# Screening for Pelvic Floor Disorders and Sexual Dysfunction in Postpartum Women: A Retrospective Cohort Study

## TL;DR

This study found that only about two-thirds of postpartum women were screened for pelvic floor disorders and sexual dysfunction in the first year after delivery, highlighting gaps in care.

## Contribution

The study provides new insights into the low screening rates and associated factors for postpartum pelvic floor disorders and sexual dysfunction.

## Key findings

- 65.9% of postpartum women were screened for pelvic floor disorders and sexual dysfunction.
- Women with earlier postpartum visits were more likely to be screened.
- Urinary and fecal incontinence were the most common diagnosed disorders.

## Abstract

Objectives

This study assesses the screen rate and prevalence of postpartum pelvic floor disorders and sexual dysfunction (PFDs/SD) within the first year of delivery.

Methods

This is a retrospective review of postpartum women seen in a university clinic who delivered at the associated hospital and had postpartum visits from June 1, 2020, to April 15, 2022. Charts were reviewed from delivery to one year postpartum. Demographic and clinical characteristics were compared between women with and without postpartum screening.

Results

Three hundred thirty-four women met inclusion criteria. Two hundred twenty (65.9%) were screened for PFDs/SD. Compared to women who were not screened, women who were screened were older (32.6 vs 31.3 years, p=0.02). Women with a cesarean delivery (73% vs. 58% vaginal, p=0.004), delivered by an attending or resident (70% vs 60% midwife, p=0.06), first postpartum visit at less than six weeks after delivery (76% vs. 43% 6-12 weeks, p<0.001), and three or more postpartum visits (80% vs. 65% two visits, 50% one visit, p<0.001) were more likely to be screened. In an adjusted model, only timing of the first postpartum visit remained significant. Urinary incontinence and fecal incontinence were the most common PFDs diagnosed. Of the 41 women who had PFDs and/or SD, 31 (75.6%) were referred to pelvic floor physical therapy (PFPT) and/or urogynecology.

Discussion

In this retrospective cohort study, we found a low rate of postpartum screening for PFDs/SDs. This deficiency highlights critical gaps in care for postpartum women.