Rzymski Paweł, Burzyński Bartłomiej, Knapik Michalina, Kociszewski Jacek, Wilczak Maciej
Department of Mother's and Child's Health, Poznań, Poland.
Department of Rehabilitation, School of Health Science, Medical University of Silesia, Katowice, Poland.
Arch Med Sci. 2020 Oct 21;17(2):314-322. doi: 10.5114/aoms.2020.100139. eCollection 2021.
Urinary incontinence in the general population occurs in 7% of non-pregnant women under 39 years old, 17% of those 40 to 59 years old, and 23-32% of those over 60 years old. In athletes the prevalence is higher, especially in high-impact training and gravity sports. Pelvic floor muscles (PFM) have two important roles; they serve as the support for abdominal organs and are crucial for closure of the urethra, vagina and rectum. We present the proper mechanisms of PFM caudal contractions with proper abdominal muscle control to avoid excessive intra-abdominal pressure. Pelvic floor sonography is discussed as the only objective method for pelvic floor examination among sportswomen and a tool which should be used routinely by urophysiotherapists and urogynecologists. A multidisciplinary individualized approach to stress urinary incontinence among athletes is presented including: physiotherapy, diagnostic imaging, use of a pessary, tampons, pharmacologic and surgical treatment. We present guidelines for stress urinary incontinence treatment in sportswomen of different age.
普通人群中，39岁以下未怀孕女性尿失禁发生率为7%，40至59岁女性为17%，60岁以上女性为23% - 32%。在运动员中，患病率更高，尤其是在高强度训练和重力运动项目中。盆底肌肉（PFM）有两个重要作用；它们支撑腹部器官，对尿道、阴道和直肠的闭合至关重要。我们介绍了PFM尾部收缩的正确机制以及正确的腹肌控制方法，以避免腹内压过高。盆底超声检查被视为运动女性盆底检查的唯一客观方法，也是泌尿物理治疗师和泌尿妇科医生应常规使用的工具。本文提出了针对运动员压力性尿失禁的多学科个体化治疗方法，包括：物理治疗、诊断成像、子宫托使用、卫生棉条、药物和手术治疗。我们还给出了不同年龄段运动女性压力性尿失禁治疗指南。
