Interview on the information event "The pelvic floor in the course of life"
July 15, 2024
5 min
At our last public event on the topic of "The pelvic floor in the course of life", our doctors and therapists summarised the most important information from their presentation and revealed further tips and tricks for dealing with pelvic floor complaints in our latest interview.
How much muscle mass do women lose during the menopause and what are the effects?
Women lose up to 30 per cent of their muscle mass between the ages of 50 and 70. However, the menopause also has other effects on a woman's entire body. For example, there is a general loss of strength, which increases the risk of falling and the body has to work harder to compensate for this incipient weakness. The pelvic floor and its muscles are also affected by the weakening. This leads to reduced stabilisation and poorer muscular closure of the urethra. The organs in the small pelvis also experience less stabilisation as a result and are more likely to descend.
What are the main complaints and associated everyday problems that bring patients to your consultation?
Incontinence when coughing, laughing or sneezing, but also during sport, are common everyday problems that we are contacted about. This often leads to those affected doing less sport and avoiding everyday activities. Another form of incontinence for which we are contacted is urge incontinence and various prolapse symptoms, for example of the bladder, urethra, uterus or rectum. This is accompanied by various symptoms such as residual urine, vaginal pressure, difficult bowel movements, pain or a foreign body sensation.
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Our urogynaecology
Urinary incontinence, which is particularly common in women in the second half of life, often means a reduction in quality of life for those affected. Social and partner contacts are made more difficult by the dysfunction and physical activities become a problem. We carefully clarify the cause of the symptoms and initiate appropriate treatment. Our specialists in urogynaecology have extensive experience in all diagnostic and therapeutic methods for the treatment of urinary incontinence.
How many women are affected by these problems and at what age?
There is no clear answer to this question, as there is a high number of unreported cases. There is still a lot of shame surrounding this issue and older patients in particular think that they simply have to live with these complaints.
What treatment options are available for pelvic floor complaints at Zollikerberg Hospital?
We offer individual physiotherapy at the therapy centre. Ideally, we carry out a vaginal examination in order to accurately assess the muscle activity and tailor the therapy accordingly. If poor perception is the main problem, it is primarily a matter of becoming aware of your own pelvic floor. We have various biofeedback options available for this. With biofeedback, we can visualise the activities of the pelvic floor on a display so that the patient receives direct feedback on the activity of the pelvic floor during the exercises. If patients are unable to consciously control the pelvic floor, there is also the option of tensing the muscle using electrical impulses. To do this, we work with a vaginally or anally inserted probe. Although the feeling of tension is somewhat unfamiliar, it is completely painless. The aim is to feel which muscle is being stimulated and how the tension feels in this area. We can now also offer a functional ultrasound of the pelvic floor, which allows us to visualise muscle activity in a completely different way. We also offer postnatal pessary therapy for incontinence or prolapse problems. Finally, complementary medicine can also be helpful, for example through localised wraps and compresses.
Without surgical intervention
Our pelvic floor therapy at the therapy centre
The pelvic floor plays an important role in various functions such as continence, posture and stability. Our experienced physiotherapists are on hand to provide you with individualised care and support.
What surgical options are there to counteract pelvic floor problems if treatment is not sufficient?
Complete stabilisation of the pelvic floor can be achieved using minimally invasive mesh inserts. The treatment is customised to the patient's individual anatomy and needs, for example in cases of bladder prolapse, uterine prolapse, rectal prolapse or if all three are present at the same time. Men can also be affected by rectal prolapse, which is why they can also be helped with customised therapies.
Do you have any tips and tricks that you can give to someone with pelvic floor problems?
When sneezing or coughing, turn your head upwards and your upper body to the side to reduce the pressure on the pelvic floor. It is also possible that the pelvic floor has too much tension; it can help to consciously relax and breathe into the abdomen. You can recognise that the pelvic floor rises and falls as a result of conscious breathing. We also recommend that new mums start a consistent and targeted postnatal training programme as soon as they have given birth. Ideally with special pessaries. We advise everyone to integrate the pelvic floor exercises recommended by therapists into their daily routine. The advantage is that there is no need to lift heavy weights and you can do something for your pelvic floor anywhere without attracting attention.
Furthermore, pelvic floor complaints are not always due to a weak pelvic floor. Too much tension can also be a reason. You should therefore have a trained specialist check which variant is the case for you. Contact a urogynaecologist at any time if you feel that your quality of life is impaired. Even if your symptoms are not as pronounced as others, your level of suffering is important. If the symptoms are bothering you, this is a good reason to get in touch. We will be happy to look at the options for support together with you.
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