Pelvic Floor Re-Education: Principles and Practice / Edition 1

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Pelvic Floor Re-education encompasses a variety of techniques for increasing the strength of, and control over, the pelvic floor muscles. These techniques are now emerging as an effective and viable alternative to surgery in the treatment of urinary incontinence and related conditions. This volume presents a reasoned, scientific approach to the use of pelvic floor re-education. Starting with the latest theories on anatomy, pathophysiology and possible causes of pelvic floor damage, the text then describes the importance of pelvic floor evaluation in determining the type of treatment required. A number of re-education techniques are assessed including isolated muscle exercise, vaginal cones, biofeedback control and electrical stimulation. Recent research work is also reviewed which allows the reader to evaluate the different modalities advocated in the management of pelvic floor dysfunction.

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Product Details

  • ISBN-13: 9783540761457
  • Publisher: Springer-Verlag New York, LLC
  • Publication date: 3/28/1997
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 190

Table of Contents

Introduction: Pelvic Floor Re-education - What does it mean? 1
1 Anatomy and function of the pelvic floor muscle 7
1.1 Functional anatomy of the pelvic floor and urinary continence mechanism 9
1.2 Innervation 22
1.3 Histomorphology of pelvic floor muscle 28
1.4 Summary and paramount: anatomy and physiology of the pelvic floor 34
2 Evaluation of the pelvic floor 37
2.1 Aims of pelvic floor evaluation 39
2.2 Clinical evaluation of the pelvic floor 42
2.3 Q-tip testing 49
2.4 The role of urodynamics in pelvic floor re-education 51
2.5 Ultrasound 64
2.6 Radiological evaluation of the pelvic floor and viscera 75
2.7 Magnetic resonance imaging (MRI) of the pelvic floor 78
2.8 Electrophysiology 83
2.9 Pelvic floor biopsy 98
3 Childbirth and pelvic floor damage 103
3.1 The pelvic floor before and after delivery 105
3.2 Delivery and urethral sphincter incompetence 111
4 Pelvic floor re-education 119
4.1 Aims of pelvic floor re-education
4.1.1 Prophylaxis of pelvic floor insufficiency 121
4.1.2 Treatment of stress urinary incontinence 123
4.1.3 Treatment of sexual dysfunction 126
4.1.4 Treatment of anal sphincter incompetence 129
4.2 Selection of patients 132
4.3 Techniques
4.3.1 Isolated muscle exercises 134
4.3.2 Vaginal cones 139
4.3.3 Electrical stimulation 143
4.3.4 Biofeedback control 153
4.4 Clinical results
4.4.1 Isolated muscle exercise 157
4.4.2 Vaginal cones 160
4.4.3 Neuromuscular electrical stimulation 163
4.4.4 Interferential therapy 168
4.4.5 Concept of an individualised combined pelvic floor re-education programme 169
4.4.6 Long-term results 176
4.4.7 Postpartum treatment 179
Appendix 183
Index 185
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