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A New Comorbidity in Female Patients With Ankylosing Spondylitis

Pelvic Organ Prolapse

Çağlayan, Mehmet MD*; Oktayoğlu, Pelin MD*; Ağaçayak, Elif MD; Dagli, Abdullah Zübeyir MD*; Okçu, Mehmet MD*; Nas, Kemal MD

JCR: Journal of Clinical Rheumatology: January 2019 - Volume 25 - Issue 1 - p 36–40
doi: 10.1097/RHU.0000000000000767
Original Articles
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Aim The aim of this study was to investigate whether increased intra-abdominal pressure caused by pelvic inflammation and frequent use of the Valsalva maneuver increases the incidence of pelvic organ prolapse (POP) among female patients with ankylosing spondylitis (AS).

Methods Thirty-nine patients diagnosed as having AS through the use of the modified New York criteria, 47 patients with chronic low-back pain (CLBP), and 38 healthy controls (HCs) were included in this study. All the patients and the HCs underwent thorough physical and gynecological examinations. Pelvic organ prolapse was graded blindly by a gynecologist. Presence or absence of cystocele (CS), rectocele (RC), and uterine prolapse (UP) was noted.

Results The incidences of CS, RC, and UD were significantly higher among the AS patients compared with the HCs (p = 0.001, 0.026, and 0002, respectively). The incidences of CS (p = 0.042) and UD (p = 0.017) were significantly higher among the AS patients compared with the CLBP patients.

Conclusions The incidence of POP is higher among patients with AS compared with normal population. These patients should be questioned about the symptoms of POP and recommended, if necessary, regular gynecological examinations, as well as specific exercises including those targeting AS.

From the *Division of Rheumatology, Department of Physical Medicine and Rehabilitation, and

Department of Obstetrics and Gynecology, Dicle University Faculty of Medicine, Diyarbakir; and

Division of Immunology and Rheumatology, Department of Physical Medicine and Rehabilitation, Sakarya University Faculty of Medicine, Sakarya, Turkey.

None of the authors received any financial support from elsewhere.

The authors declare no conflict of interest.

The study was conducted in accordance with the Helsinki Declaration and approved by the local ethics committee.

Correspondence: Mehmet Caglayan, MD, Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Dicle University Faculty of Medicine, 21280, Diyarbakir, Turkey. E-mail: ftrmehmet63@hotmail.com.

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