['Chronic conditions that cause raised intra-abdominal pressure, such as obesity, chronic cough and constipation are risk factors for pelvic floor dysfunction (PFD). We hypothesise that unipedicle transverse rectus abdominis musculocutaneous flap (UTRAM flap) for reconstruction following mastectomy for breast cancer increases the risk of PFD.', 'The aim of this study is to assess if there is increased risk of pelvic floor dysfunction associated with UTRAM flap reconstruction compared to controls.', '39 patients who had UTRAM flaps for breast reconstruction following mastectomy for breast cancer between year 1997 to 2004 were recruited as cases. They were matched by age with 36 controls, who have had breast cancer but not U TRAM flap reconstruction as part of their treatment. Validated questionnaires (Pelvic floor distress inventory PFDI-20) were completed by study participants, and demographic data were also collected. Mixed effect analysis of variance was used to assess for statistical difference in the mean PFDI-20 scores, adjusted by age, parity, BMI and history of gynaecological surgery.', 'The case group has significantly higher mean PFDI-20 score than the control group, 13 (3-29) vs 5.5 (1-11), MH odds ratio 1.8 (1.1-2.8), p value=0.02.'] Are unipedicle TRAM flap procedures associated with symptoms of pelvic floor dysfunction in women : a case control study?