The unspeakable secrets after cervical cancer surgery

The biopsy results came out, and unfortunately, Xiaowen was diagnosed with cervical cancer. Surgery was her only option. The moment she came out of the operating room, she thought everything was over and she could start a new life as if nothing had happened.

However, she fell into another abyss. She no longer dared to go out with her friends and play tennis to her heart's content, nor did she dare to laugh as she pleased...

She couldn't honestly tell others the reason.

So what is Xiaowen going through? Why doesn't she seek medical treatment in time but choose to endure it in silence?

Let’s uncover the secret together!

Cervical cancer is one of the most common malignant tumors that threaten women's lives and health. Every year, new cases of cervical cancer in my country account for about 1/3 of the new cases worldwide. Extensive hysterectomy is the conventional treatment for early cervical cancer. As a last resort, many women with cervical cancer can only choose to undergo surgery.

So what happened to Xiaowen after the operation?

Xiaowen suffered from pelvic floor dysfunction after the operation due to damage to the pelvic floor nerves and tissues during the operation. The specific manifestations include urinary retention, urinary incontinence when laughing or doing strenuous exercise, low libido, constipation or incomplete defecation, and other embarrassing symptoms.

So why does cervical cancer cause damage to pelvic floor function?

This is mainly related to our physiological anatomy and surgical characteristics. The uterus, bladder, large intestine, etc. are all neighbors, and the pelvic floor muscles hold the above organs like a tight bag. It is difficult to avoid damage to the pelvic floor tissue and nerves during hysterectomy, causing the originally tight bag to become loose. This is why loose pelvic floor muscles can cause urinary incontinence! It can also cause anorectal symptoms and sexual dysfunction. And these dysfunctions are particularly private, which makes it difficult for many women to speak up and endure silently...

What should Xiaowen do? Can she regain the good life she had when she was healthy?

If you do experience pelvic floor dysfunction after surgery like Xiaowen did, don't panic, but don't let it develop. Because pelvic floor function can be restored through active rehabilitation training. The pelvic floor muscles mainly affect urination, defecation and other functions through their contraction and relaxation. As shown in the following figure:

Therefore, we can strengthen our pelvic floor function and restore the normal physiological functions of pelvic floor related organs by restoring and strengthening pelvic floor muscle training.

Therefore, the days when Xiaowen can have fun and laugh with friends and sweat while exercising will come back!

Next, I will introduce to you several simple but effective pelvic floor muscle training methods!

1. Kegel exercises

Kegel exercise, also known as levator anus exercise, is a method of consciously training the pelvic floor muscles, mainly the levator anus muscles, to contract autonomously. Generally, the anus and vagina are contracted for no less than 3 seconds each time, and then relaxed. Do it continuously for 15-30 minutes, 2-3 times a day, or 150-200 times a day. A course of treatment is 6-8 weeks. Generally, the patient's function will be improved to a certain extent in 4-6 weeks.

2. Squat

The squat works the largest muscles in the body and has one of the greatest gains in improving strength. When performing this basic movement, make sure your form is solid before adding any resistance.

Stand upright with your feet slightly wider than shoulder-width apart and your toes slightly pointed out. If using a barbell, place it behind your neck on your trapezius muscles. Bend your knees and push your hips and buttocks back as if you were going to sit down in a chair. Keep your chin tucked in and your neck neutral. Lower until your thighs are parallel to the ground, keeping your weight on your heels and your knees slightly bent outward. Straighten your legs and return to an upright position. Complete 15 reps.

3. Bridge exercise

Lie on your back. Your lower back should be flat on the ground, your knees bent at a 90-degree angle, your feet flat, and your arms straight with your palms facing down. Lift your hips off the ground. Your body - resting on your upper back and shoulders - should form a straight line from your knees down.

Pause at the top for 1-2 seconds, then return to the starting position. Complete 10-15 reps and 2-3 sets, resting 30-60 seconds between sets.

4. Superman Movement

Start on all fours with your wrists under your shoulders and your knees under your hips. Your back should be straight and your neck should be neutral. Brace your core.

To begin the move, straighten and raise your left leg and right arm simultaneously, keeping your pelvis and shoulders neutral. Do not lift or lower your head. Hold for 5 seconds. Bend and lower your legs and arms back to the starting position while maintaining stability. Then switch, raising your right leg and left arm.

5. Incline Leg Raise

Lift your legs up when you inhale, and lower your legs when you exhale. Hold for one breath and do one movement. Do 10 times before switching to the other side.

Effect: It exercises the buttocks muscles and is good for people who sit for a long time to train the buttocks and pelvic floor muscles.

6. Vaginal dumbbells

You can use a pelvic floor rehabilitation device, that is, use vaginal dumbbells to assist in the exercise of the pelvic floor muscles. Patients can consolidate and maintain the effect of pelvic floor rehabilitation at home. The difficulty and intensity are gradually increased during the training process, and the rehabilitation effect is generally evaluated again after 3 months of training.

7. Biofeedback

You can also exercise the pelvic floor muscles through electrical stimulation of the pelvic floor muscles and biofeedback therapy. This requires the use of relevant equipment in a medical institution to strengthen the autonomous contraction of the muscles and improve the tension and strength of the pelvic floor muscles.

Although the unspeakable hidden dangers caused by these pelvic floor dysfunctions are not life-threatening like malignant cancer, they seriously affect our quality of life and sense of happiness! Therefore, after suffering from pelvic floor muscle dysfunction, you must remember to seek medical treatment in time and conduct active and effective rehabilitation training. You will find that after these unspeakable hidden dangers are resolved, life will be happier!

References

[1] Wang Yunfang, Zhao Fangqin, Li Zongqing, Wang Jingjing, Li Lingzhi, Li Fengyan, Zhang Aihong, Wu Wenxiu. New discussion on measures to prevent urinary retention after cervical cancer surgery [J]. Primary Medicine Forum, 2006(08):356-358.

[2] Cao Shulan, Sun Haiyan. Application of pelvic floor function exercise in urinary retention after cervical cancer surgery[J]. Chinese and Foreign Women's Health Research, 2018(09):87+89.

[3] Zhuo Jiahui, Xia Zhijun. Research progress on changes in pelvic floor function and rehabilitation treatment after radical hysterectomy for cervical cancer[J]. Journal of Clinical and Pathological Medicine, 2019, 39(11): 2538-2543.

[4]https://www.healthline.com/health/fitness-exercise/pelvic-floor-exercises

Note: There is no copyright issue for the pictures in this article

Author: Zhao Jiangxia, Guo Yisha, Wu Jichun, Bi Xia, Zhoupu Hospital, Shanghai University of Medicine and Health Sciences

About the Author

Bi Xia

Director of the Rehabilitation Medicine Department of Zhoupu Hospital Affiliated to Shanghai University of Medicine and Medical Sciences, and Vice President of the School of Rehabilitation of Shanghai University of Medicine and Medical Sciences. He was selected into the Excellent Discipline Leader and Leading Talent Training Program of the Pudong New Area Health System in 2010, 2018 and 2019. He has published 4 SCI papers and more than 30 core journal papers as the first author and corresponding author.

Professional fields: stroke rehabilitation, fracture postoperative rehabilitation, spinal cord injury rehabilitation, artificial joint perioperative rehabilitation, hand injury rehabilitation, etc.

Main academic positions:

Member of the Geriatric Rehabilitation Branch of the Chinese Rehabilitation Medicine Association

Member of the Medical and Nursing Integration Committee of the Chinese Rehabilitation Medicine Association

Rehabilitation Committee Member, Geriatric Rehabilitation Branch, Chinese Medical Doctor Association

Executive Director of Shanghai Rehabilitation Medicine Association

Member of the Physical Medicine and Rehabilitation Branch of the Shanghai Medical Association

Vice Chairman of the Rehabilitation Therapy Committee of Shanghai Rehabilitation Medicine Association

Member of the Orthopedic Rehabilitation Committee of Shanghai Rehabilitation Medicine Association

Member of the Spine and Spinal Cord Injury Rehabilitation Committee of Shanghai Rehabilitation Medicine Association

Member of the Community Rehabilitation Committee of Shanghai Rehabilitation Medicine Association

Member of the Sports Health Care and Rehabilitation Committee of Shanghai Rehabilitation Medicine Association

Chairman of the Rehabilitation and Physiotherapy Committee of the Shanghai Pudong New Area Medical Association and other academic positions

Wu Jichun

Therapist at the Department of Rehabilitation Medicine, Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, Master of Rehabilitation Therapy.

Expertise: fracture surgery rehabilitation, postpartum rehabilitation and sports rehabilitation.

Funded by Shanghai Science and Technology Commission's Science Popularization Project

(Project No.: 20DZ2311100)