Physical Therapy, Sports Therapy and Rehabilitation, Health Policy, Obstetrics and Gynecology, Urology
15
Scopus Publications
Scopus Publications
Genital hiatus area and pelvic floor dysfunction symptoms in transgender women after gender-affirming surgery Marina Hazin, Andrea Lemos, Rogerson Andrade, Letícia Gantzel, Leila Barbosa, Caroline Wanderley Souto Ferreira Revista Brasileira De Ginecologia E Obstetricia, 2026 Objective: To describe genital hiatus area, pelvic floor muscle (PFM) function, pelvic floor dysfunction symptoms and sexual function characteristics of transgender women submitted to gender-affirming surgery. Methods: Six participants were included in this case series conducted in a referral hospital which treats transgender individuals in Brazil. An individual assessment was performed with sociodemographic variables, clinical symptoms, PFM function, neovaginal depth and genital distances. Two and three-dimensional translabial ultrasound were used to measure hiatal dimensions. The results were shown with absolute and relative frequencies, mean and standard deviation. Results: The genital hiatus area had an average of 11.09 (SD 3.49) cm² at rest and 14.36 (SD 3.00) cm² during the Valsalva maneuver. The mean distances of clitoris-vagina, genital hiatus and perineal body were 9.30 (SD 1.57) cm, 6.60 (SD 1.43) cm and 4.00 (SD 1.90) cm, respectively. The mean vaginal depth was 9.50 (SD 3.51) cm. Most volunteers had satisfactory PFM strength and tone. Transgender women reported an increase in daytime urinary frequency (100%), nocturia (83.3%), sensation of incomplete evacuation (66.7%), straining during defecation (50%), flatal incontinence (16.6%), dyspareunia (50%) and anodyspareunia (16.6%). There were no reports of urinary or fecal incontinence, vaginal bulging, perineal pain or dysuria. Conclusion: This is the first study reporting genital hiatus area by translabial ultrasound in transgender women. Adequate levator hiatal area and neovaginal depth were found, preserved PFM tone and strength, preserved urinary and fecal continence, increased daytime urinary frequency, nocturia, sensation of incomplete evacuation, dyspareunia during vaginal sex and moderate vaginal sexual satisfaction.
Morphofunctional Profile Focusing on Strength and Ultrasound of the Upper Limbs in Female Breast Cancer Survivors: A Comparative Cross-Sectional Study Between Groups with and Without Lymphoedema and Between Ipsilateral and Contralateral Limbs Ana Rafaela Cardozo Da Silva, Juliana Netto Maia, Vanessa Maria Da Silva Alves Gomes, Naiany Tenório, Juliana Fernandes de Souza Barbosa, Ana Claudia Souza da Silva, Vanessa Patrícia Soares de Sousa, Leila Maria Alvares Barbosa, Armèle de Fátima Dornelas de Andrade, Diego Dantas Biomedicines, 2025 Background: Breast cancer is the most common neoplasm in women. Despite effective treatments, sequelae such as decreased muscle strength, upper limb dysfunction, and tissue changes are common, highlighting the need for functional assessments during rehabilitation. This study analysed the morphofunctional profile of the upper limbs in breast cancer survivors, comparing muscle strength and ultrasound findings between groups with and without lymphoedema, as well as between ipsilateral and contralateral limbs. Methods: This cross-sectional study included female breast cancer survivors treated at an oncology physical therapy clinic. Muscle strength was measured using dynamometry (handgrip and arm flexor strength), and ultrasound assessed the thickness of the dermal–epidermal complex (DEC), subcutaneous tissue (SUB), and muscle (MT). Results: The upper limbs of 41 women were evaluated. No significant differences were observed between those with and without breast cancer-related lymphoedema (BCRL). When comparing the ipsilateral and contralateral limbs, significant reductions were observed in arm flexor strength (p < 0.001; 95% CI: −9.77 to −2.50), handgrip strength (p < 0.001; 95% CI: −4.10 to −1.22), and tissue thickness, with increased DEC thickness on the forearm (0.20 mm; p = 0.022) and arm flexors (0.25 mm; p < 0.001) of the ipsilateral limb. Conclusion: Significant differences in muscle strength and tissue structure between ipsilateral and contralateral limbs may reflect surgical and local pathophysiological effects. A trend toward reduced values for these parameters was also noted in limbs with BCRL, reinforcing the importance of future research to elucidate underlying mechanisms and guide more effective therapeutic strategies.
Acute Effect of a Half-Marathon over the Muscular Function and Electromyographic Activity of the Pelvic Floor in Female Runners with or without Urinary Incontinence: A Pilot Study Horianna Cristina Silva de Mendonça, Caroline Wanderley Souto Ferreira, Alberto Galvão de Moura Filho, Pedro Vanderlei de Sousa Melo, Ana Flávia Medeiros Ribeiro, Kryslly Danielle de Amorim Cabral, Renato de Souza Melo, Leila Maria Alvares Barbosa, Ana Paula de Lima Ferreira International Journal of Environmental Research and Public Health, 2023 Objective: to verify the acute effect of running a half marathon on pelvic floor muscle (PFM) function and electromyographic (EMG) activity in female runners with and without urinary incontinence. Methods: This is a cross-sectional pilot study. The sample was divided into two groups: runners with urinary incontinence (with UI) and runners without urinary incontinence (without UI). A semi-structured form and the International Consultation on Incontinence Questionnaire—Short Form (ICIQ-UI-SF) were used for data collection. The EMG and PFM function were evaluated using the PERFECT method before and immediately after running a half marathon. Results: A total of 14 runners were included (8 with UI; 6 without UI). Runners with and without UI did not show significant differences for EMG and PERFECT. The acute effects of the half marathon on runners without UI were reduced PFM function in terms of strength (p = 0.00), reduced endurance (p = 0.02), and reduced repetition (p = 0.03), and an increase in EMG measured by the median frequency (p = 0.02). Runners with UI showed reduced PFM function in terms of strength (p = 0.05) and repetition (p = 0.01). Conclusion: there was no difference in the acute effects of the half marathon on PFM function and EMG in women with and without UI.
Prevalence and factors associated with urinary incontinence in female crossfitters: A cross-sectional study Elizabete de Souza Pereira, Ana Paula de Lima Ferreira, Milene de Oliveira Almeida, Cinthia Silva Barbosa, Gleyce de Melo Falcão Monteiro, Leila Barbosa, Andrea Lemos Luts Lower Urinary Tract Symptoms, 2022 ObjectiveTo determine the prevalence and factors associated with urinary incontinence (UI) in female crossfitters.MethodsThis is a cross‐sectional study. Data were collected using assessment forms: Knowledge, Attitude and Practice survey for young female athletes; Incontinence Severity Index; and International Consultation on Incontinence Questionnaire for UI. Descriptive analysis was conducted to obtain absolute and relative frequencies, means and 95% confidence intervals (95% CI). Multivariate analysis was carried out to determine the association between UI and sociodemographic, gynecological‐obstetric, and anthropometric variables, associated morbidities, previous history and physical activity.ResultsPrevalence of UI, in the 189 included volunteers, was 38.6% and the most frequent type was stress UI (69.9%). A total of 72.6% of incontinent women reported urine loss during CrossFit training. Knowledge (53.4%) and attitude (86.2%) regarding UI were generally adequate, while prevention, management and treatment were inadequate (96.3%). The predominant characteristics of UI were frequency of once a week or less (74.0%), in small amounts (86.3%), mild intensity (57.5%) and slight impact on quality of life (64.3%). In multivariate analysis, no variable was significantly associated with UI.ConclusionsThe prevalence of UI in female crossfitters was 38.6%. The factors investigated did not contribute to the development of UI.
Assessment of the strength and electrical activity of the pelvic floor muscles of male-to-female transgender patients submitted to gender-affirming surgery: A case series Marina Hazin, Caroline W. S. Ferreira, Rogerson Andrade, Eduarda Moretti, Dayana R. da Silva, Júlio H. Policarpo, Leila Barbosa, Andrea Lemos Neurourology and Urodynamics, 2021 AimsTo assess the strength and electrical activity of the pelvic floor muscles (PFMs) of male‐to‐female transgender individuals submitted to gender‐affirming surgery (GAS).MethodsA case series study was conducted from October 2016 to August 2018. Transgender women, who were scheduled for GAS, participated in the study. The volunteers were submitted to a clinical evaluation of the PFM followed by digital palpation (PERFECT method) and electromyography in the preoperative, 15, and 30 days after GAS. They responded to the International Consultation on Incontinence Questionnaire‐Urinary Incontinence (UI)—Short Form to evaluate the effect of UI on quality of life and to questions related to the urinary, anorectal, and sexual symptoms. Fifteen days after the GAS, patients were instructed to perform perineal exercises at home, twice a day.ResultsThe study sample consisted of 15 transgender women with an average age of 30.6 (SD = 6.7) years. There was a decline in median strength and sustained muscle contraction duration (PERFECT), in the electrical muscle activity (RMSmean and RMSmax) between pre‐GAS and 15 days after GAS (p < 0.05). However, there was an increase in these parameters between 15 and 30 days after GAS (p < 0.05). Moreover, six patients exhibited pre‐GAS UI, which continued after surgery, with a worsening of urgency symptoms and improvement in nocturia and postmicturition leakage.ConclusionStrength, sustained muscle contraction duration, and PFM electrical activity may decline 15 days after GAS, returning to pre‐GAS values in the first month after surgery.
“Posterior Tibial Nerve” or “Tibial Nerve”? Improving the reporting in health papers Eduarda Moretti, Ivson Bezerra da Silva, Alessandra Boaviagem, Leila Barbosa, Anna Myrna Jaguaribe de Lima, Andrea Lemos Neurourology and Urodynamics, 2020 AimsThe primary objective of this study is to identify which term is the most appropriate to use according to anatomical nomenclature: “posterior tibial nerve” or “tibial nerve.” Furthermore, this paper intends to show how the use of these terms in papers indexed in important health databases is numerous and to describe the anatomical characteristics of such nerve, to improve future scientific publications.MethodsThis is a descriptive study about the importance of standardizing the use of the terms “posterior tibial nerve” and “tibial nerve” and its anatomy. It comprises three phases: the first is a search in the main databases to identify the use of the terms “posterior tibial nerve” and “tibial nerve.” The second phase refers to the consultation of international anatomical terminology to identify the most appropriate term to refer to the nerve, while the third phase is related to the study of the anatomy of this nerve.ResultsThe term “tibial nerve” is more commonly used, but the use of the term “posterior tibial nerve” is still very substantial. According to international anatomical terminology, the correct term is “tibial nerve,” which is a branch of the sciatic nerve.Conclusions“Tibial nerve” is the term standardized by international anatomical terminology. The use of terms in accordance with Terminologia Anatomica is important to facilitate the process of teaching and learning, as well as to improve the reporting and interpretation of papers regarding health, and the evidence‐based clinical practice.
