Early Intervention In The Treatment Of Female Pelvic Floor Dysfunction

Female pelvic floor dysfunction disease(FPFD)is a pelvic floor defect or tissue relaxation,such as degradation or injury factors,resulting in weak pelvic floor support organization caused by the location and function of pelvic floor organs abnormal,serious impact on normal life.Its main manifestations include stool incontinence,urinary incontinence,abnormal sexual function,pelvic organ prolapse and chronic pelvic pain.It is reported that the incidence rate is 40% or so.The high risk factors are increased estrogen,pregnancy and childbirth,pelvic surgery history and gene susceptibility,such as increased female hormones with age,increasing pelvic floor load,constipation and chronic cough.And the most important of these is the inevitable pregnancy and childbirth of most women,timely detection of postpartum pelvic floor dysfunction disease and on-time treatment is very necessary.However,there is no study to determine the best time for the start of postpartum pelvic floor rehabilitation.Countries such as Europe and the United States tend to carry out rehabilitation treatment 2-3 months after childbirth,and China believes that the sooner rehabilitation treatment is better,the conclusion is not uniform.Objective: To compare the effect of pelvic floor rehabilitation therapy at different times after 0-5 years in order to find the best time for rehabilitation treatment of postpartum pelvic floor dysfunction,and to provide theoretical basis for the delayed and preventive clinical treatment of postpartum pelvic floor dysfunction disease..Methods: 150 patients with urinary incontinence(UI),vaginal wall bulging and uterine prolapse were selected in the gynecological outpatient clinic in our hospital from 0 to 5 years after delivery.The patients were divided into 3 groups according to the time after delivery,within 1 year after delivery,within 1-3 years after delivery,and within 3-5 years after delivery,50 people in each group.The patient was given electrical stimulation and biological feedback treatment,at a frequency of 50-80 Hz,a current of 0-50 mA,a pulse width of 200-300 μs,twice a week for a total of 10-15 treatments.Follow-up observations compared the incidence of UI and uterine prolapse in different groups after treatment and after half a year of treatment,the maximum contraction of the type II muscle of the pelvic floor muscle,the mean value of the contraction of the class I muscle and the variability.Results: 1.Comparison of postpartum basic data in three groups before treatment showed an increase in the incidence of stress urinary incontinence after 3-5 years of postpartum than the other two groups(P <0.05);There are no differences between the other two groups;The incidence of pelvic floor viscera prolapse in the postpartum < 1 years was lower than the other two groups,(P<0.05),There are no differences between the other two groups 2.After treating a course of treatment,the incidence of stress urinary incontinence increased significantly in the postpartum 3-5 years than the other two groups,(P <0.05).There are no differences between the other two groups There was no significant difference in the incidence of pelvic floor viscera prolapse in the three groups.3.Compared with three groups in June after treatment,the incidence of stress urinary incontinence in the postpartum 3-5 years was significantly higher.(P< 0.05).There was no difference in the other two groups,and the incidence of pelvic floor viscera prolapse in the postpartum < 1 group was significantly reduced than the other two groups.(P<0.05),The incidence of uterine prolapse in the postpartum 3-5-year group increased significantly(P<0.05).4.With the increase of postpartum time,the maximum value of pelvic floor Ⅱ muscle and the average of class I muscle showed a decreasing trend,and the variability of class I muscle increased significantly.After treatment,the systolic pressure increased obviously,the variability decreased.And the maintenance effect of 6 months after treatment is the best group of postpartum < 1 years.Conclusion: Early Intervention 1 years postpartum can effectively reduce the incidence of stress urinary incontinence and uterine prolapse,and effectively improve the maximum value of pelvic floor ⅱ muscle,improve the average of class I muscle,reduce the variability of class I muscle.Early postpartum intervention in pelvic floor dysfunction can last at least 6 months.It is the best time to treat pelvic floor dysfunction disease within 1 years after delivery.