Postpartum pelvic floor rehabilitation issues you want to know, this article has!
tell everyone a little story first.
When I was young, every time my mom and I went shopping, she always went to the bathroom. Because of this incident, I quarreled with her several times, and finally refused to go shopping with her. After
grew up, I knew that my mother couldn't hold back the urine and her pelvic floor muscles were injured. The reason for the injury is that I gave birth.
Postpartum symptoms such as leakage of urine, inability to hold urine, and fecal incontinence have been plagued by many women, and even become difficult for them to talk about.
Why do these things happen after delivery? Is there any way to solve pelvic floor muscle injury? The "medical community" invited Professor Liu Xiaohua from Shanghai First Maternity and Infant Health Hospital to bring us a treasure trove of pelvic floor muscle injury rehabilitation!
Why does pelvic floor muscle injury occur?
The pelvic floor muscles are located at the bottom of the pelvis. It is like a suspended trampoline. It is composed of a group of muscles that close the pelvic floor and holds the pelvic organs such as the uterus, bladder, and rectum. The
pelvic floor muscles maintain the above-mentioned organs in their respective normal positions, ensuring the tightening of the vagina, and at the same time maintaining the normal functions of the urethra and rectal sphincter.
The risk factors for pelvic floor muscle injury are pregnancy and childbirth [1].
As the fetus enlarges during pregnancy, the uterus also increases rapidly. At the same time, changes in hormone levels cause the relaxation and damage of the pelvic floor muscles.
In addition, excessive pressure and stretching during childbirth can also cause pelvic floor muscle damage, especially elderly women, dystocia, polyhydramnios, giant babies and twins, will increase the risk of pelvic floor muscle damage [2 ].
Tips for self-testing pelvic floor muscle injury
Professor Liu Xiaohua pointed out that the clinical manifestations of pelvic floor muscle injury include urinary incontinence, vaginal relaxation, uterine prolapse, etc. . The more obvious manifestations of include urine leakage when coughing or sneezing at , and abnormal masses found when washing the vulva (indicating the possibility of vaginal bulging or uterine prolapse). In addition to these clinical symptoms, pelvic floor muscle injury brings many harms to women, such as vaginal relaxation, unsatisfactory sexual life, stress urinary incontinence, repeated vaginitis, and urinary tract infections. If
is not treated in time, it may also cause vaginal bulging and pelvic organ prolapse. And with age, organizational flexibility decreases, these problems may become more and more serious.
How do women self-check pelvic floor muscle damage? Professor Liu Xiaohua gave two tips for self-checking the pelvic floor muscles for damage.
The first method, , is to observe whether the urine flow line can be held when the urine is in a line. If it can be held, it indicates that the pelvic floor muscles have better contraction ability.
The second method, , is for women to stretch their fingers into the vagina and contract the pelvic floor muscles. If the fingers feel tight, it means that the pelvic floor muscles have better contraction ability.
Of course, the most reliable diagnostic method is to go to the hospital for a regular pelvic floor muscle examination, which generally includes pelvic floor muscle strength (pressure and tension testing), pelvic floor muscle activation (myopotential), muscle coordination, nerve conduction speed, The anatomical location of pelvic floor muscles and organs (ultrasound imaging), etc.
can judge the damage of the pelvic floor based on the test and evaluation results, and then formulate a rehabilitation plan. How to recover
pelvic floor muscles?
Professor Liu Xiaohua said that the best time to repair pelvic floor muscle injury is between 6 weeks postpartum and 6 months postpartum . During this period, pelvic floor muscle exercises can get a greater degree of recovery.
Some women worry about whether it is too late to exercise their pelvic floor muscles 20 years after delivery.
Professor Liu Xiaohua said: " pelvic floor muscle exercise can be a lifelong thing. Maybe the effect of pelvic floor muscle exercise at the age of 50 is not as good as that at the age of 30, but it is beneficial to women. This It is the same as insisting on muscle exercises in other parts. "
pelvic floor muscle rehabilitation mainly has the following three methods:
one: Kegel exercise
Kegel exercise is mainly repeated contraction to relax the pelvic floor muscles, Is a non-surgical treatment to promote the recovery of pelvic floor function [3].
You can sit or lie down, contract the pelvic floor muscles for 5 seconds (5 seconds), relax for 10 seconds (10 seconds), and repeat the above actions 10 times.
is that simple!
Image source: Xiaohongshu
But there are four points to note:
1, first find the pelvic floor muscles, you can use the previous method of self-checking the pelvic floor muscles to find the pelvic floor muscles.
2, empty the bladder before performing Kegel exercises.
3. Only focus on the pelvic floor muscles during exercise.
4. Ensure that the buttocks and abdominal muscles are completely relaxed.
2: Biofeedback
Pelvic floor biofeedback is the use of professional equipment to collect the EMG signals of the pelvic floor muscles, and at the same time, these signals are fed back to the patient in the form of visual and auditory (such as animation, music, games, etc.) to guide the patient to enhance And control the autonomy of pelvic floor muscles, promote pelvic floor blood circulation and tissue metabolism, promote intestinal peristalsis, increase pelvic floor muscle strength and endurance, eliminate inflammation, relieve cramps and pain, and restore pelvic floor muscles to control urine and normal defecation .
three: electrical stimulation
pelvic floor muscle electrical stimulation is to emit low-frequency currents through electrical conductors to stimulate the pelvic floor muscles to achieve the therapeutic effect. Pelvic floor muscle electrical stimulation mainly has the effects of awakening proprioceptors, promoting passive muscle exercise, inhibiting bladder detrusor contraction, labor pain, and promoting local blood circulation.
Professor Liu Xiaohua introduced that the current Shanghai First Maternity and Infant Health Hospital mainly focuses on electrical stimulation.
I don’t know how many women think that urine leakage and vaginal looseness after childbirth cannot be treated. Just like mothers and grandma’s generations, they may still have urine leakage by the age of 60, but they dare not say it, either. Will not choose regular treatment.
As Professor Liu Xiaohua said, pelvic floor muscle exercise is a lifetime thing, as long as you start to do it, it is beneficial to women!
What questions do you have about pelvic floor rehabilitation?
Quickly ask questions in the message area~
References:
[1] Kari B, Hilde G, Str-Jensen J, et al. Postpartum pelvic floor muscle training and pelvic organ prolapse—a randomized trial of primiparous women[J]. American Journal of Obstetrics & Gynecology, 2015, 212(1).
[2] Du Yafei, Chen Ran, Liu Jing, etc. Pelvic floor dysfunction and its influencing factors in postpartum women[J]. Laboratory Medicine and Clinics, 2018, 15 (3): 289-292.
[3] Gu Haifeng, Li Yongxue. The effect of autonomous Kegel exercise on bladder function after cervical cancer surgery[J].Massage and Rehabilitation Medicine,2016,7(23):22,24.
expert profile
Liu Xiaohua, Medical PhD. Chief Physician of Obstetrics and Gynecology Department, Director of Obstetrics Department of Shanghai First Maternity and Infant Health Hospital (direction of placental diseases). Ambassador of the American Maternal and Fetal Medicine (SMFM) China.
has been engaged in clinical work in obstetrics and gynecology for 23 years. Clinical subspecialty and research direction: placental disease and fetal heart rate monitoring during delivery. In AJOG (American Journal of Obstetrics and Gynecology), BJOG (British Journal of Obstetrics and Gynecology) and other important journals in obstetrics and gynecology, a total of 18 SCI papers have been published, Lancet published one comment, and 6 domestic core journals. He is currently a reviewer for many domestic and international magazines such as Lancet and BMJ.
This article first appeared: the medical profession of obstetrics and gynecology channel
author: Prawn
Editor: Tang Ying
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