In recent years, the incidence of pelvic floor dysfunction diseases has been increasing year by year, but the general public has insufficient awareness of pelvic floor diseases and self-care awareness, low willingness to seek medical treatment and treatment, and poor compliance with treatment.
This issue specially invites Zheng Fang, director and chief physician of Dianjiang County Pelvic Floor Diagnosis and Treatment Center, to explain the relevant knowledge of pelvic floor dysfunction diseases to everyone, so that everyone can pay attention to and care for pelvic floor problems, actively take measures, provide timely treatment, and reduce the risk of pelvic floor dysfunction. The occurrence of pelvic floor dysfunction diseases and improve the quality of life.
Expert Introduction》》》
Zheng Fang, chief physician, director of Dianjiang County Pelvic Floor Diagnosis and Treatment Center, and director of Anorectal Department. Academic and technical leader in Chongqing, deputy director of the Anorectal Committee of the Chongqing Society of Traditional Chinese Medicine, member of the Pelvic Floor Medicine Society of the World Federation of Traditional Chinese Medicine, director of the sixth council of the Anorectal Branch of the Chinese Society of Traditional Chinese Medicine, and director of the Anorectal Branch of the Chinese Medical Association. Director of the special committee and executive director of the China Constipation Association. Specializes in the diagnosis and treatment of benign colorectal and anal diseases and pelvic floor dysfunction.
Reporter: What is pelvic floor dysfunction? What are the performances?
Zheng Fang: Pelvic floor dysfunction is a pelvic floor defect or pelvic floor supporting tissue relaxation and weakness caused by various causes, which in turn causes the displacement of pelvic organs, causing the position and function of other pelvic organs to be abnormal. The clinical manifestations include pelvic organ prolapse, urinary incontinence, defecation disorders, and fecal incontinence , lower urinary tract sensory disorders, chronic pelvic pain, sexual dysfunction and other diseases of a series of pelvic floor injuries and defects, which are interrelated and often occur together.
Reporter: What are the injuries caused by pelvic floor defects or injuries?
Zheng Fang: mainly has the following aspects:
① Pelvic floor: urinary incontinence, fecal incontinence, and constipation.
② Reproductive and urinary system: abnormal sensation of bladder and urethra .
③Reproductive system: pelvic organ prolapse.
④Gastrointestinal system: colorectal dysfunction.
⑤ Musculoskeletal system: sexual dysfunction.
⑥ nervous system : Pelvic floor pain syndrome.
Reporter: What are the factors that cause pelvic floor dysfunction?
Zheng Fang: The causes of pelvic floor dysfunction are complex and often the result of multiple factors, including pregnancy, vaginal delivery, postmenopausal estrogen reduction, malnutrition, congenital dysplasia of pelvic floor tissue, obesity, smoking, drinking, Chronic cough, heavy physical labor, genetic connective tissue diseases, etc. can all cause it. Among them, pregnancy, childbirth and pelvic floor surgery are important independent risk factors.
performs pelvic floor surgery for patients
Reporter: Who are the groups at high risk of pelvic floor dysfunction?
Zheng Fang: Pelvic floor dysfunction is common in middle-aged and elderly women and women in their childbearing period. Its incidence rate is as high as 20%-40%, and it increases with age.
An epidemiological survey shows that among married women in my country, 45% of women over the age of 30 have varying degrees of pelvic floor dysfunction and low sexual life quality; 50% of women over the age of 40 have varying degrees of urinary incontinence, pelvic floor dysfunction, and urinary incontinence. Organ prolapse , etc. 60% of stress urinary incontinence patients are complicated by varying degrees of pelvic organ prolapse; 50% of pelvic organ prolapse patients are complicated by stress urinary incontinence, etc. Among patients with fecal incontinence, 24%-53% have urinary incontinence, and 7%-22% have genital prolapse. Constipation is often accompanied by urination difficulties.
Reporter: How to detect pelvic floor dysfunction disease early?
Zheng Fang: The clinical manifestations of pelvic floor dysfunction are diverse and complex. Therefore, it is necessary to combine clinical examination and symptom questionnaires to comprehensively evaluate the severity of symptoms and their impact on the patient's life and health, and to determine the treatment plan. The determination is related to the patient's subjective feeling and objective performance.
Among them, clinical examination methods include: ① vaginal examination to determine the degree and type of prolapse; ② pelvic floor muscle function assessment; ③ pelvic floor three-dimensional ultrasound; ④ pelvic magnetic resonance; ⑤ urodynamic examination; ⑥ recto-anal pressure measurement; ⑦ Colonic transit experiment; ⑧ defecography; ⑨ balloon extrusion experiment.
Reporter: How to prevent pelvic floor dysfunction?
Zheng Fang: Balanced diet, weight control, sugar restriction, smoking cessation, no coffee drinking, correct posture, regular protective training; avoid or reduce abdominal pressure activities that increase such as weight-bearing, squatting, and heavy physical labor; Maintain a regular daily life to ensure smooth discharge of urine and feces; treat constipation, cough and other chronic diseases with increased abdominal pressure; train bladder function and improve the ability to control urine independently.
Reporter: How to treat pelvic floor dysfunction?
Zheng Fang: Prevention and early treatment of pelvic floor dysfunction are more important. Based on the overall theory of the pelvic floor, pelvic floor electrophysiology and pelvic and abdominal dynamics are used as the basis for diagnosis, and individualized joint treatment plans are formulated based on the type, degree, location, age, health status and sexual life of pelvic floor dysfunction. . Including lifestyle intervention, behavioral therapy, pelvic floor muscle training, biofeedback and electromagnetic stimulation, acupuncture , traditional Chinese medicine, psychotherapy, sacral neuromodulation, pelvic floor reconstruction, stem cell injection treatment, etc.
Non-surgical treatment is the first-line treatment for pelvic floor dysfunction. It activates the pelvic floor neuromuscles, increases the strength and elasticity of the pelvic floor muscles, restores function, relieves symptoms, and improves the quality of life. This treatment method is mainly suitable for patients with mild or moderate pelvic floor dysfunction or patients who cannot tolerate surgery or are unwilling to undergo surgical treatment, as well as auxiliary treatment before and after surgery for severe patients.
For patients with severe pelvic floor dysfunction who are ineffective or relapsed through non-surgical treatment, surgical treatment should be used to significantly relieve symptoms and improve quality of life. (Text/Li Ling Zheng Fang; Photo/Dianjiang County People’s Hospital)
