Reconstruction Of Postpartum Pelvic Floor Muscle Function

Objective:Through the evaluation of pelvic floor muscle function on postpartum 42-60 Days, and different treatments for patients with postpartum pelvic floor dysfunction such as postpartum urinary incontinence, we explored the correlation of postpartum pelvic floor dysfunction diseases and contractility of pelvic floor muscles, and research for the better therapy method and processes to treat the postpartum pelvic floor dysfunction diseases.Method:A group of 102 patients who met the criteria for pelvic floor dysfunction in postpartum 42～60 Day, such as postpartum urinary incontinence or pelvic organ prolapse, were recruited as a study group; 100 postpartum women whose pelvic floor function normally during the same period were recruited as a control group. A questionnaire survey was conducted to learn about the general situation of the selected object. The correlation of postpartum pelvic floor dysfunction and contractility of pelvic object. The correlation of postpartum pelvic floor dysfunction and contractility of pelvic floor muscles was determined through the electromyographic recording of pelvic floor, measuring the continued contractility as the function of pelvic floor class I muscle and the rapid contractility as the function of pelvic floor class II muscle. The patients diagnosed PFD were either instructed to have Kegel Training for pelvic floor muscle at home, or treated in hospital with an electric stimulation and biological feedback therapy using an electric stimulator. The pelvic floor muscles contractility was measured before and after the treatments. The recovery rates were compared to determine the effectiveness of the two therapies.Results:1, Evaluation:①There was no significant difference in the pregnancy days and post-natal days between the Study group and Control group (P> 0.05); Age, pre-delivery body mass index, new born baby weight, vaginal birth rate and a history of abdominal pressure of the Study Group were significantly higher than the Control Group (P<0.05,P< 0.01,P< 0.001).②Both the sustained and rapid contractilities of pelvic floor muscle in the Study group were significantly lower than the Control group (P<0.01).③there were 66 cases of postpartum urine incontinence,36 cases of pelvic organ de vertical (34 cases of vaginal wall expansion out, and 2 cases of mild uterine droop) in the Study group. The rapid contractility was in order of: urinary incontinence group< pelvic organ prolapse group< the control group (P<0.001), while the sustained contractility was in order of pelvic organ prolapse group< urinary incontinence group< the Control group (P< 0.001)2, Effect of Therapy:among the 102 patients having postpartum urinary incontinence or pelvic organ prolapse,72 patients were treated in hospital with Electrical stimulation and Biofeedback therapy using a neural Stimulator, the other 30 patients were instructed to have Kegel Pelvic floor muscle exercise as an exercise group. Among the stimulation group,72 patients had completed one full course (6-8weeks) of treatment,20 patients (among 72 cases) had completed two full courses. There is no difference between the two groups in the age, pregnant week, post-natal days, pre-delivery body mass index, new born baby weight, the rate of vaginal delivery rates, and increased abdominal pressure (P> 0.05).①Both the rapid and the sustained contractility was significantly improved after a course of either treatment (P<0.01).②There was no significant difference in the increased value of the rapid contractility between two groups (P>0.05), while the increased value of sustained contractility in the Stimulated group was significantly higher than the exercise group (P<0.05.③There were significant improvements in the rapid contractility by comparing:one course treatment vs. pretreatment, two-course treatment vs. one-course treatment (P< 0.05). The sustained contractility was improved after either one course or two courses of treatment (P< 0.01), and was not significant different between them (P> 0.05).Conclusion:1,Postpartum pelvic floor dysfunction diseases are associated with the declined contractility of pelvic floor muscle through the electromyographic recording of pelvic floor, postpartum urinary incontinence is associated with weakened contractility of class II muscle (rapid muscle contractility); pelvic organ prolapse is associated with the declined contractility of class I muscle (the sustained contractility). It provided an objective and useful valuation index for postpartum pelvic floor muscle function2,Postpartum pelvic floor muscle exercises, biofeedback and electrical stimulation are all effective for the rehabilitation of pelvic floor; electric stimulation plus biofeedback is superior over the simple pelvic floor muscle exercises; two courses of treatment is better than one course.