Climacteric; Pelvic Floor; Pelvic Floor Disorders; Manometry; Muscle Strength Dynamometer.
Introduction: Pelvic Floor disorders are a global health problem that encompasses several disorders. The combination of risk factors, anatomical changes and weakening of the pelvic floor components can lead to the appearance of pathological symptoms associated with changes in its function. In this sense, the assessment of the pelvic floor muscles (PFM) is recommended by the International Continence Society (ICS), considered essential to evaluate the function of the PFM before and during PFM training to evaluate dysfunctions, provide the best training program and measure improvements. Objective: to investigate the accuracy of vaginal dynamometry correlating the pressure and strength of the pelvic floor muscles in women during the reproductive phase and climacteric periods. Methodology: Cross-sectional observational study, carried out from May/2023 to July/2024, with 72 women, recruited from the Januário Cicco Maternity School (MEJC) of the Federal University of Rio Grande do Norte (UFRN), Brazil. The sample was selected by convenience, following the eligibility criteria: Women aged 18 years and over, without an intact hymen, absence of urinary or vaginal infection, absence of gynecological bleeding, absence of cognitive dysfunction and who had not undergone childbirth or gynecological surgery at least six months ago. Data collection occurred through the application of an anamnesis questionnaire, followed by functional evaluation and reevaluation of the pelvic floor muscles, for this purpose, using the following resources: vaginal palpation, manometry and dynamometry, (reevaluation occurred at least 15 days after the assessment). Analyzes were performed using SPSS® software (version 28.0, IBM, Chicago, USA). The level of statistical significance adopted was p<0.05. The Spearman test was used to verify correlations between vaginal manometry classifications (very weak, weak, moderate, good and strong) with vaginal dynamometry. The Receiver Operating Characteristic (ROC) analysis was used to establish the best cutoff point of the instrument indicated to discriminate between very weak and weak pressure and moderate to strong pressure. The indices to establish the cutoff point included sensitivity and specificity. Results: The analysis of the correlation between manometry and dynamometry results was significant and weak (r =0.3; p = 0.01). The dynamometry ROC curve showed an area under the curve of 66%, which was considered statistically significant (95% CI: 0.53 - 0.78; p = 0.024). The cutoff point established was 0.5141, with sensitivity of 70.6% and specificity of 52.6%. Manometry and dynamometry suggest that, although the assessment methods are related, there is considerable variability in the way each method measures the pelvic floor muscles.