The female pelvic floor is composed of multiple layers of muscles and fascia that seal the pelvic outlet. Pelvic floor tissue plays an important role in maintaining the normal position of pelvic organs such as the uterus, bladder, and rectum. Weakness of pelvic floor muscles and fascia tissue can lead to pelvic organ prolapse.
The most common causes of the disease include vaginal delivery injury, degenerative changes in pelvic floor tissue after menopause, and the presence of diseases with increased abdominal pressure, such as obesity, long-term constipation, chronic cough, etc. During childbirth, it can lead to the expansion of the soft birth canal and surrounding pelvic floor tissues, elongation or even tearing of muscle fibers, and damage to pelvic floor nerves. With the aging of the population, the level of estrogen decreases after menopause, and the support of pelvic floor muscle ligaments decreases, seriously affecting women's health and quality of life.
Mild patients generally do not experience any discomfort, while severe patients may consciously have vaginal lumps protruding, accompanied by varying degrees of lower back pain or falling sensation. Symptoms are obvious after standing for too long or being tired, and symptoms are relieved after bed rest. They may also have difficulty defecating and urinating. Long term friction between the exposed cervix or vaginal wall and clothing can lead to local ulcers, bleeding, and purulent discharge after secondary infection. Uterine prolapse rarely affects menstruation, and even does not affect conception, pregnancy, and childbirth. If the front vaginal wall bulges, there may be dysuria, such as urinary exhaustion, urinary retention, urinary incontinence, etc. Sometimes the front vaginal wall needs to be lifted upward to urinate. Vaginal posterior wall protrusion may be accompanied by difficulty in defecation, and sometimes it is necessary to push the protruding vaginal posterior wall with fingers to expel feces.
Pelvic organ prolapse often occurs in multiple locations simultaneously, such as uterine prolapse often accompanied by bulging of the anterior and posterior walls of the vagina, thickening and keratinization of the vaginal mucosa, and hypertrophy and elongation of the cervix. The anterior wall of the vagina bulges out in a spherical shape, the bulging bladder is soft, and the wrinkles on the vaginal mucosa disappear. When the posterior wall of the vagina bulges, it is often accompanied by old perineal lacerations, and the rectum protruding into the vagina can be palpated during digital rectal examination.
Pelvic organ prolapse caused by pelvic floor injury and functional degradation increasingly affects the health and quality of life of middle-aged and elderly women. Pelvic floor reconstruction surgery can repair female pelvic floor defects, reconstruct structures, and replace tissues, achieving the goal of restoring the anatomical position of organs. It is suitable for patients with pelvic floor organ prolapse (uterus, vagina, intestine, and bladder) who require surgical treatment.
Pelvic floor muscle exercise, also known as Kegel exercise, is the simplest, most feasible, safe, and effective pelvic floor rehabilitation method to date. It guides patients to autonomously and repeatedly contract the anus and yang tract, relaxing for 15-30 minutes after each contraction for 3 seconds. Two to three groups are performed daily for 4-6 weeks as one course of treatment, but it is important to be careful not to contract both abdominal and thigh muscles at the same time. The correct exercise method can strengthen weak pelvic floor muscle tissue, enhance pelvic floor support, improve and prevent further development of early prolapse. Pelvic floor function exercises can also be supplemented with biofeedback therapy or electrical stimulation to enhance the effectiveness of pelvic floor function exercises.
How can we better prevent pelvic floor organ prolapse in women? Pelvic floor organ prolapse is a common disease in female patients, which is mainly manifested by the presence of protruding objects at the vaginal opening, which may be the anterior or posterior wall of the vagina, or the uterine body. Therefore, this type of disease can be well prevented. Generally speaking, we believe that there are three main factors for this type of disease, one is pregnancy and childbirth; One is age, mainly due to insufficient hormones in the body after menopause; One is excessive weight, which compresses the pelvic floor muscles by pelvic organs. So, for these three points, we have different prevention methods. Firstly, we should shorten the delivery process as much as possible during pregnancy. Secondly, after delivery, we should have good pelvic floor rehabilitation and weight control. For some severe cough and constipation, we should actively treat them. For menopausal patients, we can also use some estrogen ointment locally, preferably locally. Before use, we should avoid some contraindications, such as ovarian tumors, breast tumors, etc.
What exercises cannot be performed for female pelvic floor organ prolapse? What should be paid attention to in daily life? The following exercises that increase pelvic floor load need to be reduced and avoided: running, jumping, skipping rope, boxing, squatting, sit ups, squatting horse steps, lifting heavy objects, high lifting/kicking exercises, high-intensity exercises/exercise courses that require running and jumping. Pelvic floor organ prolapse is a disease caused by the relaxation of pelvic floor muscles in women. Patients with this condition can be advised to avoid heavy physical activity and treat chronic cough, constipation, and other diseases. For severe patients, we recommend surgical treatment, which currently has a relatively ideal effect.