TOEven if the Princess of Wales’ abdominal surgery remains shrouded in mystery, what is known is that during her convalescence she is followed by various professionals also to undergo the pelvic floor rehabilitation. THEL Mirror he anticipated that Kate Middleton he will be under the careful supervision of the royal doctors and will also benefit from the aftercare of the London Cliniccenter of excellence for personalized care.
But what is pelvic floor rehabilitation? In which cases is it indicated, what does it consist of, who does it and what benefits it brings. We talked about it with two experts, la gynecologist Raffaela Di Pace and themidwife Fabiana Toneatto dell’Konenki Association.
Pelvic floor rehabilitation: when is it necessary?
«Among the various hypotheses, Kate Middleton could have undergone a hysterectomy because she had fibroids or in any case a benign pathology», explains the Doctor Raffaela Di Pace, gynecologist, PhD in Physiopathology of Menopause and sexologist consultant, founder ofKonenki Association.
After hysterectomy
«After an intervention of this type it is always the case of do a pelvic floor assessment, because by removing the uterus the spaces and dimensions in the pelvis are modified. In fact, the uterus, being positioned in the center and supported by ligaments, is somewhat of the center of support for the pelvic floor. When removed it can be beneficial prolapse problems you hate relaxation of the vaginal walls”, explains the gynecologist. «This is especially true for those women who already before the hysterectomy had problems with laxity of the vaginal walls, often due to multiple births. Especially if the babies had high birth weight. Or it happens in women with their own characteristics of laxity, prolapse or if they are overweight.”
In the postpartum
«Pelvic floor rehabilitation finds indications at different moments of the woman’s life. Surely in the post partumeven if you have undergone a cesarean section since it is the pregnancy one of the first risk factors on the pelvic muscles”explains Doctor Toneatto.
In menopause
«Menopause often requires evaluation and treatment of the pelvic floor as the Hormonal deficiency causes a weakening of the pelvic muscles. And this sometimes also causes symptoms that can be traced back to‘urinary incontinence. There are also pre- and post-surgical protocols»explains the midwife.
Why do rehabilitation after abdominal surgery?
«It is only useful if gynecological surgery has been performed, since surgery can in some cases reduce the woman’s proprioception in controlling the pelvic floor muscles», explains the Doctor. Fabiana Toneatto, midwife. «Furthermore, if the uterus is removed, part of the suspension system provided by the bands and ligaments that anchor the uterus to the pelvic girdle is missing. In this case it is essential to strengthen the so-called support system – i.e. the pelvic floor – with specific exercises and manipulations”, explains the midwife.
What is pelvic static assessment
«It is useful to do an evaluation of the pelvic floor for see if what is called “pelvic static”, i.e. the balance and suspension of the pelvic organs and the vaginal wall, remains adequate even after the removal of the uterus and once any problems have been identified”, continues the gynecologist.
Pelvic floor assessment: a little followed practice in Italy
«The evaluation must however be carried out in all those situations in which risk factors for the patient’s pelvic health are identified. In Italy this type of evaluation is still uncommon, while in other European countries this type of evaluation is much more frequent”, adds gynecologist Di Pace.
How pelvic floor rehabilitation is carried out
«The pelvic floor rehabilitation session involves first of all teaching the woman how to so-called awareness. You have to help her understand where the pelvic floor muscles are And how does it work.
Later they teach kinesiotherapy exercises designed to strengthen or, in case of hypertonicity, to relax, the aforementioned muscles. Kinesitherapy involves stages of increasing difficulty in order to arrive at the so-called automation that is, to the fact that the woman alone can practice at different times of the day.
Furthermore, you can use electromedical equipment such as TENS or electrostimulation depending on the disorder, as auxiliary methods for strengthening and the possibility of muscle recovery”, adds Doctor Toneatto.
Who is the pelvic floor specialist?
«They deal with pelvic floor rehabilitation different professional figures: the midwife, the physiotherapist, the osteopath. Each with their own professional peculiarities. As regards the midwives there is a professional association with a database where you can search for midwives who have a specialization in this sense or have obtained a master’s degree”.
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