Pelvic floor complaint profiles in young adult women: a file review study in pelvic physical therapy practices in the Netherlands

BACKGROUND: Many patients with pelvic floor complaints, including urinary and fecal incontinence, micturition and defecation problems, pelvic organ prolapses, pelvic pain, and painful intercourse, receive pelvic physical therapy treatment. Based on available evidence, pelvic floor complaint profiles, including these complaints, have not been described using real-world pelvic physical therapy records and multi-complaint clustering methods. Pelvic floor complaint profiles may help to enhance therapists' clinical reasoning and patients' understanding and self-disclosure.

AIM: This retrospective file review study explores preliminary complaint profiles and associations between pelvic floor complaints.

METHOD: Pelvic physical therapists entered recorded pelvic floor complaints from self-selected pregnant, parous, and nulliparous patients' files in an online survey. Complaints were extracted from clinical records and coded as binary (recorded/not recorded). Descriptive statistics and correlations were calculated, and latent class analysis was performed to gain insight into pelvic floor complaint profiles and their associations with pregnancy and parity. Model selection was based on BIC/log-likelihood statistics and expert clinical review.

RESULTS: A model with five profiles was selected based on statistical and theoretical selection criteria. One profile showed the highest probabilities for recorded pelvic pain, one for recorded defecation and micturition problems, one for recorded fecal incontinence and defecation problems, another for recorded pelvic organ prolapses and urinary incontinence, and one for recorded painful intercourse and micturition problems. The first and second profiles appeared most characteristic for pregnant patients, the third and fourth for parous patients, and the fifth for nulliparous patients.

CONCLUSION: The identified profiles may facilitate the inclusion and consideration of potential contributing factors for combined pelvic floor complaints in clinical practice and scientific research. Addressing pelvic floor complaints in profiles may help pelvic healthcare providers during their history-taking, enhance multidisciplinary treatment approaches, and help patients understand experienced combinations of pelvic floor complaints. This may ultimately benefit women's pelvic health.