Don’t take urinary incontinence lightly, train your pelvic floor muscles!

Author: Fan Guorong and Li Ying, deputy chief nurses at Peking Union Medical College Hospital

Reviewer: Sun Zhijing, Chief Physician, Peking Union Medical College Hospital

Ms. Li is 59 years old. She gained nearly 25 kilograms when she was pregnant. She had urine leakage when she sneezed and coughed during pregnancy and after giving birth. Later, she also had urine leakage when she caught a cold. Now, when Ms. Li walks briskly, she can feel urine flowing out involuntarily, and her underwear will get wet. Ms. Li is very scared. Why is the urine leakage getting worse? In fact, it is caused by pelvic floor dysfunction.

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Female pelvic floor dysfunction is caused by the weakness of pelvic floor support tissue, resulting in abnormal pelvic organ position and/or urination, defecation, sexual and support functions. Factors such as increased fetal weight during pregnancy, obesity, and heavy physical activity can lead to increased abdominal pressure. In addition, factors such as the traction of the pelvic floor during childbirth and aging can change the pelvic floor support structure, reduce pelvic floor muscle strength, and relax pelvic floor support tissue, which will cause urinary incontinence to become more and more serious.

There are many manifestations of urine leakage. Some people leak urine when they sneeze or cough; some people have to go to the bathroom immediately when they have to urinate, and they can't hold it in at all; some people always feel that they haven't urinated completely after urinating, and they want to urinate again after a while; some people have a feeling of vaginal falling, and can even feel the internal tissue at the vaginal opening, as if something has fallen out; some people are troubled by constipation, and have difficulty defecating and feel that they can't urinate completely; some people sometimes can't control their bowel movements and often soil their pants; some women complain that they can't enjoy sex, and that things have become boring, or even painful and painful; some people go to the hospital repeatedly, but can't find out what's going on with their stomach pain and vulvar pain.

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In fact, these symptoms are manifestations of female pelvic floor dysfunction, including urination dysfunction, pelvic organ prolapse, defecation dysfunction, sexual dysfunction, chronic pelvic pain and other problems. These problems can be summarized in five words, that is, "urine, defecation, sex, pain, prolapse". The prevalence of female pelvic floor dysfunction is not low, ranging from 18.1% to 57.5% in my country, and as high as 50% in postmenopausal women. Many women have multiple pelvic floor symptoms.

Female pelvic floor dysfunction can seriously affect women's quality of life, and problems such as urinary incontinence and prolapse during pregnancy and postpartum can also increase the risk of long-term pelvic floor dysfunction. Therefore, women should face this problem, screen, diagnose and treat as early as possible. For mild to moderate pelvic floor diseases, standardized and systematic rehabilitation treatment can be carried out. If the rehabilitation treatment is not effective or the pelvic floor disease is moderate to severe, surgical treatment can be considered.

It is important to prevent pelvic floor dysfunction. Two home exercise methods are recommended.

The first method is pelvic floor muscle exercise, which is what we often call Kegel exercise and anal contraction exercise. It can not only prevent pelvic floor dysfunction, but also treat pelvic floor dysfunction. To do this exercise, you first need to accurately find the pelvic floor muscles. There are pelvic floor muscles in the places where you usually urinate, defecate, and give birth. You can try to pinch off the urine or clamp the vagina, which is actually contracting the pelvic floor muscles. You don't need to use a lot of force to tighten the pelvic floor muscles. Just clamp them gently like a claw machine. At the same time, pay attention to keeping the muscles in other parts relaxed, and don't tighten the muscles of the abdomen, legs, and buttocks. Tighten the pelvic floor muscles, hold for 5 seconds and then relax for 5 seconds (do 5 times), hold for 2 seconds and then relax for 4 seconds (do 5 times), and alternate the two movements for 5 to 10 minutes each time, and repeat 2 to 3 times a day. Only by persisting in exercise can you achieve a good effect in preventing pelvic floor diseases. But be careful not to over-exercise. If the pelvic floor muscles are over-trained, the muscle strength will become weaker.

The second method is the hip bridge. When training, first lie flat on a yoga mat or other hard surface, lie on your back, bend your knees and spread your legs apart, shoulder-width apart, with your feet on the ground and close to your hips, and stretch your arms to both sides of your body, with your arms touching the ground. Next, tighten your abdomen, use your shoulders and feet as support points to lift your hips upward, and try to make your body a flat surface. Hold for 6 seconds, and you can count "1001, 1002...1006" loudly to avoid holding your breath, and then slowly lower your hips. This is one hip bridge exercise. Do 20 in each set, and do 3 sets a day. The hip bridge exercise is a convenient and efficient method. It will also increase core strength and has a good effect on improving low back pain.

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In short, pelvic floor dysfunction is not terrible, but "empty talk without practice" is terrible. I hope every woman can insist on pelvic floor muscle exercises and hip bridge exercises, which can not only prevent pelvic floor dysfunction, but also alleviate the troubles of the disease to a certain extent!