Eisenberg Vered, Kafri Rachel
Sheba Medical Center.
Maccabi Healthcare Services.
Harefuah. 2018 Jan;157(1):34-37.
Pelvic floor damage can occur during pregnancy, during childbirth or post-partum, and may be expressed by symptoms such as urinary incontinence, fecal and gas incontinence, sexual dysfunction, pelvic organ prolapse and chronic pelvic pain. Some of the symptoms, which manifest later in a woman's life, will go unrecognized in the immediate postpartum period. Most women do not mention their general health, unless specifically asked. Physiotherapists, who are adept with the anatomy of the musculoskeletal system and the ability to diagnose unique differences, can aid in the diagnosis and treatment of postpartum pelvic floor problems. Monitoring, pelvic floor physiotherapy and exercise can be effective both in treatment and prevention of functional disorders of the pelvic floor. In this article, we will discuss pelvic floor problems and their appearance throughout pregnancy and childbirth, and the means of treatment from the physiotherapist's perspective. We raise the question as to whether all postpartum women could benefit from a training program of pelvic floor muscles. Pelvic floor physiotherapy is included in the health basket in Israel, but is not broadly utilized. Wider use could be adopted, particularly in light of the latest research evidence.
盆底损伤可发生在孕期、分娩期间或产后，其症状可能包括尿失禁、粪便及气体失禁、性功能障碍、盆腔器官脱垂和慢性盆腔疼痛。有些症状在女性后期生活中才会显现，在产后即刻可能未被察觉。大多数女性不会提及她们的总体健康状况，除非被特意询问。物理治疗师熟悉肌肉骨骼系统的解剖结构且具备诊断独特差异的能力，能够协助诊断和治疗产后盆底问题。监测、盆底物理治疗和锻炼在治疗和预防盆底功能障碍方面均有效。在本文中，我们将从物理治疗师的角度探讨整个孕期和分娩过程中的盆底问题及其表现，以及治疗方法。我们提出一个问题，即是否所有产后女性都能从盆底肌肉训练项目中受益。盆底物理治疗在以色列被纳入医保范围，但并未得到广泛应用。鉴于最新的研究证据，可采用更广泛的应用方式。
