01.10.2013 | Original Article | Ausgabe 10/2013
Levator myalgia: why bother?
International Urogynecology Journal
- Kerrie Adams, W. Thomas Gregory, Blake Osmundsen, Amanda Clark
Introduction and hypothesis
We report the prevalence of levator myalgia (LM) and describe symptom bother and comorbidities associated with this examination finding.
We performed a cross-sectional study of patients referred to urogynecology practices: a private practice (COMM) and a tertiary university-based practice (UNIV). We identified within our population a subset of patients with LM and a reference group without LM. The primary outcome was to report the prevalence of LM within a urogynecology referral population. Our secondary outcomes include mean Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) scores, medication use, medical co-morbidities, and presence of vulvodynia.
The prevalence of LM was 24 % at the UNIV detected on 5,618 examinations and 9 % at the COMM based on 946 examinations. Women with LM were significantly younger: mean age 56.8 years vs 65.5 (p < 0.001). There was no difference in mean parity (2.3), BMI (28.2 kg/m2), and race (94 % white). Patients with LM reported significantly higher mean symptom bother scores (PFDI, PFIQ; p = <0. 001) related to prolapse, defecatory dysfunction, and urinary symptoms. Women with LM were more likely to report a diagnosis of fibromyalgia (OR 4.4 [1.7, 11.0]), depression (OR 1.8 [1.2, 2.7]), a history of sexual abuse (OR 2.4 [1.3, 4.7]), and use narcotic pain medications (OR 2.5 [1.2, 5.2]).
Levator myalgia is a prevalent condition in urogynecology practice, and is associated with approximately 50 % greater bother in urinary, defecatory, and prolapse symptoms.