Urinary leakage after childbirth is not entirely the cause of the pelvic floor muscles

1. Damaged connective tissue

The vagina, the levator ani muscle and the surrounding fascia ligaments 產後尿滲 and the front and back bony structures together form the "hammocks"-like structure of the pelvic floor. Under normal circumstances, when the abdominal pressure increases due to coughing, sneezing, etc., the levator ani muscle will contract very quickly, and the surrounding fascia and ligaments will tighten the "hammocks" structure, the urethra will be compressed, and the internal pressure of the urethra will increase. Resist the elevated intra-abdominal pressure, thereby controlling the discharge of urine, and the urine will not overflow; if the "hammocks" structure is destroyed, the levator ani muscle relaxes, the elasticity of ligaments or fascia decreases, and when the abdominal pressure increases, the urethra cannot be closed normally and the urethra cannot be closed normally. Increase resistance and leakage of urine will occur. This is also the mechanism of stress urinary incontinence.

Therefore, when the abdominal pressure increases, the bladder pressure increases. When the pelvic floor muscles, fascia and ligaments need to increase the urethral pressure together, as long as the urethral pressure is greater than the bladder, there will be no urine leakage.

In other words, if there is no problem with the pelvic floor muscles and there is still no leakage of urine, it is possible that the connective tissues such as fascia and ligaments around us may have been damaged, and abnormal pelvic floor screening for fascia and ligaments It is impossible to pass the test result. This kind of development still requires companies to exercise pelvic floor muscles. Strengthening the pelvic floor muscles can compensate for the lack of tension in the fascia and ligaments, making the "hammocks" structural design safer and more stable.

2. Weakened urinary control reflex

Muscle activity is inseparable from the innervation of the Chinese nervous system. Normal users will synchronize the contraction of the pelvic floor muscles before the development of the action of increased abdominal pressure in the enterprise. This teaching technique is called "The Knack", and this neural reflex is called the urinary control reflex. Some people think that through pelvic floor rehabilitation, the "hammocks" support economic structure has returned to normal work, but there is still coughing and leakage of urine. The possible impact is that we cannot synchronize the pelvic floor muscles without coughing. In this social situation, through the training of urinary control reflex, effective management can be achieved to improve the symptoms of urinary leakage. Before coughing, you should contract your pelvic floor muscles before coughing.

3. Hormone deficiency

There are a large number of estrogen receptors and progesterone receptors in the urethral epithelium, urethral sphincter system and urethral sphincter support system. Estrogen can promote the maturation of the urethral epithelium and the formation of blood vessels under the urethra mucosa. With age, hormone levels decrease, the urethral mucosa will shrink, and the blood vessels under the urethral mucosa will become scarce, resulting in weaker urethral closure and reduced urethral tension. Naturally, there is no way to deal with those powerful external forces. .

Therefore, urine leakage occurs when abdominal pressure such as coughing and sneezing suddenly increases. This is like a faucet, even if it is tightened, if the water outside the rubber pad is not sealed, it will leak.

In postmenopausal women, estrogen replacement therapy significantly improves the clinical symptoms of women. In women with premature ovarian failure and early menopause, the incidence of stress urinary incontinence is significantly higher than in women of normal menopausal age.

Fourth, urethral sphincter function defect

The female urethral sphincter is composed of urethral striped sphincter, urethral smooth muscle sphincter and urethral lamina propria. Together they form a complex urethral sphincter, or urethral sphincter system. Defects in the anatomy or function of the urethral sphincter system may also cause stress urinary incontinence.

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