Electromyostimulation in the treatment of early forms of postpartum pelvic floor dysfunction

Objective. To study the results of electromyostimulation using an electrical device Tonis in patients with minimal signs of postpartum pelvic floor trauma. Patients and methods. The study included 24 women aged 20–32 years (27.4 (24.4; 29.1)) who were observed 6–12 months after delivery of their first child through vaginal childbirth in a cephalic presentation and whose examination revealed minimal signs of pelvic floor trauma or dysfunction. The electromyostimulation trainer Tonis was used 20 minutes daily (postpartum rehabilitation program) for 3 months. Results. After 3 months of training, in all patients, previously minimal complaints ceased. The POP-Q measurements significantly improved almost in all patients: the uterus was in a higher position, the topography of both the anterior and posterior vaginal walls improved, and the genital hiatus narrowed. Conclusion. Transperineal ultrasound showed a statistically significant improvement in the height of the central tendon of the perineum and in the muscle mass, the number of patients with muscle diastasis decreased, urethral hypermobility also decreased. Key words: postpartum rehabilitation, POP-Q system, transperineal ultrasound, electromyostimulation

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Transperineal ultrasound imaging of the pelvic floor muscles in women with pelvic floor dysfunction symptoms: A cross-sectional study

Middle East Fertility Society Journal ◽

10.1016/j.mefs.2017.12.004 ◽

2018 ◽

Vol 23 (3) ◽

pp. 232-237

Author(s):

Nadia M. Madkour

Keyword(s):

Pelvic Floor ◽

Ultrasound Imaging ◽

Pelvic Floor Dysfunction ◽

Cross Sectional Study ◽

Pelvic Floor Muscles ◽

Transperineal Ultrasound ◽

Sectional Study ◽

Cross Sectional

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Pelvic Floor Dysfunction at 3- and 4-Dimensional Transperineal Ultrasound in Patients with Deep Infiltrating Endometriosis

Journal of Minimally Invasive Gynecology ◽

10.1016/j.jmig.2016.08.073 ◽

2016 ◽

Vol 23 (7) ◽

pp. S26-S27

Author(s):

M Mabrouk ◽

D Raimondo ◽

L Zannoni ◽

Forno S Del ◽

V Martelli ◽

...

Keyword(s):

Pelvic Floor ◽

Pelvic Floor Dysfunction ◽

Transperineal Ultrasound ◽

Deep Infiltrating Endometriosis ◽

Infiltrating Endometriosis

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Magnetic resonance imaging and 3-dimensional transperineal ultrasound evaluation of pelvic floor dysfunction in symptomatic women: a prospective comparative study

ULTRASONOGRAPHY ◽

10.14366/usg.19007 ◽

2019 ◽

Vol 38 (4) ◽

pp. 355-364 ◽

Cited By ~ 1

Author(s):

Dahlia O. El-Haieg ◽

Nadia M. Madkour ◽

Mohammad Abd Alkhalik Basha ◽

Reda A. Ahmad ◽

Somayya M. Sadek ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Comparative Study ◽

Pelvic Floor ◽

Pelvic Floor Dysfunction ◽

Transperineal Ultrasound ◽

Resonance Imaging ◽

3 Dimensional ◽

Ultrasound Evaluation ◽

Prospective Comparative Study

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Pelvic Muscle Rehabilitation: A Standardized Protocol for Pelvic Floor Dysfunction

Advances in Urology ◽

10.1155/2014/487436 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Rodrigo Pedraza ◽

Javier Nieto ◽

Sergio Ibarra ◽

Eric M. Haas

Keyword(s):

Pelvic Floor ◽

Pelvic Floor Dysfunction ◽

Rehabilitation Program ◽

Management Approach ◽

Lifestyle Modifications ◽

Baseline Phase ◽

Muscle Strengthening ◽

Therapeutic Modalities ◽

Standardized Protocol ◽

Integrated Diagnosis

Introduction. Pelvic floor dysfunction syndromes present with voiding, sexual, and anorectal disturbances, which may be associated with one another, resulting in complex presentation. Thus, an integrated diagnosis and management approach may be required. Pelvic muscle rehabilitation (PMR) is a noninvasive modality involving cognitive reeducation, modification, and retraining of the pelvic floor and associated musculature. We describe our standardized PMR protocol for the management of pelvic floor dysfunction syndromes.Pelvic Muscle Rehabilitation Program. The diagnostic assessment includes electromyography and manometry analyzed in 4 phases: (1)initial baseline phase; (2)rapid contraction phase; (3)tonic contraction and endurance phase; and (4)late baseline phase. This evaluation is performed at the onset of every session. PMR management consists of 6 possible therapeutic modalities, employed depending on the diagnostic evaluation: (1)down-training; (2)accessory muscle isolation; (3)discrimination training; (4)muscle strengthening; (5)endurance training; and (6)electrical stimulation. Eight to ten sessions are performed at one-week intervals with integration of home exercises and lifestyle modifications.Conclusions. The PMR protocol offers a standardized approach to diagnose and manage pelvic floor dysfunction syndromes with potential advantages over traditional biofeedback, involving additional interventions and a continuous pelvic floor assessment with management modifications over the clinical course.

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Pelvic floor dysfunction at transperineal ultrasound and voiding alteration in women with posterior deep endometriosis

International Urogynecology Journal ◽

10.1007/s00192-019-03963-4 ◽

2019 ◽

Vol 30 (9) ◽

pp. 1527-1532 ◽

Cited By ~ 4

Author(s):

Mohamed Mabrouk ◽

Diego Raimondo ◽

Matteo Parisotto ◽

Simona Del Forno ◽

Alessandro Arena ◽

...

Keyword(s):

Pelvic Floor ◽

Pelvic Floor Dysfunction ◽

Transperineal Ultrasound ◽

Deep Endometriosis

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Dynamics of male pelvic floor muscle contraction observed with transperineal ultrasound imaging differ between voluntary and evoked coughs

Journal of Applied Physiology ◽

10.1152/japplphysiol.01225.2013 ◽

2014 ◽

Vol 116 (8) ◽

pp. 953-960 ◽

Cited By ~ 14

Author(s):

Ryan E. Stafford ◽

Stuart Mazzone ◽

James A. Ashton-Miller ◽

Christos Constantinou ◽

Paul W. Hodges

Keyword(s):

Pelvic Floor ◽

Pelvic Floor Muscle ◽

Pelvic Floor Dysfunction ◽

Levator Ani ◽

Transperineal Ultrasound ◽

Intraabdominal Pressure ◽

Voluntary Cough ◽

Bladder Base ◽

History Of ◽

Urological Disorders

Coughing provokes stress urinary incontinence, and voluntary coughs are employed clinically to assess pelvic floor dysfunction. Understanding urethral dynamics during coughing in men is limited, and it is unclear whether voluntary coughs are an appropriate surrogate for spontaneous coughs. We aimed to investigate the dynamics of urethral motion in continent men during voluntary and evoked coughs. Thirteen men (28–42 years) with no history of urological disorders volunteered to participate. Transperineal ultrasound (US) images were recorded and synchronized with measures of intraabdominal pressure (IAP), airflow, and abdominal/chest wall electromyography during voluntary coughs and coughs evoked by inhalation of nebulized capsaicin. Temporal and spatial aspects of urethral movement induced by contraction of the striated urethral sphincter (SUS), levator ani (LA), and bulbocavernosus (BC) muscles and mechanical aspects of cough generation were investigated. Results showed coughing involved complex urethral dynamics. Urethral motion implied SUS and BC shortening and LA lengthening during preparatory and expulsion phases. Evoked coughs resulted in greater IAP, greater bladder base descent (LA lengthening), and greater midurethral displacement (SUS shortening). The preparatory inspiration cough phase was shorter during evoked coughs, as was the latency between onset of midurethral displacement and expulsion. Maximum midurethral displacement coincided with maximal bladder base descent during voluntary cough, but followed it during evoked cough. The data revealed complex interaction between muscles involved in continence in men. Spatial and temporal differences in urethral dynamics and cough mechanics between cough types suggest that voluntary coughing may not adequately assess capacity of the continence mechanism.

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