The disease usually affects Pelvic Floor, mostly, women. Usually it occurs with urinary incontinence or pelvic organ prolapse and other associated disorders. The main treatment is always recommended muscle pelvic floor rehabilitation, followed by surgical treatment or CO2 laser therapies.
What is known as Pelvic Floor disease?
The disease affects Pelvic Floor a preferably, though not exclusive, women. It occurs mainly in the form of urinary incontinence or lift (prolapse) of pelvic organs (uterus, bladder, rectum, vagina). You can also generate other associated disorders, as problems during urination (urgency, frequency, nocturia), constipation, pain or discomfort during sexual intercourse and recurrent urinary tract infections.The average estimated prevalence ranges between 20 to 30%, in general terms, with an elevation of up to 30 to 40% in middle-aged and up to 50% in the elderly.
What organs and muscles affected?
The pelvic floor is a group of muscles and ligaments that close the abdominal cavity at the bottom. Its function is to hold the pelvic organs (bladder, uterus and vagina and rectum) in proper anatomic position. The levator ani and a sheet of connective tissue, Endopelvic fascia, muscle are primarily responsible for this support function. Pelvic Floor disease occurs therefore a weakness of these two structures, which makes this feature lose support.
Causes of Disease Pelvic Floor
The main causes of the weakening of the pelvic floor are:- Pregnancy and vaginal delivery- Chronic cough- Chronic constipation- Certain types of sports or work activities associated with repetitive abdominal efforts and maintained over time
Disease Symptoms Pelvic Floor
Some symptoms of disease Pelvic Floor can be:
- Feeling that you need to go to defecate several times over a short period of time- Feeling that you can not finish defecating- Constipation or pains to make the effort to defecate- A frequent need to urinate- Painful urination- Pain in the lower back that can not be explained by other causes- Continued pain in the pelvic area, genitals or rectum- Pain during sex- Escapes involuntary urine or stool- Feeling of "lump" in the genitals
Diagnosis of Disease Pelvic Floor
To carry out the diagnosis of disease Pelvic Floor, you can perform various examinations by the expert in Gynecology and Obstetrics :- Detailed medical history. In the general and gynecological history of the patient should be specifically mentioned the problems of urinary incontinence. Feelings of shame associated with this condition cause that often the problem is not mentioned by the patient.- Voiding Diary to verify the impact of the problem on the quality of life of the patient. For this specific questionnaires as the ICIQ-SF they are used.- Physical examination with basic neurological examination (perineal sensitivity and reflexes).- Stress test like cough partially filled bladder to expose urinary incontinence. It is also very useful to have in consultation biofeedback devices that allow easily assess the strength and muscle tone in the pelvic floor.- Other diagnostic tests: urinalysis and study of post void residual.- Special tests, such as urodynamics, which allows to distinguish the type of urinary incontinence (stress or urgency) and establish the degree of severity. Pad test, which allows us to quantify the volume of urine loss.
Types of Treatment for Disease Pelvic Floor
- Rehabilitation of the pelvic floor muscle: It is the active contraction of the pelvic floor muscles on a regular basis, which can be done with or without the aid of biofeedback systems. form may be employed as techniques associated electrostimulation. Once the patient has learned to do the exercises, you must maintain a work discipline to maintain the effectiveness of treatment.- Surgical Treatment: The first step of treatment is rehabilitation. In cases where this is not enough to offset the symptoms, you can use different surgical techniques aimed at correcting the urethral hypermobility and increase the support of the urethra. In cases of genital prolapse it may even be necessary removal of the uterus.- Laser Co2: Recently are being used laser therapies for vaginal rejuvenation and correction of mild prolapses. The laser produces a controlled and precise in the vaginal mucosa thermal effect, causing contraction and tissue retensioning. The laser energy deposited along the vaginal wall without damaging heats the tissue, stimulating the formation of new collagen in the endopelvic fascia.