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1.
Rev. colomb. cir ; 37(2): 308-311, 20220316. fig
Article in Spanish | LILACS | ID: biblio-1362980

ABSTRACT

Las hernias perineales presentan una incidencia variable entre el 0,3-6 %. El abordaje quirúrgico se puede realizar por vía perineal o por vía laparoscópica. Se presentan las imágenes de una paciente con una hernia perineal adquirida primaria, tratada exitosamente mediante un abordaje mixto.


Perineal hernias present a variable incidence between 0.3-6%. The surgical approach can be performed perineally or laparoscopically. Images of a patient with a primary acquired perineal hernia, successfully treated using a mixed approach, are presented.


Subject(s)
Humans , Pelvic Floor , Hernia, Abdominal , Laparoscopy , Hernia
2.
Int. braz. j. urol ; 47(6): 1150-1159, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1340025

ABSTRACT

ABSTRACT Purpose: To evaluate the efficacy of intravaginal electrical stimulation (IVES) added to bladder training (BT) on incontinence-related quality of life (QoL) and clinical parameters in women with idiopathic overactive bladder (OAB). Materials and Methods: Sixty-two women with idiopathic OAB were randomized into two groups using the random numbers generator as follows: Group 1 received BT alone (n:31), and Group 2 received BT+IVES (n:31). IVES was performed for twenty minutes three days a week over a course of eight weeks for a total of 24 sessions. Patients were evaluated in terms of incontinence severity (24-hour pad test), pelvic floor muscles strength (perineometer), 3-day voiding diary (frequency of voiding, nocturia, incontinence episodes and number of pads), symptom severity (OAB-V8), incontinence-related QoL (IIQ-7), treatment success (positive response rate), cure/improvement rate and treatment satisfaction (Likert scale). Results: A statistically significant improvement was found in all parameters for all groups at the end of the treatment compared to the baseline values except pelvic floor muscles strength in Group 1 (p <0.05). At the end of treatment, incontinence severity, frequency of voiding, nocturia, incontinence episodes, number of pads, symptom severity, and QoL were significantly improved in Group 2 compared to Group 1 (p <0.05). Treatment satisfaction, cure/improvement, and positive response rates were significantly higher in group 2 compared to Group 1 (p <0.05). Conclusion: We conclude that BT+IVES were more effective than BT alone on both incontinence-related QoL and clinical parameters in women with idiopathic OAB.


Subject(s)
Humans , Female , Urinary Bladder, Overactive/therapy , Quality of Life , Prospective Studies , Surveys and Questionnaires , Pelvic Floor , Electric Stimulation
3.
Fisioter. Bras ; 22(5): 697-711, Nov 11, 2021.
Article in Portuguese | LILACS | ID: biblio-1353485

ABSTRACT

Prolapso de órgão pélvico (POP) consiste no deslizamento de órgãos pélvicos femininos através do introito vaginal, por falhas no sistema de suporte. Acredita-se que a etnia esteja diretamente associada ao aparecimento do POP. Objetivo: Revisar estudos publicados nos últimos 5 anos para verificar a relação entre etnia e a incidência de prolapso de órgãos pélvicos em mulheres de diversas raças. Métodos: Revisão integrativa de literatura efetuada através de uma busca em artigos científicos publicados em revistas impressas e eletrônicas no período compreendido entre os anos de 2015 e março de 2020, nas bases PubMed, Bireme e PEDro. Resultados: Foram incluídos 4 estudos segundo os critérios de elegibilidade. Foram identificados estudos sobre diferenças étnicas em POP ou períneo descendente. A população estudada foi de mulheres afrodescendentes, caucasianas e asiáticas. Na avaliação metodológica, apenas um estudo foi considerado moderado, enquanto os demais foram considerados fortes. Conclusão: A análise dos dados foi capaz de demonstrar diferenças em sintomas, nos perfis genético, metabólico e de composição das fibras musculares. Observou-se que mulheres afrodescendentes apresentam maior índice de prolapsos de parede anterior, as caucasianas de parede posterior e asiáticas apresentaram maior descida uterina e prolapsos de cúpula vaginal.


Subject(s)
Ethnic Groups , Pelvic Organ Prolapse , Women , Pelvic Floor
4.
Rev. habanera cienc. méd ; 20(5): e3857, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1352085

ABSTRACT

Introducción: La manometría anorrectal de alta resolución ha permitido una mayor comprensión de la fisiopatología del daño motor y sensorial, que suelen tener los pacientes con disfunción del suelo pélvico. Objetivo: Ofrecer los resultados de la introducción de la técnica en Cuba, en un primer grupo de pacientes, la caracterización del mismo, los valores obtenidos para los parámetros de estudio y los diagnósticos más frecuentes. Material y Métodos: Se revisaron los registros de manometría anorrectal de alta resolución, realizados en el Laboratorio de Motilidad del CNCMA, entre septiembre de 2017 y junio de 2019. Se analiza el registro de los datos generales de los pacientes y los parámetros específicos de alta resolución. Se estudiaron 159 pacientes que constituyeron el universo de estudio, la mayoría fueron pacientes por encima de los 60 años. Se aplica la Clasificación de Londres para el diagnóstico del tipo de disfunción anorrectal resultante. Resultados: Predominio de sexo femenino. La indicación más frecuente para la prueba fue la incontinencia fecal, seguida en menor medida por el estreñimiento. En las mujeres fue frecuente el antecedente obstétrico o de intervención quirúrgica relacionada. La disinergia defecatoria más frecuente fue el tipo III. El diagnóstico de disfunción anorrectal más frecuente fueron los desórdenes del tono anal y la contractilidad. Conclusiones: La introducción de la técnica fue exitosa. Se introdujeron en Cuba los estudios de manometría anorrectal de alta resolución, lo que permitió mayor conocimiento del daño establecido en los pacientes a quienes se les realiza la prueba, siendo la IF la disfunción que resultó más frecuente en el estudio. Se obtuvieron por primera vez parámetros específicos de alta resolución en pacientes cubanos, lo que permitirá estandarizar la técnica a otros servicios y tendrá como consecuencia mayor calidad en el diagnóstico de estos pacientes(AU)


Introduction: High-resolution anorectal manometry has allowed a better understanding of the pathophysiology of motor and sensory damage in patients with pelvic floor dysfunction. Objective: To offer the outcomes of the introduction of the technique applied in a first group of patients in Cuba, as well as its characterization, the values obtained for the study parameters and the most frequent diagnoses. Material and Methods: The high-resolution anorectal manometry records, which were performed at the CNCMA Motility Laboratory between September 2017 and June 2019, were reviewed. The record of the patients´ general data and specific discharge parameters were analyzed. The London Classification was applied for the diagnosis of the resulting type of anorectal dysfunction. Results: A total of 159 patients were studied. There was a predominance of females over 60 years of age. The most common indication for the test was fecal incontinence, followed by constipation. Obstetric history or history of surgical intervention were frequent in women. Type III dyssynergia was the most frequent type of dyssynergic defection. The most frequent diagnoses of anorectal dysfunction were disorders of anal tone and contractility. Conclusions: The introduction of the technique was successful. It allowed the identification of the damaged structures, which led to a faster and more timely therapeutic decision-making for the patient. The London Classification was used in the diagnosis of dysfunction(AU)


Subject(s)
Humans , Male , Female , Surgical Procedures, Operative , Pelvic Floor , Fecal Incontinence , Reference Parameters
5.
Arq. gastroenterol ; 58(3): 302-307, July-Sept. 2021. tab
Article in English | LILACS | ID: biblio-1345301

ABSTRACT

ABSTRACT BACKGROUND: Few studies have investigated the constipation or obstructed defecation symptoms identified by using imaging, as dynamic three-dimensional ultrasound and correlate vaginal delivery, parity, and age. OBJECTIVE: The aim of this study was to assess the prevalence of pelvic floor dysfunctions in female patients with obstructed defection symptoms and to determine whether specific pelvic floor dysfunctions identified by dynamic three-dimensional ultrasonography (echodefecography) are correlated with vaginal delivery, parity, and age. The secondary goal is to report the prevalence of coexisting pelvic floor dysfunctions. METHODS: This is a retrospective cohort study including patients with obstructed defecation symptoms underwent echodefecographyto evaluate pelvic floor dysfunctions in the posterior compartment and correlate with vaginal delivery, parity, and age. RESULTS: Of 889 female: 552 (62%) had had vaginal delivery and 337 (38%) were nulliparous. The prevalence of dysfunctions identified by echodefecography (rectocele, intussusception, enterocele/sigmoidocele, and dyssynergia) was similar between the two groups and was not associated with number of deliveriesor age. However, the prevalence of sphincter defects showed higher rates in women with vaginal delivery and increased with the parity. Up to 33% of patients had coexisting dysfunctions. CONCLUSION: The prevalence of dysfunctions such as rectocele, intussusception, dyssynergia, and enterocele/sigmoidocele assessed by echodefecography in patients with obstructed defecation symptoms are found similar regardless of vaginal delivery, number of deliveries or stratified-age. In vaginal delivery, number of deliveries does impact on detection of sphincter defects and liability to fecal incontinence.


RESUMO CONTEXTO: Poucos estudos investigaram pacientes portadoras de defecação obstruída identificados por exames de imagens, como ultrassonografia tridimensional dinâmica, correlacionando parto vaginal, paridade e idade. OBJETIVO: O objetivo deste estudo foi avaliar a prevalência de disfunções do assoalho pélvico em pacientes do sexo feminino com sintomas de defecação obstruída e determinar se disfunções específicas do assoalho pélvico identificadas por ultrassonografia tridimensional dinâmica (ecodefecografia) estão correlacionadas com parto vaginal, paridade e idade. O objetivo secundário é relatar a prevalência de disfunções do assoalho pélvico coexistentes. MÉTODOS: Este é um estudo de coorte retrospectivo incluindo pacientes com sintomas de obstrução da defecação submetidas à ecodefecografia para avaliar disfunções do assoalho pélvico no compartimento posterior e correlacionar com parto vaginal, paridade e idade. RESULTADOS: De 889 mulheres: 552 (62%) tiveram parto vaginal e 337 (38%) eram nulíparas. A prevalência de disfunções identificadas pela ecodefecografia (retocele, intussuscepção, enterocele/sigmoidocele e dissinergia) foi semelhante entre os dois grupos e não foi associada ao número de partos ou à idade. No entanto, a prevalência de defeitos esfincterianos apresentou taxas mais elevadas em mulheres com parto vaginal e aumentou com a paridade. Até 33% dos pacientes apresentavam disfunções coexistentes. CONCLUSÃO: A prevalência de disfunções como retocele, intussuscepção, dissinergia e enterocele/sigmoidocele avaliada pela ecodefecografia em pacientes com sintomas de defecação obstruída são semelhantes independentemente do parto normal, número de partos ou idade estratificada. No parto vaginal, o número de partos tem impacto na detecção de defeitos esfincterianos e na possibilidade de incontinência fecal.


Subject(s)
Humans , Female , Pregnancy , Pelvic Floor/diagnostic imaging , Defecation , Parity , Retrospective Studies , Ultrasonography , Constipation , Constipation/etiology , Constipation/epidemiology , Delivery, Obstetric
6.
Rev. colomb. cir ; 36(4): 732-737, 20210000. fig
Article in Spanish | LILACS | ID: biblio-1291284

ABSTRACT

Introducción. El enterocele es causado por un defecto herniario del piso pélvico, siendo el más común la hernia interrecto-vaginal. Se produce por un debilitamiento del piso pélvico, por diversos factores, entre ellos, las cirugías en la región pélvica, el estreñimiento crónico o las patologías que aumentan la presión intraabdominal, el antecedente de prolapso rectal o vaginal, y también, factores congénitos. Presentación de caso. Paciente femenina de 84 años de edad, con antecedentes de un parto eutócico y múltiples procedimientos quirúrgicos, entre ellos histerectomía hace 40 años y rectosigmoidectomía por enfermedad diverticular complicada hace 6 años, quien cuatro meses antes presenta constipación crónica, que empeora en los días previos a su ingreso, con dolor perineal intenso y salida de asas intestinales a nivel de la región perineal, que la obliga a consultar a Urgencias. Al encontrarse con asas intestinales expuestas, con cambios de coloración, es intervenida quirúrgicamente con resultado satisfactorio, postquirúrgico inmediato optimo y seguimiento por consulta externa por 3 meses sin evidencia de recidiva. Discusión. La hernia interrecto-vaginal tiene una incidencia baja y una presentación clínica variada. El único tratamiento es quirúrgico


Introduction. The enterocele is produced by an hernia defect of the pelvic floor, being the most common the interrecto-vaginal hernia. It is produced by weakness of the pelvic floor for multiples factors, among them surgeries of the pelvic region, chronic constipation or pathologies that increase intra-abdominal pressure, a history of rectal or vaginal prolapse, and congenital factors. Case report. A 84-year-old female patient, with a history of eutocic delivery and multiple surgical procedures, including hysterectomy 40 years ago and rectosigmoidectomy for complicated diverticular disease 6 years ago, presented four months earlier with chronic constipation, which worsens in the days before her admission, with intense perineal pain and exit of intestinal loops at the level of the perineal region, which forced her to consult the emergency room. At examination the intestinal loops were found exposed, with color changes, she underwent surgery with satisfactory results, optimal immediate postoperative and outpatient follow-up for 3 months with no evidence of recurrence. Discussion. Interrecto-vaginal hernia has a low incidence and a varied clinical presentation. The only treatment is surgery


Subject(s)
Humans , Perineum , Douglas' Pouch , Hernia , Pelvic Floor , Intestine, Small
7.
Rev. bras. ginecol. obstet ; 43(7): 535-544, July 2021. tab, graf
Article in English | LILACS | ID: biblio-1347254

ABSTRACT

Abstract Objective To investigate the feasibility of pelvic floor muscle training (PFMT) through gametherapy for relieving urinary symptoms of climacteric women with stress ormixed urinary incontinence (UI). Methods Randomized clinical trial, divided into two groups: Gametherapy (G_Game) and Control (G_Control). Both groups received recommendations about unsupervised PFMT, and G_Game also received supervised PFMT through gametherapy. After 5 consecutive weeks, the feasibility was investigated considering participant adherence, urinary symptoms (evaluated by the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form [ICIQ-UI-SF] questionnaire), and pelvic floor function (PERFECT Scheme: power, endurance, repetition and fast). The Fisher exact, Kruskal-Wallis, Wilcoxon sign paired, and Mann-Whitney U tests were used by intention-to-treat analysis, using STATA 15.1 (StataCorp, College Station, TX, USA) software. Results The present study included 20 women per group and observed a higher adherence in G_Game. In the intragroup analysis, a decrease in the ICIQ-UI-SF score was observed in both groups (14.0 to 10.0; 13.5 to 0), associated with increased endurance (2.5 to 3.5; 2.5 to 4.0) in G_Control and G_Game, respectively. Moreover, there was a concomitant increase in pelvic floor muscles (PFMs) power (2.0 to 3.0), repetition (3.0 to 5.0), and fast (10.0 to 10.0) in G_Game. In the intergroup analysis, a reduction of UI was observed (p<0.001; r=0.8), as well an increase in PFM power (p=0.027, r=0.2) and endurance (p=0.033; r=0.3) in G_Game. Conclusion The feasibility of supervised PFMT through gametherapy was identified by observing participant adherence, relief of urinary symptoms, and improvement in PFM function.


Resumo Objetivo Investigar a viabilidade do treinamento dos músculos do assoalho pélvico (TMAP) por meio de gameterapia no alívio de sintomas urinários em mulheres climatéricas com incontinência urinária (IU) de esforço ou mista. Métodos Ensaio clínico randomizado, dividido em dois grupos: Gameterapia (G_Game) e Controle (G_Controle). Ambos os grupos receberam recomendações sobre TMAP não supervisionado, e G_Gametambém recebeu TMAP supervisionado por meio de gameterapia. Após 5 semanas consecutivas, a viabilidade foi investigada considerando a aderência das participantes, sintomas urinários (avaliados pelo questionário International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form [ICIQ-UI-SF]) e função do assoalho pélvico (esquema PERFECT: power, endurance, repetition, fast). Os testes exatos de Fisher, Kruskal-Wallis, sinal de Wilcoxon pareado e Mann-Whitney U foram usados pela análise de intenção de tratar, usando o software STATA 15.1 (StataCorp, College Station, TX, EUA). Resultados O presente estudo incluiu 20 mulheres por grupo e observou uma maior adesão no G_Game. Na análise intragrupo, foi observada diminuição no escore do ICIQUI- SF emambos os grupos (de 14,0 para 10,0; de 13,5 para 0), associada ao aumento da resistência (de 2,5 para 3,5; de 2,5 para 4,0) em G_Control e G_Game, respectivamente. Além disso, houve um aumento concomitante no power (de 2,0 para 3,0), repetition (de 3,0 para 5,0) e fast (de 10,0 para 10,0) dosmúsculos do assoalho pélvico (MAPs) no G_Game. Na análise intergrupos, foi observada redução da IU (p<0,001; r=0,8), assim como do power (p=0,027; r=0,2) e da endurance (p=0,033; r=0,3) dos MAPs no G_Game. Conclusão A viabilidade do TMAP supervisionado por meio de gameterapia foi identificada pela observação da aderência das participantes, pelo alívio dos sintomas urinários e pela melhora da função dos MAPs.


Subject(s)
Humans , Female , Urinary Incontinence/therapy , Urinary Incontinence, Stress/therapy , Climacteric , Feasibility Studies , Treatment Outcome , Pelvic Floor , Exercise Therapy
8.
Fisioter. Bras ; 22(3): 425-441, Jul 15, 2021.
Article in Portuguese | LILACS | ID: biblio-1290534

ABSTRACT

A disfunção do assoalho pélvico envolve condições nosológicas, como incontinência urinária e disfunção sexual, com impacto negativo na qualidade de vida. O presente estudo objetivou avaliar a força muscular do assoalho pélvico de mulheres com disfunção pélvica. Trata-se de desenho analítico transversal realizado com uma amostra de conveniência de 167 mulheres com queixas de disfunções musculares do assoalho pélvico. Foram analisadas características sociodemográficas e clínicas, qualidade de vida relacionada à incontinência e força muscular pélvica. Estatísticas univariadas e bivariadas foram calculadas. A idade média das mulheres foi de 50,2 anos. A maioria foi classificada com impacto muito grave (76,6%) na qualidade de vida relacionada à incontinência, 41 (24,6%) apresentaram contração muscular não sustentada e 7 (4,2%) apresentaram contração. Associações significativas foram identificadas entre força muscular pélvica e idade (p = 0,025), menopausa (p = 0,039) e histerectomia (p = 0,026). A pesquisa permitiu concluir que os fatores de risco responsáveis por problemas no assoalho pélvico podem ser considerados cruciais para avaliar o nível de impacto da incontinência urinária e sua evolução como resultado de intervenções precoces, simples e de baixo custo na atenção primária à saúde. As disfunções do assoalho pélvico afetam negativa e substancialmente a qualidade de vida das mulheres. (AU)


Pelvic floor dysfunction involves nosological conditions, such as urinary incontinence and sexual dysfunction, which have a negative impact on quality of life. This study aimed to evaluate pelvic floor muscle strength of women with pelvic dysfunction. This is an analytical cross-sectional performed design with a convenience sample of 167 women with complaints of pelvic floor muscle dysfunctions. Sociodemographic and clinical characteristics, quality of life related to incontinence and pelvic muscle strength were analyzed. Univariate and bivariate statistics were calculated. The mean age of women was 50.2 years. Most were classified having a very severe impact (76.6%) on incontinencerelated quality of life, 41 (24.6%) presented non-sustained muscle contraction and 7 (4.2%) presented in contraction. Significant associations were identified between pelvic muscle strength and age (p = 0.025), menopause (p = 0.039) and hysterectomy (p = 0.026). This study allowed us to conclude that the risk factors responsible for pelvic floor problems can be considered crucial to assess the level of impact of urinary incontinence and its evolution as a result of early, simple and low cost interventions in primary health care. Pelvic floor dysfunctions affect negatively and substantially the quality of life of women. (AU)


Subject(s)
Humans , Female , Pelvic Floor , Muscle Strength , Quality of Life , Urinary Incontinence , Muscle Contraction
9.
Fisioter. Bras ; 22(3): 442-455, Jul 15, 2021.
Article in Portuguese | LILACS | ID: biblio-1290536

ABSTRACT

Introdução: A fibromialgia é uma síndrome crônica, com etiologia desconhecida, frequente em mulheres e com sintomas que afetam a qualidade de vida. Tem se discutido que essa condição afete inclusive a musculatura do assoalho pélvico. Objetivo: Verificar o conhecimento a respeito do períneo, a presença de sintomas de perdas urinárias e o nível de satisfação sexual em mulheres fibromiálgicas. Métodos: Participaram dessa abordagem 7 fibromiálgicas atendidas semanalmente pela fisioterapia. Para avaliação inicial, utilizamos um Questionário de Consciência Perineal e o Índice de Satisfação Sexual Feminina (FSFI). Durante os dois meses de intervenção, foram realizadas 2 palestras educativas e 8 encontros para a realização de exercícios perineais. Depois da intervenção, o FSFI foi aplicado novamente e os dados foram analisados por estatística simples. Resultados: As participantes demonstraram conhecer a localização das estruturas do sistema urinário, porém 4 das mulheres (57,1%) relataram não saber contrair a musculatura do assoalho pélvico. Todas relataram urgência miccional, raras perdas urinárias ao esforço e insatisfação sexual, antes da intervenção melhorando na reavaliação. Conclusão: As participantes pouco conhecem sobre a musculatura do assoalho pélvico, sua contração adequada e a atuação da fisioterapia nessa condição. A satisfação sexual encontrou-se prejudicada inicialmente apresentando melhora após as intervenções. (AU)


Introduction: Fibromyalgia is a chronic syndrome, with unknown etiology, common in women and with symptoms that affect quality of life. It has been argued that this condition affects even the pelvic floor musculature. Objective: To verify the knowledge about the perineum, the presence of symptoms of urinary loss and the level of sexual satisfaction in fibromyalgia women. Methods: Seven fibromyalgia patients attended weekly by physical therapy participated in this approach. For initial assessment, we used Perineal Awareness Questionnaire and Female Sexual Satisfaction Index (FSFI). During two months of intervention, 2 educational lectures and 8 meetings were held to perform perineal exercises. After intervention, FSFI was applied again, and the data were analyzed using simple statistics. Results: The participants demonstrated to know the location of the structures of the urinary system, however 4 of the women (57.1%) reported not knowing how to contract the pelvic floor muscles. All of them reported urinary urgency, rare urinary losses on exertion and sexual dissatisfaction, before the intervention, improving the reassessment. Conclusion: The participants know little about the musculature of the pelvic floor, its adequate contraction, and the role of physical therapy in this condition. Sexual satisfaction was initially impaired, showing improvement after the interventions. (AU)


Subject(s)
Humans , Female , Fibromyalgia , Physical Therapy Modalities , Orgasm , Quality of Life , Urinary Tract , Pelvic Floor , Consciousness
10.
Rev. Assoc. Med. Bras. (1992) ; 67(6): 851-856, June 2021. tab, graf
Article in English | LILACS | ID: biblio-1346925

ABSTRACT

SUMMARY OBJECTIVE: To evaluate the sexual function of women in the puerperal period after a postpartum pelvic floor musculature training program. We also sought to evaluate correlations between sexual dysfunction in the women and their delivery type and compare the frequency of sexual dysfunction and the quality of resumed sexual function following vaginal and cesarean deliveries. METHODS: This clinical study included an intervention, carried out between July and December 2019, in which data were collected about 28 rooming-in women at a Maternity School. Data were divided into vaginal delivery and cesarean delivery. Sexual function was evaluated by the Female Sexual Function Index and the International Consultation on Incontinence Questionnaire-Short Form to assess the Incontinence Urinary and qualifies urinary loss. The intervention consisted of a muscle training exercise program. ANOVA tests were used to establish differences between groups. RESULTS: There was an improvement in all outcomes, but there was no time versus group interaction. Improvement in sexual function was observed (p<0.001), the impact of urinary incontinence on quality of life (p<0.001), and pressure of the muscles of pelvic floor muscles (p<0.001) over time. There was no time versus group interaction for sexual function (p=0.87), the impact of urinary incontinence on quality of life (p=0.88), and pressure of the pelvic floor muscles (p=0.66). CONCLUSIONS: Pelvic floor muscle exercise programs seem to be a very promising strategy concerning improving sexual activity among puerperal patients.


Subject(s)
Humans , Female , Pregnancy , Urinary Incontinence/therapy , Pelvic Floor , Quality of Life , Postpartum Period , Exercise Therapy
11.
Fisioter. Bras ; 22(2): 205-215, Maio 25, 2021.
Article in Portuguese | LILACS | ID: biblio-1284160

ABSTRACT

Introdução: A síndrome da bexiga hiperativa pode afetar as mulheres após o tratamento para câncer de colo do útero, interferindo diretamente a qualidade de vida e funcionalidade. Objetivo: Verificar os efeitos da Fisioterapia nos sintomas da síndrome da bexiga hiperativa em mulheres submetidas ao tratamento de câncer de colo do útero. Métodos: Trata-se de um ensaio clínico não controlado, com mulheres que realizaram o tratamento para câncer de colo do útero. Foi utilizada uma ficha de avaliação para verificar dados ginecológicos/obstétricos, assim como hábitos de vida das pacientes. Os sintomas da síndrome da bexiga hiperativa foram avaliados por meio do Incontinence Questionnaire Overactive Bladder. Para a intervenção fisioterapêutica foi utilizado o protocolo de Treinamento dos Músculos do Assoalho, Eletroestimulação Transcutânea do Nervo Tibial e Terapia Comportamental. Resultados: No pós-tratamento ocorreu decréscimo estatisticamente significativo na mediana dos sintomas da síndrome da bexiga hiperativa e no impacto da qualidade de vida em relação ao pré-tratamento, indicando melhora do quadro. Conclusão: Esta pesquisa concluiu que o protocolo fisioterapêutico utilizado apresentou eficácia na melhora dos sintomas da síndrome da bexiga hiperativa após tratamento para câncer de colo do útero. (AU)


Introduction: A hyperactive bladder syndrome can affect women after treatment for cervical cancer, directly interfering with quality of life and functionality. Objective: To verify the effects of physical therapy on the symptoms of hyperactive bladder syndrome in women undergoing treatment for cervical cancer. Methods: This is an uncontrolled clinical trial, with women who underwent treatment for cervical cancer. An evaluation form was used to check gynecological/obstetric data, as well as the patients' lifestyle. The symptoms of the hyperactive bladder syndrome were obtained through the hyperactive bladder questionnaire. For the physiotherapeutic intervention, the floor muscle training, transcutaneous electrostimulation of the tibial nerve and behavioral therapy protocol was used. Results: In the post-treatment there was a statistically significant decrease in the median of the symptoms of the hyperactive bladder syndrome and no impact on the quality of life in relation to the pre-treatment, an improvement indicated in the condition. Conclusion: This research concluded that the physical therapy protocol used showed improvement of symptoms of overactive bladder syndrome after treatment for cervical cancer. (AU)


Subject(s)
Humans , Female , Uterine Cervical Neoplasms , Physical Therapy Modalities , Urinary Bladder, Overactive , Signs and Symptoms , Urinary Incontinence , Efficacy , Pelvic Floor
12.
Fisioter. Bras ; 22(2): 216-232, Maio 25, 2021.
Article in Portuguese | LILACS | ID: biblio-1284162

ABSTRACT

Introdução: As intervenções fisioterapêuticas podem prevenir e minimizar as disfunções na musculatura do assoalho pélvico durante a gestação. Objetivo: Verificar quais são as intervenções fisioterapêuticas no assoalho pélvico durante a gestação e no preparo para o parto e elaborar um manual com informações mais relevantes encontradas nessa pesquisa. Métodos: Foi realizada uma revisão bibliográfica nas bases de dados: Pubmed, Scielo e PEDro. Foram selecionados 10 artigos relevantes publicados entre o período de 1997 a 2019. Resultados: Os estudos sobre massagem perineal mostraram que houve redução de episiotomia, dor perineal e laceração. Quanto ao treinamento dos músculos do assoalho pélvico, houve aumento significativo da pressão desses músculos, menor taxa de episiotomia e do tempo da segunda fase do trabalho de parto. O Epi-no® mostrou aumento significativo de períneo intacto e taxas mais baixas de episiotomia quando realizados com auxílio do fisioterapeuta. Conclusão: Os estudos mostram que o treinamento da musculatura do assoalho pélvico supervisionado e massagem perineal são eficazes para o preparo para o parto. O treinamento com Epino® no pré parto apontou ser eficaz na redução de laceração e episiotomia intraparto, porém para determinar sua real eficácia, é necessário aumentar o número amostral. (AU)


The physiotherapeutic intervention can prevent and minimize dysfunction in the pelvic muscles floor during pregnancy. Aim: To verify which are the physiotherapeutic interventions in the pelvic floor during pregnancy and on the preparation to delivery, and to elaborate a manual with more relevant information found in this process. Methods: A literature review was performed in the databases: Pubmed, Scielo and PEDro. Nine relevant published articles were selected between 1997 and 2019. Results: The studies about perineal massage showed reductions of episiotomy, less perineal pain and laceration. For the kinesiotherapy, there was a significant increase of muscle pressure, more strength and lower rate of the second phase of labor. An imported increase in intact perineum and lower rates of episiotomy was observed on Epi-no®, when performed by the physiotherapist. Conclusion: Studies show that supervised pelvic musculature floor training and perineal massage are effective to prepare for the childbirth. Epi-no® training in pre-delivery is effective on the intrapartum period regarding laceration reduction and episiotomy, but it is necessary more samples to determine the real efficacy. (AU)


Subject(s)
Humans , Female , Pregnancy , Pregnancy , Physical Therapy Modalities , Pelvic Floor
13.
Fisioter. Bras ; 22(2): 233-248, Maio 25, 2021.
Article in Portuguese | LILACS | ID: biblio-1284167

ABSTRACT

Introdução: A incontinência urinária é uma disfunção do assoalho pélvico e acomete mulheres das mais variadas idades. A atividade física tem diversos benefícios, no entanto o assoalho pélvico pode ser a única área do corpo em que seu efeito positivo pode ser questionado. O CrossFit® é um programa de treinamento de alto impacto que envolve exercícios aeróbicos e anaeróbicos. Esta atividade possui um caráter motivacional e desafiador e vem ganhando milhões de adeptos no mundo todo. Objetivo: Revisar os estudos publicados nos últimos 5 anos a respeito das disfunções do assoalho pélvico em atletas praticantes de CrossFit®. Métodos: Revisão integrativa de literatura realizada através de pesquisa nas bases de dados Pubmed, Bireme (Lilacs, Medline, Scielo), Science Direct e PeDro, entre os anos de 2015 a 2020. Resultados: Foram incluídos 6 artigos aplicáveis aos critérios de elegibilidade. A população estudada são mulheres de 16 a 75 anos, praticantes de CrossFit®. Na avaliação metodológica, os estudos foram considerados fracos a moderados e apenas um forte. Conclusão: Como principais achados deste estudo, observou-se uma prevalência significativa de IU em praticantes de CrossFit®; essa disfunção parece estar relacionada a um atraso na ativação da musculatura pélvica quando exigida durante os exercícios. (AU)


Introduction: Urinary Incontinence is a pelvic floor dysfunction and affects women of all ages. Physical activity has several benefits; however, the pelvic floor may be the only area of the body in which its positive effect can be questioned. CrossFit® is a training program of high impact that involves aerobic and anaerobic exercises. This activity has a motivational and challenging character and has been gaining millions of followers worldwide. Objective: To review the studies published in the last 5 years regarding pelvic floor dysfunctions in athletes practicing CrossFit®. Methods: Integrative literature review carried out by searching the Pubmed, Bireme (Lilacs, Medline, Scielo), Science Direct and PeDro databases, between the years 2015 to 2020. Results: 6 articles applicable to the eligibility criteria were included. The studied population are women aged 16 to 75 years practicing CrossFit®. In the methodological evaluation, the studies were considered weak to moderate and only one strong. Conclusion: This study observed a significant prevalence of urinary incontinence in CrossFit® practitioners; this dysfunction seems to be related to a delay in the activation of the pelvic muscles when required during exercises. (AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Young Adult , Exercise , Pelvic Floor Disorders , Urinary Incontinence , Women , Pelvic Floor
14.
Int. braz. j. urol ; 47(1): 120-130, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1134327

ABSTRACT

ABSTRACT Aim: To evaluate the radiotherapy (RT) effect in the pelvic floor muscles (PFM) function in men with prostate cancer (PC). Materials and Methods: A cross-sectional study included three groups of patients with PC and RT indication: 1) Pre-RT group: evaluated before the beginning of RT; 2) Acute group: evaluated between six months and one year after RT; 3) Late Group: evaluated between two and a half years and four years post-RT. PFM assessment was divided into: a) functional assessment through the digital anal palpation (Modified Oxford Scale) and surface electromyography (sEMG) with anal probe; b) anatomical assessment by pelvic magnetic resonance imaging (MRI) with thickness measurements of levator ani muscle and pelvic specific parameters at rest and under Valsalva maneuver. We used Student t test, considering as significant p <0.05. Results: Thirty-three men were assessed: Pre-RT (n=12); Acute (n=10) and Late (n=11) groups. PFM functional assessment showed Late group with lower electromyographic activity, especially in the sustained contractions when compared to the Pre-RT (p=0.003) and Acute groups (p=0.006). There was no significant difference between groups in MRI. Conclusion: PFM functional assessment showed a decrease in sEMG activity in the Late group post-RT. Most of the sample (72.7%) did not know how to actively contract the PFM or had a weak voluntary contraction when assessed by digital anal palpation. Also, these patients presented higher prevalence of pelvic complaints. No changes were observed in the morpho-functional parameters evaluated by MRI, except the measurement of the membranous urethra length when comparing Pre-RT Group and Acute and Late Groups.


Subject(s)
Humans , Male , Prostate/immunology , Pelvic Floor/diagnostic imaging , Palpation , Magnetic Resonance Imaging , Cross-Sectional Studies , Electromyography , Muscle Contraction
15.
Fisioter. Bras ; 21(6): 592-600, Jan 6, 2021.
Article in Portuguese | LILACS | ID: biblio-1283723

ABSTRACT

Introdução: Sabe-se a importância da fisioterapia na recuperação e prevenção das disfunções do assoalho pélvico, e a dança do ventre é reconhecida por atuar nesta musculatura. Objetivo: Investigar a funcionalidade dos músculos do assoalho pélvico a partir de eletromiografia em bailarinas de dança do ventre. Métodos: Foram avaliadas mulheres de 18 a 35 anos de idade, praticantes de dança do ventre há pelo menos dois anos, comparadas a mulheres não praticantes. Foram analisados parâmetros eletromiográficos para as fibras tônicas e fásicas durante a contração e o repouso. Os valores percentuais foram obtidos a partir do pico de contração voluntária máxima. Resultados: Verificou-se significância estatística na ativação muscular das fibras fásicas durante a contração e em repouso das mulheres que praticam dança do ventre mais de duas vezes na semana. Conclusão: Os achados sugerem que a prática regular da dança do ventre apresenta menor ativação de fibras fásicas tanto durante a contração quanto no repouso comparado ao grupo de mulheres não praticantes. Torna-se necessária a associação de programas de treinamento de fibras fásicas a fim de evitar, em longo prazo, prejuízos em relação à força muscular, à agilidade e às funções geniturinárias. (AU)


Introduction: It is known the importance of physical therapy in the recovery and prevention of pelvic floor dysfunctions, and belly dancing is recognized for acting on this musculature. Objective: To investigate the functionality of the pelvic floor muscles using electromyography in belly dancers. Methods: Women aged 18 to 35 years, practicing belly dancing for at least two years, were evaluated, compared to non-practicing women. Electromyographic parameters were analyzed for tonic and phasic fibers during contraction and rest. The percentage values were obtained from the peak of maximum voluntary contraction. Results: There was statistical significance in the muscle activation of the phasic fibers during contraction and at rest for women who practice belly dancing more than twice a week. Conclusion: The findings suggest that the regular practice of belly dancing presents less activation of phasic fibers both during contraction and at rest compared to the group of non-practicing women. The association of phasic fiber training programs is necessary in order to avoid, in the long term, losses in relation to muscle strength, agility and genitourinary functions. (AU)


Subject(s)
Humans , Pelvic Floor , Electromyography , Dancing , Muscle Strength
16.
Article in Chinese | WPRIM | ID: wpr-921556

ABSTRACT

Objective To observe the patients after transvaginal mesh(TVM)implantation surgery by using transperineal ultrasound(TPUS),compare the diagnosis of pelvic organ prolapse(POP)by TPUS and clinical examination[according to the Pelvic Organ Prolapse Quantification(POP-Q)system published by the International Continence Society],and to explore the role of ultrasound in postoperative evaluation as well as the high-risk factors of post-surgery POP recurrence. Methods This is a retrospective study based on the POP-Q records and TPUS data sets of patients within 6 months after TVM surgery during September 2013 and November 2019.The diagnostic results of TPUS and POP-Q were compared.The incidences of hiatal ballooning and levator avulsion were separately compared between the TPUS group and the control group. Results A total of 147 patients were enrolled.The Kappa values between TPUS and POP-Q in the diagnosis of anterior and posterior compartment POP were 0.268(


Subject(s)
Humans , Pelvic Floor/diagnostic imaging , Pelvic Organ Prolapse/diagnostic imaging , Retrospective Studies , Surgical Mesh/adverse effects , Ultrasonography
17.
Article in Chinese | WPRIM | ID: wpr-887501

ABSTRACT

OBJECTIVE@#To observe the effect of moxibustion on postpartum urodynamics and recovery of pelvic floor function based on the pelvic floor muscle function training.@*METHODS@#A total of 150 puerperal women were randomly divided into an observation group (75 cases, 15 cases dropped off) and a control group (75 cases, 15 cases dropped off). The control group was treated with pelvic floor muscle function training, twice a day. Based on the treatment in the control group, the observation group was treated with @*RESULTS@#Compared before treatment, the levels of FUL, MUCP, BC, Pdet Qmax and SLPP in the observation group after treatment were increased (@*CONCLUSION@#The moxibustion combined with pelvic floor muscle function training could improve postpartum urodynamics and pelvic floor muscle strength.


Subject(s)
Exercise Therapy , Female , Humans , Moxibustion , Pelvic Floor , Postpartum Period , Urinary Incontinence, Stress , Urodynamics
18.
Chinese Medical Journal ; (24): 200-205, 2021.
Article in English | WPRIM | ID: wpr-878027

ABSTRACT

BACKGROUND@#It has been a global trend that increasing complications related to pelvic floor surgeries have been reported over time. The current study aimed to outline the development of Chinese pelvic floor surgeries related to pelvic organ prolapse (POP) over the past 14 years and investigate the potential influence of enhanced monitoring conducted by the Chinese Association of Urogynecology since 2011.@*METHODS@#A total of 44,594 women with POP who underwent pelvic floor surgeries between October 1, 2004 and September 30, 2018 were included from 22 tertiary academic medical centers. The data were reported voluntarily and obtained from a database. We compared the proportion of each procedure in the 7 years before and 7 years after September 30, 2011. The data were analyzed by performing Z test (one-sided).@*RESULTS@#The number of different procedures during October 1, 2011-September 30, 2018 was more than twice that during October 1, 2004-September 30, 2011. Regarding pelvic floor surgeries related to POP, the rate of synthetic mesh procedures increased from 38.1% (5298/13,906) during October 1, 2004-September 30, 2011 to 46.0% (14,107/30,688) during October 1, 2011-September 30, 2018, whereas the rate of non-mesh procedures decreased from 61.9% (8608/13,906) to 54.0% (16,581/30,688) (Z = 15.53, P < 0.001). Regarding synthetic mesh surgeries related to POP, the rates of transvaginal placement of surgical mesh (TVM) procedures decreased from 94.1% (4983/5298) to 82.2% (11,603/14,107) (Z = 20.79, P < 0.001), but the rate of laparoscopic sacrocolpopexy (LSC) procedures increased from 5.9% (315/5298) to 17.8% (2504/14,107).@*CONCLUSIONS@#The rate of synthetic mesh procedures increased while that of non-mesh procedures decreased significantly. The rate of TVM procedures decreased while the rate of LSC procedures increased significantly.@*TRIAL REGISTRATION NUMBER@#NCT03620565, https://register.clinicaltrials.gov.


Subject(s)
China , Female , Gynecologic Surgical Procedures/adverse effects , Humans , Pelvic Floor/surgery , Pelvic Organ Prolapse/surgery , Surgical Mesh/adverse effects , Treatment Outcome , Vagina
19.
An. Fac. Cienc. Méd. (Asunción) ; 54(2): 131-136, 2021.
Article in Spanish | LILACS | ID: biblio-1281109

ABSTRACT

El Angiomixoma Agresivo (AA) del suelo pélvico es una rara neoplasia mesenquimal de histología benigna, pero con un comportamiento característico localmente agresivo, que frecuentemente se presenta en mujeres en edad reproductiva. Suele presentar un crecimiento insidioso desde su origen en la musculatura perineal, lo que conlleva una clínica inespecífica, sutil y generalmente de larga evolución. El diagnóstico por la imagen, principalmente a expensas de la Tomografía Computarizada (TC) y la Resonancia Magnética (RM) con contraste, es de notable importancia, tanto por permitir detectar y caracterizar fiablemente una entidad poco frecuente, como por facilitar una planificación quirúrgica adecuada que permita obtener márgenes de resección libres de enfermedad, incluso en aquellos con infiltración de las estructuras vecinas. Presentamos el caso de una paciente adolescente con antecedente de tumoración en región vulvar derecha, en relación con extensión de un gran tumor retroperitoneal cuyo estudio histológico confirmó un Angiomixoma Agresivo.


Aggressive angiomyxoma of the pelvic floor is a rare mesenchymal neoplasm of benign histology, but with a characteristic locally aggressive behavior, which mostly occurs in women of reproductive age. It usually presents an insidious growth from its origin in the perineal musculature, which leads to a non-specific, subtle and generally long-lasting clinical course. Diagnostic imaging, mainly at the expense of CT and MRI with contrast, is of notable importance, both for allowing detection and reliable characterization of a rare entity, and for facilitating adequate surgical planning to obtain disease-free resection margins, even in those with infiltration of neighboring structures. We present the case of an adolescent patient with a history of tumor in the right vulvar region, which imaging studies confirmed to be the extension of a large retroperitoneal tumor whose pathological anatomy describes as an aggressive pelvic an angiomyxoma.


Subject(s)
Magnetic Resonance Spectroscopy , Tomography, X-Ray Computed , Pelvic Floor , Neoplasms , Diagnosis , Anatomy
20.
Rev. Esc. Enferm. USP ; 55: e03705, 2021. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1250744

ABSTRACT

ABSTRACT Objective: To present a proposal of a protocol for pelvic floor muscle evaluation and training to provide care to women with urinary incontinence. Method: Professional experience report, conducted in an outpatient facility for voiding dysfunctions in the Brazilian Unified Health System, conducted by an enterostomal therapist nurse. Results: Elaboration of a proposal of care protocol in nursing consultations based on a directed physical examination, nursing diagnoses of the International Classification for Nursing Practice, and the adaptation of a muscle training protocol as prescription. Steps: static observation, dynamic observation, and palpation to verify the tension and evaluation of strength, sustentation, relaxation, and muscle coordination, followed by prescriptions for relaxation, proprioception, training for strength, sustentation, abdominal and pelvic coordination, and maintenance, as per diagnosis. Conclusion: This protocol proposal intends to support the evaluation of the pelvic muscles of women with urinary incontinence or at risk for developing this condition by nurses of all levels of healthcare, especially as part of nursing consultations in primary care.


RESUMEN Objetivo: Presentar una propuesta de protocolo de evaluación y entrenamiento de la musculatura del suelo pélvico para atender a mujeres con incontinencia urinaria. Método: Relato de experiencia profesional realizado en un centro ambulatorio de disfunciones miccionales del Sistema Único de Salud de Brasil, conducido por enfermera estomaterapeuta. Resultados: Elaboración de una propuesta de protocolo de atención en consulta de enfermería basada en el examen físico dirigido, los diagnósticos de enfermería de la Clasificación Internacional de la Práctica de Enfermería y la adaptación de un protocolo de entrenamiento muscular como prescripción. Etapas: inspección estática, inspección dinámica y palpación para comprobar la tensión, evaluación de la fuerza, sustentación, relajación y coordinación muscular; seguidas de prescripciones de relajación, propiocepción, entrenamiento de fuerza, sustentación, coordinación abdomino-pélvica y mantenimiento, según el diagnóstico. Conclusión: Esta propuesta de protocolo pretende apoyar la evaluación de la musculatura pélvica en mujeres con incontinencia urinaria o con riesgo de desarrollarla por parte de los enfermeros de todos los niveles atención a la salud, especialmente como parte de la consulta de enfermería en atención primaria.


RESUMO Objetivo: Apresentar uma proposta de protocolo de avaliação e treinamento da musculatura do assoalho pélvico para atendimento à mulher com incontinência urinária. Método: Relato de experiência profissional realizado em ambulatório de disfunções miccionais do Sistema Único de Saúde, conduzido por enfermeira estomaterapeuta. Resultados: Elaboração de uma proposta de protocolo de atendimento em consulta de enfermagem baseada em exame físico direcionado, diagnósticos de enfermagem da Classificação Internacional para a Prática de Enfermagem e adaptação de um protocolo de treinamento muscular como prescrição. Etapas: inspeção estática, inspeção dinâmica e palpação para verificação de tensão, avaliação de força, sustentação, relaxamento e coordenação muscular; seguidos de prescrições para relaxamento, propriocepção, treino de força, de sustentação, de coordenação abdomino-pélvica e de manutenção, conforme o diagnóstico. Conclusão: Esta proposta de protocolo pretende subsidiar a avaliação, por enfermeiros de todos os níveis de atenção à saúde, da musculatura pélvica de mulheres com incontinência urinária ou em risco de desenvolvimento, especialmente como parte da consulta de enfermagem na atenção primária.


Subject(s)
Urinary Incontinence , Women's Health , Pelvic Floor , Nursing Process
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