By Diego Riva, Gianfranco Minini
This publication bargains an updated evaluate of childbirth-related pelvic flooring disorder overlaying prevention, prognosis, and administration. It encompasses all suitable stipulations, with specific specialize in genital prolapse, urinary incontinence, and fecal incontinence. threat elements for pelvic flooring harm regarding childbirth are pointed out, and a 3D simulation of supply is gifted. The position of assorted diagnostic instruments, together with pelvic flooring ultrasonography and magnetic resonance imaging and anal sphincter electromyography, is obviously defined. the significance of physiotherapy in fighting destiny changes is defined, and the indicators for surgical procedure, that's reserved for extra critical events, are mentioned. The publication highlights the necessity for a multidisciplinary strategy concerning obstetricians, gynecologists, urologists, midwives, radiologists, physiotherapists, muscle laboratory engineers, and laptop technicians.
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Extra info for Childbirth-Related Pelvic Floor Dysfunction: Risk Factors, Prevention, Evaluation, and Treatment
E7. 006. Epub 2012 Dec 5 8. Fielding JR, Dumanli H, Schreyer AG et al (2000) MR-based three-dimensional modeling of the normal female pelvic floor in women: quantification of muscle mass. AJR Am J Roentgenol 174:657–660 9. Gilpin SA, Gosling JA, Smith AR, Warrell DW (1989) The pathogenesis of genitourinary prolapse and stress urinary incontinence of urine: a histological and histochemical study. Br J Obstet Gynaecol 96:15–23 10. Sebe P, Fritsch H, Oswald J, Schwentner C, Lunacek A, Bartsch G, Radmayr C (2005) Fetal development of the female external urinary sphincter complex: an anatomical and histological study.
A. Baudino 29. South MM, Stinnett SS, Sanders DB, Weidner AC (2009) Levator ani denervation and reinnervation 6 months after childbirth. e7 30. Weidner AC, Jamison MG, Branham V, South MM, Borawski KM, Romero AA (2006) Neuropathic injury to the levator ani occurs in 1 in 4 primiparous women. Am J Obstet Gynecol 195:1851–1856 31. Weidner AC, Sanders DB, Nandedkar SD, Bump RC (2000) Quantitative electromyographic analysis of levator ani and external anal sphincter muscles of nulliparous women. Am J Obstet Gynecol 183:1249–1256 32.
The exact mechanism of injury associating vaginal delivery with pelvic floor disorders is not known, but is likely multifactorial, potentially including mechanical and neurovascular injury to the pelvic floor [1, 2]. Operative vaginal delivery significantly increases the risk of PFDs. The evaluation and diagnosis of pelvic floor disorders, critical precursors of treatment, are feasible without specialized equipment. A specific history, voiding diary, focused physical exam and simple office tests provide sufficient data to diagnose most complaints.
Childbirth-Related Pelvic Floor Dysfunction: Risk Factors, Prevention, Evaluation, and Treatment by Diego Riva, Gianfranco Minini