Reeducation of the pelvic floor muscles/perineum
The perineum, also called pelvic floor muscles, consists of a set of ligaments and muscular structures located at the bottom of the basin, between the pubic bone, the sacrum and coccyx. As the name suggests is like the floor of the basin/pelvis.
The pelvic floor muscles have the function of support the pelvic organs – uterus, bladder and rectum – and assist in the maintenance of continence since they have the function to close the urethra (the urine leading to the exterior), vagina and anus. The perineum is also the structure responsible for the blood supply to the genitalsand is therefore entirely related to male and female sexual satisfaction.
Urinary incontinence fecal incontinence stoma prolapse (falling organs), constipation postural changes pelvic pain or sexual dysfunction are some problems whose origin is due to anatomical changes and the weakening of the pelvic muscles perineum.
There are several risk factors that can lead to the of these muscles such as age, some types of medication, being overweight, physical inactivity chronic cough, the practice of high-impact sports athletes), pregnancy the number of pregnancies and type of birth, menopause women only), prostate cancer surgery ( for men), and changes in the position of the bladder (both men and women). Other causes are diseases of the nervous system which can compromise the mechanism that conducts signals between the bladder and the brain: stroke, diabetes Parkinson’s disease, bladder tumors, among others.
The disorder most common in childhood is nocturnal enuresis, which is characterized by inadequate control of urination and urine leakage at least twice a month especially at night is more common among boys.
Strengthening the pelvic floor muscles is one of the most recommended to accelerate the recovery of continence and it is achieved through physical therapy.
The treatments consist in increasing body perception and awareness pelvic floor muscles by teaching the patient on their condition, changes in behavior and lifestyle, and by conducting a work force of these muscles. Thus, the rehabilitation works in the promotion, prevention, treatment and recovery, enhancing the function of the pelvic floor and controlling the bladder function, which may prevent, or delay, surgical intervention. It also operates globally,_ involving posture, breathing and body awareness.
The treatment is performed by a physical therapist specialized in the field.
These treatments are suitable for all kinds of women at any age and/or time in their lives, since pregnancy (pre-and post-delivery) to the menopause, or women who engage in situations of high impact sportsand men who have been undergoing protatectomias.
It is also very important the rehabilitation after any pelvic surgery, either in male or female. This includes the genital reconstruction or other cosmetic surgery at this level.