged to an institution after undergoing elective surgery died within 6 months, investigators found in a study designed to identify the incidence of and risk factors for postoperative admission to a skilled nursing center, rehabilitation center, or nursing home.

Although 30-day postoperative mortality for the 167 patients was similar (2% of the transferred patients versus 3% of those discharged to home), the 24% 6-month mortality rate among institutionalized patients was significantly greater than the 5% rate for those discharged, Dr. Arek J. Wiktor said at the annual clinical congress of the American College of Surgeons.

“Elderly patients often have functional decline following major surgery. But there is a lack of outcomes [information] on those who require postdischarge care,” Dr. Wiktor said.

He and his associate, Dr. Thomas N. Robinson, both with the University of Colorado at Denver, studied surgical patients aged 50 years and older (mean age, 63). Most (96%) were men.

A total 29 of the 167 patients (17%) required postoperative institutionalization, and there was a significant difference in institutionalization rates between those aged 70 years or older and younger patients, Dr. Wiktor said.

Operative time and blood loss did not differ significantly between patients transferred to a facility and those discharged to home. Mean operative times were 298 minutes in the facility group vs. 276 minutes in the discharge group, and mean blood loss was 561 mL versus 603 mL, respectively.

Identification of risk factors for institutionalization was a secondary aim of the study. Patients admitted to a facility after surgery were older (mean age of 70 years versus 64 years), had a longer ICU stay (11 days versus 6 days), and had a longer overall hospital stay (20 days versus 9 days) than those discharged to home.

“Preoperative markers of frailty strongly correlated with institutionalization,” Dr. Wiktor said. Preoperative cognitive function was assessed on the basis of the Mini-Cognitive Examination. The admitted patients had a mean score of 2.6 versus 4.0 in those ultimately discharged to home, a significant difference. Similarly, the mean preoperative function score was 88.5 in admitted patients versus 97.4 in those discharged to home, as measured on the Barthel Index scale. The researchers also found a significant difference in comorbidities on the Charlson Index: 4.9 in the admitted group versus 2.6 in the discharged group.

Dr. Martin A. Makary, a study discussant, asked why the investigators chose to assess patients 50 years and older for an “elderly” study.

Dr. Wiktor replied, “That is why we chose such a wide age group and started at 50. We didn't want to short-change ourselves if we saw a trend earlier versus later.”

Could the age disparity be explained by older patients undergoing more complex procedures? asked Dr. Makary, the Mark Ravitch Chair of Gastrointestinal Surgery and director of the Johns Hopkins Center for Surgical Outcomes in Baltimore.

Complexity was not likely a factor, Dr. Wiktor replied, because the investigators anticipated that all participants would be admitted to critical care after their elective surgery.

“Surprising to me was that four out of five of your elderly patients went home after major surgery,” said Dr. Hasan Badre Alam, a comoderator of the session. He commented that none of the risk factors identified are modifiable.

“It would be useful to identify risk factors that distinguish the 24% who are going to die [by 6 months] versus the 76% who will not,” said Dr. Alam, a staff surgeon at Massachusetts General Hospital, Boston.

“That is why this research is so interesting and sometimes frustrating,” Dr. Wiktor replied. “Patients come with comorbidities, and sometimes there is little you can do. But having a frank discussion with these patients before surgery may lead to them making small changes.”

My Take

Stratify Risks to Improve Outcomes

Modifiable risk factors for poor surgical outcome would be nice to have, but there would also be tremendous value in just being able to risk-stratify elderly patients preoperatively for a higher-quality informed consent discussion.

It has already been established that patients with dementia who undergo surgery do not fare as well postoperatively as patients without dementia. In this study, cognitive dysfunction is also linked to poor outcomes.

The more precisely we can stratify risk, the better we will be able to identify target groups for interventional studies that may be able to improve outcomes.

FRANK MICHOTA, M.D., is the Director of Academic Affairs in the Department of Hospital Medicine at the Cleveland Clinic. He reports no relevant conflicts of interest.

HOLLYWOOD, FLA. — Women with a pelvic floor disorder do not experience significantly diminished rates of sexual activity compared with unaffected women, based on a study of 505 women older than 40 years.

Only the desire component of the Female Sexual Function Index (FSFI) was significantly lower among women with a pelvic floor disorder, suggesting no notable impact on arousal, lubrication, orgasm, satisfaction, or pain, Dr. Tola B. Omotosho said at the annual meeting of the American Urogynecologic Society.

“Sexual health is an essential component of a woman's overall well-being,” Dr. Omotosho said. “But there remains limited and conflicting information about the impact of pelvic floor disorders on sexual health and well-being.”

So Dr. Omotosho and her Fellows' Pelvic Research Network colleagues recruited 505 women older than 40 years from September 2007 to April 2009. The cohort included 308 urogynecology patients with a pelvic floor disorder and 197 general gynecology patients without such a disorder. Participants came from 11 clinical sites in the United States.

Women in the pelvic floor disorder group were older, with a mean age of 56, vs. 52 years in the unaffected group. Although mean parity also was significantly higher in affected women (2.6 vs. 2.1), only age remained significantly different after multivariate analysis adjustment. There were no significant differences in race, body mass index, depression, comorbidity, or relationship status between groups.

The primary outcome measure was the total mean score on the FSFI, where a higher score indicates better sexual function. The mean total score in the pelvic floor disorder group was 23.2, and was not significantly lower than the mean 24.4 score in the unaffected women.

“Women with pelvic floor disorders were as sexually active as women without pelvic floor disorders when [the results were] adjusted for age,” said Dr. Omotosho, an ob.gyn

Sexual activity in the past 6 months with a male partner was reported by 62% of affected and 75% of unaffected women. This difference was not statistically significant after age was controlled for, Dr. Omotosho said. The lack of a sexual partner was the most commonly cited reason for sexual inactivity. Only heterosexual women were studied because the FSFI is not validated in a lesbian population.

Of the women with a pelvic floor disorder, 75% had urinary incontinence, defined as a score of 1 or greater on the Incontinence Severity Index. In addition, 53% met criteria for anal incontinence, defined as a score of 1 or greater for liquid or solid stool on the Wexner Fecal Incontinence Scale. Also, 30% had at least stage II pelvic organ prolapse based on a Pelvic Organ Prolapse Quantification examination.

The inclusion of only women older than 40 years is a potential limitation of the study, Dr. Omotosho said. A multicenter design and the use of validated instruments were strengths.

HOLLYWOOD, FLA. — Women with a pelvic floor disorder do not experience significantly diminished rates of sexual activity compared with unaffected women, based on a study of 505 women older than 40 years.

Only the desire component of the Female Sexual Function Index (FSFI) was significantly lower among women with a pelvic floor disorder, suggesting no notable impact on arousal, lubrication, orgasm, satisfaction, or pain, Dr. Tola B. Omotosho said at the annual meeting of the American Urogynecologic Society.

“Sexual health is an essential component of a woman's overall well-being,” Dr. Omotosho said. “But there remains limited and conflicting information about the impact of pelvic floor disorders on sexual health and well-being.”

So Dr. Omotosho and her Fellows' Pelvic Research Network colleagues recruited 505 women older than 40 years from September 2007 to April 2009. The cohort included 308 urogynecology patients with a pelvic floor disorder and 197 general gynecology patients without such a disorder. Participants came from 11 clinical sites in the United States.

Women in the pelvic floor disorder group were older, with a mean age of 56, vs. 52 years in the unaffected group. Although mean parity also was significantly higher in affected women (2.6 vs. 2.1), only age remained significantly different after multivariate analysis adjustment. There were no significant differences in race, body mass index, depression, comorbidity, or relationship status between groups.

The primary outcome measure was the total mean score on the FSFI, where a higher score indicates better sexual function. The mean total score in the pelvic floor disorder group was 23.2, and was not significantly lower than the mean 24.4 score in the unaffected women.

“Women with pelvic floor disorders were as sexually active as women without pelvic floor disorders when [the results were] adjusted for age,” said Dr. Omotosho, an ob.gyn

Sexual activity in the past 6 months with a male partner was reported by 62% of affected and 75% of unaffected women. This difference was not statistically significant after age was controlled for, Dr. Omotosho said. The lack of a sexual partner was the most commonly cited reason for sexual inactivity. Only heterosexual women were studied because the FSFI is not validated in a lesbian population.

Of the women with a pelvic floor disorder, 75% had urinary incontinence, defined as a score of 1 or greater on the Incontinence Severity Index. In addition, 53% met criteria for anal incontinence, defined as a score of 1 or greater for liquid or solid stool on the Wexner Fecal Incontinence Scale. Also, 30% had at least stage II pelvic organ prolapse based on a Pelvic Organ Prolapse Quantification examination.

The inclusion of only women older than 40 years is a potential limitation of the study, Dr. Omotosho said. A multicenter design and the use of validated instruments were strengths.

HOLLYWOOD, FLA. — Women with a pelvic floor disorder do not experience significantly diminished rates of sexual activity compared with unaffected women, based on a study of 505 women older than 40 years.

Only the desire component of the Female Sexual Function Index (FSFI) was significantly lower among women with a pelvic floor disorder, suggesting no notable impact on arousal, lubrication, orgasm, satisfaction, or pain, Dr. Tola B. Omotosho said at the annual meeting of the American Urogynecologic Society.

“Sexual health is an essential component of a woman's overall well-being,” Dr. Omotosho said. “But there remains limited and conflicting information about the impact of pelvic floor disorders on sexual health and well-being.”

So Dr. Omotosho and her Fellows' Pelvic Research Network colleagues recruited 505 women older than 40 years from September 2007 to April 2009. The cohort included 308 urogynecology patients with a pelvic floor disorder and 197 general gynecology patients without such a disorder. Participants came from 11 clinical sites in the United States.

Women in the pelvic floor disorder group were older, with a mean age of 56, vs. 52 years in the unaffected group. Although mean parity also was significantly higher in affected women (2.6 vs. 2.1), only age remained significantly different after multivariate analysis adjustment. There were no significant differences in race, body mass index, depression, comorbidity, or relationship status between groups.

The primary outcome measure was the total mean score on the FSFI, where a higher score indicates better sexual function. The mean total score in the pelvic floor disorder group was 23.2, and was not significantly lower than the mean 24.4 score in the unaffected women.

“Women with pelvic floor disorders were as sexually active as women without pelvic floor disorders when [the results were] adjusted for age,” said Dr. Omotosho, an ob.gyn

Sexual activity in the past 6 months with a male partner was reported by 62% of affected and 75% of unaffected women. This difference was not statistically significant after age was controlled for, Dr. Omotosho said. The lack of a sexual partner was the most commonly cited reason for sexual inactivity. Only heterosexual women were studied because the FSFI is not validated in a lesbian population.

Of the women with a pelvic floor disorder, 75% had urinary incontinence, defined as a score of 1 or greater on the Incontinence Severity Index. In addition, 53% met criteria for anal incontinence, defined as a score of 1 or greater for liquid or solid stool on the Wexner Fecal Incontinence Scale. Also, 30% had at least stage II pelvic organ prolapse based on a Pelvic Organ Prolapse Quantification examination.

The inclusion of only women older than 40 years is a potential limitation of the study, Dr. Omotosho said. A multicenter design and the use of validated instruments were strengths.

HOLLYWOOD, FLA. — Women with a pelvic floor disorder do not experience significantly diminished rates of sexual activity compared with unaffected women, based on a study of 505 women older than 40 years.

Only the desire component of the Female Sexual Function Index (FSFI) was significantly lower among women with a pelvic floor disorder, suggesting that there was no notable impact on arousal, lubrication, orgasm, satisfaction, or pain, Dr. Tola B. Omotosho said at the annual meeting of the American Urogynecologic Society.

“Sexual health is an essential component of a woman's overall well-being,” she said.

However, “there remains limited and conflicting information about the impact of pelvic floor disorders on sexual health and well-being,” Dr. Omotosho said.

Dr. Omotosho and her Fellows' Pelvic Research Network colleagues recruited 505 women older than 40 years from September 2007 to April 2009. The cohort included 308 urogynecology patients with a pelvic floor disorder and 197 general gynecology patients without such a disorder.

Participants came from 11 clinical sites in the United States.

Women in the pelvic floor disorder group were older, with a mean age of 56, vs. 52 years in the unaffected group. Although mean parity also was significantly higher in affected women (2.6 vs. 2.1), only age remained significantly different after multivariate analysis adjustment.

There were no significant differences in race, body mass index, depression, comorbidity, or relationship status between groups.

The primary outcome measure was the total mean score on the FSFI, where a higher score indicates better sexual function. The mean total score in the pelvic floor disorder group was 23.2, and was not significantly lower than the mean 24.4 score in the unaffected women.

“Women with pelvic floor disorders were as sexually active as women without pelvic floor disorders when [the results were] adjusted for age,” said Dr. Omotosho, an ob.gyn. fellow at the University of New Mexico Health Sciences Center in Albuquerque.

Dr. Omotosho said that she had no relevant disclosures.

Sexual activity in the past 6 months with a male partner was reported by 62% of the affected and 75% of the unaffected women. This difference was not statistically significant after the investigators controlled for age, Dr. Omotosho said .

The lack of a sexual partner was the most commonly cited reason for sexual inactivity. Only heterosexual women were studied because the FSFI is not validated in a lesbian.

Of the women with a pelvic floor disorder, 75% had urinary incontinence, defined as a score of 1 or greater on the Incontinence Severity Index. In addition, 53% met criteria for anal incontinence, defined as a score of 1 or greater for liquid or solid stool on the Wexner Fecal Incontinence Scale.

Also, 30% had at least stage II pelvic organ prolapse based on a Pelvic Organ Prolapse Quantification examination.

The inclusion of only women older than 40 years is a potential limitation of the study, Dr. Omotosho said.

On the other hand, the multicenter design and use of validated instruments were strengths.

HOLLYWOOD, FLA. — Women with a pelvic floor disorder do not experience significantly diminished rates of sexual activity compared with unaffected women, based on a study of 505 women older than 40 years.

Only the desire component of the Female Sexual Function Index (FSFI) was significantly lower among women with a pelvic floor disorder, suggesting that there was no notable impact on arousal, lubrication, orgasm, satisfaction, or pain, Dr. Tola B. Omotosho said at the annual meeting of the American Urogynecologic Society.

“Sexual health is an essential component of a woman's overall well-being,” she said.

However, “there remains limited and conflicting information about the impact of pelvic floor disorders on sexual health and well-being,” Dr. Omotosho said.

Dr. Omotosho and her Fellows' Pelvic Research Network colleagues recruited 505 women older than 40 years from September 2007 to April 2009. The cohort included 308 urogynecology patients with a pelvic floor disorder and 197 general gynecology patients without such a disorder.

Participants came from 11 clinical sites in the United States.

Women in the pelvic floor disorder group were older, with a mean age of 56, vs. 52 years in the unaffected group. Although mean parity also was significantly higher in affected women (2.6 vs. 2.1), only age remained significantly different after multivariate analysis adjustment.

There were no significant differences in race, body mass index, depression, comorbidity, or relationship status between groups.

The primary outcome measure was the total mean score on the FSFI, where a higher score indicates better sexual function. The mean total score in the pelvic floor disorder group was 23.2, and was not significantly lower than the mean 24.4 score in the unaffected women.

“Women with pelvic floor disorders were as sexually active as women without pelvic floor disorders when [the results were] adjusted for age,” said Dr. Omotosho, an ob.gyn. fellow at the University of New Mexico Health Sciences Center in Albuquerque.

Dr. Omotosho said that she had no relevant disclosures.

Sexual activity in the past 6 months with a male partner was reported by 62% of the affected and 75% of the unaffected women. This difference was not statistically significant after the investigators controlled for age, Dr. Omotosho said .

The lack of a sexual partner was the most commonly cited reason for sexual inactivity. Only heterosexual women were studied because the FSFI is not validated in a lesbian.

Of the women with a pelvic floor disorder, 75% had urinary incontinence, defined as a score of 1 or greater on the Incontinence Severity Index. In addition, 53% met criteria for anal incontinence, defined as a score of 1 or greater for liquid or solid stool on the Wexner Fecal Incontinence Scale.

Also, 30% had at least stage II pelvic organ prolapse based on a Pelvic Organ Prolapse Quantification examination.

The inclusion of only women older than 40 years is a potential limitation of the study, Dr. Omotosho said.

On the other hand, the multicenter design and use of validated instruments were strengths.

HOLLYWOOD, FLA. — Women with a pelvic floor disorder do not experience significantly diminished rates of sexual activity compared with unaffected women, based on a study of 505 women older than 40 years.

Only the desire component of the Female Sexual Function Index (FSFI) was significantly lower among women with a pelvic floor disorder, suggesting that there was no notable impact on arousal, lubrication, orgasm, satisfaction, or pain, Dr. Tola B. Omotosho said at the annual meeting of the American Urogynecologic Society.

“Sexual health is an essential component of a woman's overall well-being,” she said.

However, “there remains limited and conflicting information about the impact of pelvic floor disorders on sexual health and well-being,” Dr. Omotosho said.

Dr. Omotosho and her Fellows' Pelvic Research Network colleagues recruited 505 women older than 40 years from September 2007 to April 2009. The cohort included 308 urogynecology patients with a pelvic floor disorder and 197 general gynecology patients without such a disorder.

Participants came from 11 clinical sites in the United States.

Women in the pelvic floor disorder group were older, with a mean age of 56, vs. 52 years in the unaffected group. Although mean parity also was significantly higher in affected women (2.6 vs. 2.1), only age remained significantly different after multivariate analysis adjustment.

There were no significant differences in race, body mass index, depression, comorbidity, or relationship status between groups.

The primary outcome measure was the total mean score on the FSFI, where a higher score indicates better sexual function. The mean total score in the pelvic floor disorder group was 23.2, and was not significantly lower than the mean 24.4 score in the unaffected women.

“Women with pelvic floor disorders were as sexually active as women without pelvic floor disorders when [the results were] adjusted for age,” said Dr. Omotosho, an ob.gyn. fellow at the University of New Mexico Health Sciences Center in Albuquerque.

Dr. Omotosho said that she had no relevant disclosures.

Sexual activity in the past 6 months with a male partner was reported by 62% of the affected and 75% of the unaffected women. This difference was not statistically significant after the investigators controlled for age, Dr. Omotosho said .

The lack of a sexual partner was the most commonly cited reason for sexual inactivity. Only heterosexual women were studied because the FSFI is not validated in a lesbian.

Of the women with a pelvic floor disorder, 75% had urinary incontinence, defined as a score of 1 or greater on the Incontinence Severity Index. In addition, 53% met criteria for anal incontinence, defined as a score of 1 or greater for liquid or solid stool on the Wexner Fecal Incontinence Scale.

Also, 30% had at least stage II pelvic organ prolapse based on a Pelvic Organ Prolapse Quantification examination.

The inclusion of only women older than 40 years is a potential limitation of the study, Dr. Omotosho said.

On the other hand, the multicenter design and use of validated instruments were strengths.

CHICAGO — Patients with diabetes mellitus who undergo resection for pancreatic cancer do not have significantly increased risk for delayed gastric emptying, symptomatic fistulae formation, or extended length of hospital stay, compared with nondiabetic patients, data from a retrospective study suggest.

“We are all concerned that diabetics will have more gastric emptying issues, and we might be more likely to put a J [jejunostomy] tube into that patient. Our data suggest rates [of delayed emptying] are not significantly higher,” said Dr. David A. Kooby of the division of surgical oncology, Emory University, Atlanta.

Dr. Kooby was a coauthor of research presented by Dr. Carrie K. Chu at the annual clinical congress of the American College of Surgeons.

To compare 60-day complication rates, they and their associates reviewed the records of 251 patients with pancreatic ductal adenocarcinoma who underwent resection in 2000–2008. Of this group, 116 patients (46%) had preoperative diabetes.

The patients with diabetes were more likely to have at least one comorbidity than were those without diabetes, Dr. Chu said.

The type of pancreatectomy did not differ significantly between groups, nor did hospital length of stay (13–14 days). Most patients underwent pancreaticoduodenectomy. Just 1% of nondiabetic patients had total pancreatectomy, while none of the diabetes patients did. The remainder underwent left pancreatectomy.

There were no dramatic differences in complications by organ system, except for renal dysfunction. A total of 23% of 116 patients with diabetes versus 13% of 135 nondiabetic patients experienced renal dysfunction, “but it was mostly a mild elevation of creatinine,” said Dr. Chu, a surgical resident at Emory.

The 30-day mortality rates were 2.2% in the diabetes mellitus group and 1.7% in the nondiabetic patients, a difference that was not statistically significant, Dr. Chu said.

“The key point is that there was no major difference between diabetics and nondiabetics,” Dr. Kooby said.

CHICAGO — Patients with diabetes mellitus who undergo resection for pancreatic cancer do not have significantly increased risk for delayed gastric emptying, symptomatic fistulae formation, or extended length of hospital stay, compared with nondiabetic patients, data from a retrospective study suggest.

“We are all concerned that diabetics will have more gastric emptying issues, and we might be more likely to put a J [jejunostomy] tube into that patient. Our data suggest rates [of delayed emptying] are not significantly higher,” said Dr. David A. Kooby of the division of surgical oncology, Emory University, Atlanta.

Dr. Kooby was a coauthor of research presented by Dr. Carrie K. Chu at the annual clinical congress of the American College of Surgeons.

To compare 60-day complication rates, they and their associates reviewed the records of 251 patients with pancreatic ductal adenocarcinoma who underwent resection in 2000–2008. Of this group, 116 patients (46%) had preoperative diabetes.

The patients with diabetes were more likely to have at least one comorbidity than were those without diabetes, Dr. Chu said.

The type of pancreatectomy did not differ significantly between groups, nor did hospital length of stay (13–14 days). Most patients underwent pancreaticoduodenectomy. Just 1% of nondiabetic patients had total pancreatectomy, while none of the diabetes patients did. The remainder underwent left pancreatectomy.

There were no dramatic differences in complications by organ system, except for renal dysfunction. A total of 23% of 116 patients with diabetes versus 13% of 135 nondiabetic patients experienced renal dysfunction, “but it was mostly a mild elevation of creatinine,” said Dr. Chu, a surgical resident at Emory.

The 30-day mortality rates were 2.2% in the diabetes mellitus group and 1.7% in the nondiabetic patients, a difference that was not statistically significant, Dr. Chu said.

“The key point is that there was no major difference between diabetics and nondiabetics,” Dr. Kooby said.

CHICAGO — Patients with diabetes mellitus who undergo resection for pancreatic cancer do not have significantly increased risk for delayed gastric emptying, symptomatic fistulae formation, or extended length of hospital stay, compared with nondiabetic patients, data from a retrospective study suggest.

“We are all concerned that diabetics will have more gastric emptying issues, and we might be more likely to put a J [jejunostomy] tube into that patient. Our data suggest rates [of delayed emptying] are not significantly higher,” said Dr. David A. Kooby of the division of surgical oncology, Emory University, Atlanta.

Dr. Kooby was a coauthor of research presented by Dr. Carrie K. Chu at the annual clinical congress of the American College of Surgeons.

To compare 60-day complication rates, they and their associates reviewed the records of 251 patients with pancreatic ductal adenocarcinoma who underwent resection in 2000–2008. Of this group, 116 patients (46%) had preoperative diabetes.

The patients with diabetes were more likely to have at least one comorbidity than were those without diabetes, Dr. Chu said.

The type of pancreatectomy did not differ significantly between groups, nor did hospital length of stay (13–14 days). Most patients underwent pancreaticoduodenectomy. Just 1% of nondiabetic patients had total pancreatectomy, while none of the diabetes patients did. The remainder underwent left pancreatectomy.

There were no dramatic differences in complications by organ system, except for renal dysfunction. A total of 23% of 116 patients with diabetes versus 13% of 135 nondiabetic patients experienced renal dysfunction, “but it was mostly a mild elevation of creatinine,” said Dr. Chu, a surgical resident at Emory.

The 30-day mortality rates were 2.2% in the diabetes mellitus group and 1.7% in the nondiabetic patients, a difference that was not statistically significant, Dr. Chu said.

“The key point is that there was no major difference between diabetics and nondiabetics,” Dr. Kooby said.

HOLLYWOOD, FLA. — A better body image perception following pelvic organ prolapse treatment correlated with improved sexual function in a multicenter, prospective cohort study of 239 women.

Sexual function improved 4-6 months after treatment compared with baseline, regardless of whether patients had surgery or pessary placement. Sexual function improvements also correlated with decreased bother from pelvic organ prolapse.

“Sexual dysfunction is highly prevalent in women attending urogynecology services,” Dr. Lior Lowenstein said at the annual meeting of the American Urogynecologic Society. He estimated that this condition affects as many as 60% of sexually active patients.

Other researchers previously showed that women seeking treatment for advanced pelvic organ prolapse report a worse perception of body image and decreased quality of life, compared with controls without pelvic organ prolapse (Am. J. Obstet. Gynecol. 2006;194:1455-61). The current study was designed to see if treatment improves body image and/or sexual function, and if there is any relationship among these fectors.

Dr. Lowenstein and his colleagues enrolled 384 consecutive women presenting for urogynecologic care at one of eight U.S. academic medical centers. At baseline, the mean prolapse stage was III, and the mean age was 62 years. At 4-6 months' follow-up, 145 women were lost to follow-up, but there were no significant demographic differences between that group and the 239 women who remained, said Dr. Lowenstein, who was a urogynecology fellow at Loyola University Medical Center in Chicago at the time of the study. He is now an instructor at Rambam Medical Center in Haifa, Israel.

Overall, 86% of the patients chose surgery—most commonly sacrocolpopexy. The remainder opted for more conservative treatment with a pessary. A total of 126 women (61%) in the surgery cohort and 22 (67%) in the pessary group said they were sexually active—not a significant difference.

A meeting attendee asked if women treated with pessaries needed to remove them prior to sexual intercourse. “That was not part of the questionnaire we gave them, but it is an important issue that needs to be explored,” Dr. Lowenstein said.

The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire–12 (PISQ-12) was used to assess sexual function. Poorer sexual function, defined by lower scores on the PISQ-12, significantly correlated with worse body image perception. Worse body image perception was reflected by higher scores on the Modified Body Image Perception Scale.

Lower PISQ-12 numbers also correlated with significantly more bothersome prolapse—defined by higher scores on the prolapse subscale of the Pelvic Floor Distress Inventory. Interestingly, Dr. Lowenstein said, the anatomic site of prolapse did not make a significant difference. The PISQ-12 scores were not significantly related to prolapse stage or affected compartment (anterior, apical, or posterior).

In addition to the three validated questionnaires, the investigators took a patient history, conducted a routine pelvic examination, and determined prolapse stage using the Pelvic Organ Prolapse Quantification exam at baseline and follow-up.

Dr. Lowenstein presented these results on behalf of Fellows' Pelvic Research Network. He had no relevant disclosures. The complete study findings have been published in the Journal of Sexual Medicine (2009;6:2286-91).

“Body image perception has an important role in sexual function in women with pelvic organ prolapse,” Dr. Lowenstein said. He added that the results suggest sexual function may be related more to a woman's perception of her body image than to actual topographic changes from pelvic organ prolapse.

A meeting attendee asked which specific body image parameters improved on the Modified Body Image Perception Scale. That is an objective of another analysis now underway, Dr. Lowenstein said.

HOLLYWOOD, FLA. — A better body image perception following pelvic organ prolapse treatment correlated with improved sexual function in a multicenter, prospective cohort study of 239 women.

Sexual function improved 4-6 months after treatment compared with baseline, regardless of whether patients had surgery or pessary placement. Sexual function improvements also correlated with decreased bother from pelvic organ prolapse.

“Sexual dysfunction is highly prevalent in women attending urogynecology services,” Dr. Lior Lowenstein said at the annual meeting of the American Urogynecologic Society. He estimated that this condition affects as many as 60% of sexually active patients.

Other researchers previously showed that women seeking treatment for advanced pelvic organ prolapse report a worse perception of body image and decreased quality of life, compared with controls without pelvic organ prolapse (Am. J. Obstet. Gynecol. 2006;194:1455-61). The current study was designed to see if treatment improves body image and/or sexual function, and if there is any relationship among these fectors.

Dr. Lowenstein and his colleagues enrolled 384 consecutive women presenting for urogynecologic care at one of eight U.S. academic medical centers. At baseline, the mean prolapse stage was III, and the mean age was 62 years. At 4-6 months' follow-up, 145 women were lost to follow-up, but there were no significant demographic differences between that group and the 239 women who remained, said Dr. Lowenstein, who was a urogynecology fellow at Loyola University Medical Center in Chicago at the time of the study. He is now an instructor at Rambam Medical Center in Haifa, Israel.

Overall, 86% of the patients chose surgery—most commonly sacrocolpopexy. The remainder opted for more conservative treatment with a pessary. A total of 126 women (61%) in the surgery cohort and 22 (67%) in the pessary group said they were sexually active—not a significant difference.

A meeting attendee asked if women treated with pessaries needed to remove them prior to sexual intercourse. “That was not part of the questionnaire we gave them, but it is an important issue that needs to be explored,” Dr. Lowenstein said.

The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire–12 (PISQ-12) was used to assess sexual function. Poorer sexual function, defined by lower scores on the PISQ-12, significantly correlated with worse body image perception. Worse body image perception was reflected by higher scores on the Modified Body Image Perception Scale.

Lower PISQ-12 numbers also correlated with significantly more bothersome prolapse—defined by higher scores on the prolapse subscale of the Pelvic Floor Distress Inventory. Interestingly, Dr. Lowenstein said, the anatomic site of prolapse did not make a significant difference. The PISQ-12 scores were not significantly related to prolapse stage or affected compartment (anterior, apical, or posterior).

In addition to the three validated questionnaires, the investigators took a patient history, conducted a routine pelvic examination, and determined prolapse stage using the Pelvic Organ Prolapse Quantification exam at baseline and follow-up.

Dr. Lowenstein presented these results on behalf of Fellows' Pelvic Research Network. He had no relevant disclosures. The complete study findings have been published in the Journal of Sexual Medicine (2009;6:2286-91).

“Body image perception has an important role in sexual function in women with pelvic organ prolapse,” Dr. Lowenstein said. He added that the results suggest sexual function may be related more to a woman's perception of her body image than to actual topographic changes from pelvic organ prolapse.

A meeting attendee asked which specific body image parameters improved on the Modified Body Image Perception Scale. That is an objective of another analysis now underway, Dr. Lowenstein said.

HOLLYWOOD, FLA. — A better body image perception following pelvic organ prolapse treatment correlated with improved sexual function in a multicenter, prospective cohort study of 239 women.

Sexual function improved 4-6 months after treatment compared with baseline, regardless of whether patients had surgery or pessary placement. Sexual function improvements also correlated with decreased bother from pelvic organ prolapse.

“Sexual dysfunction is highly prevalent in women attending urogynecology services,” Dr. Lior Lowenstein said at the annual meeting of the American Urogynecologic Society. He estimated that this condition affects as many as 60% of sexually active patients.

Other researchers previously showed that women seeking treatment for advanced pelvic organ prolapse report a worse perception of body image and decreased quality of life, compared with controls without pelvic organ prolapse (Am. J. Obstet. Gynecol. 2006;194:1455-61). The current study was designed to see if treatment improves body image and/or sexual function, and if there is any relationship among these fectors.

Dr. Lowenstein and his colleagues enrolled 384 consecutive women presenting for urogynecologic care at one of eight U.S. academic medical centers. At baseline, the mean prolapse stage was III, and the mean age was 62 years. At 4-6 months' follow-up, 145 women were lost to follow-up, but there were no significant demographic differences between that group and the 239 women who remained, said Dr. Lowenstein, who was a urogynecology fellow at Loyola University Medical Center in Chicago at the time of the study. He is now an instructor at Rambam Medical Center in Haifa, Israel.

Overall, 86% of the patients chose surgery—most commonly sacrocolpopexy. The remainder opted for more conservative treatment with a pessary. A total of 126 women (61%) in the surgery cohort and 22 (67%) in the pessary group said they were sexually active—not a significant difference.

A meeting attendee asked if women treated with pessaries needed to remove them prior to sexual intercourse. “That was not part of the questionnaire we gave them, but it is an important issue that needs to be explored,” Dr. Lowenstein said.

The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire–12 (PISQ-12) was used to assess sexual function. Poorer sexual function, defined by lower scores on the PISQ-12, significantly correlated with worse body image perception. Worse body image perception was reflected by higher scores on the Modified Body Image Perception Scale.

Lower PISQ-12 numbers also correlated with significantly more bothersome prolapse—defined by higher scores on the prolapse subscale of the Pelvic Floor Distress Inventory. Interestingly, Dr. Lowenstein said, the anatomic site of prolapse did not make a significant difference. The PISQ-12 scores were not significantly related to prolapse stage or affected compartment (anterior, apical, or posterior).

In addition to the three validated questionnaires, the investigators took a patient history, conducted a routine pelvic examination, and determined prolapse stage using the Pelvic Organ Prolapse Quantification exam at baseline and follow-up.

Dr. Lowenstein presented these results on behalf of Fellows' Pelvic Research Network. He had no relevant disclosures. The complete study findings have been published in the Journal of Sexual Medicine (2009;6:2286-91).

“Body image perception has an important role in sexual function in women with pelvic organ prolapse,” Dr. Lowenstein said. He added that the results suggest sexual function may be related more to a woman's perception of her body image than to actual topographic changes from pelvic organ prolapse.

A meeting attendee asked which specific body image parameters improved on the Modified Body Image Perception Scale. That is an objective of another analysis now underway, Dr. Lowenstein said.

HOLLYWOOD, FLA. — Women with a pelvic floor disorder do not experience significantly diminished rates of sexual activity compared with unaffected women, based on a study of 505 women.

Only the desire component of the Female Sexual Function Index (FSFI) was significantly lower among women with a pelvic floor disorder, suggesting no notable impact on arousal, lubrication, orgasm, satisfaction, or pain, Dr. Tola B. Omotosho said at the annual meeting of the American Urogynecologic Society.

Dr. Omotosho and colleagues recruited 505 women older than 40 years from September 2007 to April 2009. The cohort included 308 urogynecology patients with a pelvic floor disorder and 197 general gynecology patients without such a disorder.

Women in the pelvic floor disorder group were significantly older, with a mean age of 56, vs. 52 years in the unaffected group. Mean parity was higher in affected women (2.6 vs. 2.1), which was not significant after adjustment.

The primary outcome measure was the total mean score on the FSFI, where a higher score indicates better sexual function. The mean total score in the pelvic floor disorder group was 23.2, not significantly lower than the mean 24.4 score in the unaffected women.

“Women with pelvic floor disorders were as sexually active as women without pelvic floor disorders,” with sexual activity in the past 6 months reported by 62% of affected and 75% of unaffected women. This difference was not statistically significant, said Dr. Omotosho, an ob.gyn. fellow at the University of New Mexico Health Sciences Center, Albuquerque.

HOLLYWOOD, FLA. — Women with a pelvic floor disorder do not experience significantly diminished rates of sexual activity compared with unaffected women, based on a study of 505 women.

Only the desire component of the Female Sexual Function Index (FSFI) was significantly lower among women with a pelvic floor disorder, suggesting no notable impact on arousal, lubrication, orgasm, satisfaction, or pain, Dr. Tola B. Omotosho said at the annual meeting of the American Urogynecologic Society.

Dr. Omotosho and colleagues recruited 505 women older than 40 years from September 2007 to April 2009. The cohort included 308 urogynecology patients with a pelvic floor disorder and 197 general gynecology patients without such a disorder.

Women in the pelvic floor disorder group were significantly older, with a mean age of 56, vs. 52 years in the unaffected group. Mean parity was higher in affected women (2.6 vs. 2.1), which was not significant after adjustment.

The primary outcome measure was the total mean score on the FSFI, where a higher score indicates better sexual function. The mean total score in the pelvic floor disorder group was 23.2, not significantly lower than the mean 24.4 score in the unaffected women.

“Women with pelvic floor disorders were as sexually active as women without pelvic floor disorders,” with sexual activity in the past 6 months reported by 62% of affected and 75% of unaffected women. This difference was not statistically significant, said Dr. Omotosho, an ob.gyn. fellow at the University of New Mexico Health Sciences Center, Albuquerque.

HOLLYWOOD, FLA. — Women with a pelvic floor disorder do not experience significantly diminished rates of sexual activity compared with unaffected women, based on a study of 505 women.

Only the desire component of the Female Sexual Function Index (FSFI) was significantly lower among women with a pelvic floor disorder, suggesting no notable impact on arousal, lubrication, orgasm, satisfaction, or pain, Dr. Tola B. Omotosho said at the annual meeting of the American Urogynecologic Society.

Dr. Omotosho and colleagues recruited 505 women older than 40 years from September 2007 to April 2009. The cohort included 308 urogynecology patients with a pelvic floor disorder and 197 general gynecology patients without such a disorder.

Women in the pelvic floor disorder group were significantly older, with a mean age of 56, vs. 52 years in the unaffected group. Mean parity was higher in affected women (2.6 vs. 2.1), which was not significant after adjustment.

The primary outcome measure was the total mean score on the FSFI, where a higher score indicates better sexual function. The mean total score in the pelvic floor disorder group was 23.2, not significantly lower than the mean 24.4 score in the unaffected women.

“Women with pelvic floor disorders were as sexually active as women without pelvic floor disorders,” with sexual activity in the past 6 months reported by 62% of affected and 75% of unaffected women. This difference was not statistically significant, said Dr. Omotosho, an ob.gyn. fellow at the University of New Mexico Health Sciences Center, Albuquerque.