The Science of the Pelvic Floor: Uncovering the Silent Secrets of Pelvic Floor Dysfunction

Many mothers will have this experience after giving birth: sneeze, laugh, run upstairs... accidentally leak urine. Although embarrassed and uncomfortable, they are too ashamed to say it out loud, thinking that this is a normal phenomenon after giving birth and just bear with it. In fact, postpartum urinary incontinence is a manifestation of pelvic floor dysfunction. In addition to urinary incontinence, pelvic floor muscle relaxation can also cause many health risks, such as pelvic organ prolapse, pelvic pain, sexual dysfunction and fecal incontinence, etc. It is also a destruction of women's self-confidence and self-esteem, and seriously affects women's quality of life.

Let’s talk about the pelvic floor muscles that affect women’s lower body and happiness in the second half of their lives.

First, let us understand what are the pelvic floor muscles?

The pelvic floor muscles are the muscles that close the pelvic floor. This muscle group is like a "hanging net" that tightly holds the urethra, bladder, vagina, uterus, rectum and other organs, thus maintaining their normal position to perform their functions.

What is pelvic floor dysfunction?

The female pelvic floor support tissue becomes weak due to factors such as degeneration and trauma, resulting in pelvic floor dysfunction. Generally, it mainly includes: pelvic organ prolapse (uterus, bladder, rectal prolapse); abnormal urination (frequent urination, urinary incontinence, urinary retention); abnormal defecation (fecal incontinence, constipation); sexual dysfunction (sexual indifference, sexual intercourse pain, no orgasm); chronic pelvic pain (perineal pain, bladder pain), etc.

What are the causes?

The reasons why women experience pelvic floor muscle relaxation and pelvic floor dysfunction can often be divided into several aspects. First, during pregnancy and delivery, the fetus continues to compress the pelvic floor, which causes traction on the fascia, ligaments, and muscles of the pelvic floor, causing certain damage. Therefore, some female friends who have cesarean sections will also experience pelvic floor relaxation. After delivery, the tension of the pelvic floor tissue may not be restored, and pelvic floor dysfunction may occur. In addition, with the increase of age, estrogen gradually decreases, and the pelvic floor function, muscles, fascia, etc. that appear after menopause atrophy, pelvic floor muscle relaxation may also occur. If the patient has chronic diseases, such as chronic cough, long-term constipation, the need to hold breath for a long time, or heavy manual laborers need to bear weight continuously, etc., it may cause an increase in abdominal pressure, which further leads to the relaxation of the pelvic floor muscles.

How to check?

General palpation can give a good judgement of the pelvic floor condition: the patient lies on the gynecological examination bed, and the doctor usually asks her to hold her breath and cough to judge the degree of vaginal wall bulging and the position of the cervix. After the doctor's judgment, pelvic floor muscle screening and pelvic floor ultrasound examination can be performed, and pelvic floor muscle strength test can be performed using instruments.

If you encounter such problems, please don't worry. Next, you will be guided on how to seek medical treatment and recover.

Through the assessment of pelvic floor muscle function, the doctor will develop a personalized rehabilitation plan for you, such as: providing lifestyle guidance, correcting incorrect exercise methods, guiding the use of pelvic floor rehabilitation devices, and planning to come to the hospital for pelvic floor rehabilitation treatment.

There are two types of pelvic floor muscle treatment: surgical treatment and non-surgical treatment .

Indications for surgical treatment: For example, patients with symptomatic prolapse, or patients with prolapse of grade II or above with obvious progression.

Indications for non-surgical treatment: mild to moderate pelvic floor dysfunction, post-operative adjuvant treatment, the best method: electrical stimulation therapy, biofeedback training, and self-exercise.

Electrical stimulation therapy

It can better correct damaged muscles and nerves and has long-term therapeutic effects.

Biofeedback training

Electrical stimulation combined with voluntary exercise.

Self-exercise <br /> Kegel exercises

To prevent disease before it happens, we should detect, diagnose, treat and control the disease early.

If you experience any of the above symptoms, please see a doctor as soon as possible.

END

Author: Yao Tianyi (Department of Gynecology, Chongming Hospital, Shanghai Health and Medical College)

Supervisor: Zhang Lei (Department of Gynecology, Chongming Hospital, Shanghai Health and Medical College)

Reviewer: Li Jianhua (Chairman of the Sports Rehabilitation Committee of the Chinese Rehabilitation Medicine Association, Director of the Rehabilitation Medicine Center of the Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine)

Editor: Jia Jing (Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine)