Pelvic Floor Dysfunction And Pelvic Surgery In The Elderly

This text provides a comprehensive, state of the art review of this field and will serve as a resource for urologists, colorectal surgeons, geriatricians, and gynecologists as well as researchers interested in neuromuscular phenomena in the pelvis. The book also reviews new data regarding risk factors for pelvic floor muscle dysfunction and profiles new minimally invasive surgical strategies for well known pelvic disease processes. Each chapter is chock full of data from landmark trials which have been published over the past few years and placed in context with respect to current management techniques for pelvic floor disorders. Written by experts in their field, Pelvic Floor Dysfunction and Pelvic Surgery in the Elderly: An Integrated Approach provides a concise yet comprehensive summary to help guide patient management.​

This 2nd revised edition covers management and treatment of bladder and bowel dysfunctions in men and women, pelvic organ prolapse, issues concerning the elderly, neurologically impaired patients and those with pelvic pain. New chapters cover quality of life, treatment of bladder and bowel dysfunction in children, the history of pelvic floor muscle exercise and manual therapy. The use of real-time ultrasound to evaluate pelvic floor muscle contractility is discussed, and a new section covers ethical issues in the management of incontinence. This is a useful reference and practical guide for health professionals dealing with incontinence and pelvic floor disorders.

This 2nd revised edition covers management and treatment of bladder and bowel dysfunctions in men and women, pelvic organ prolapse, issues concerning the elderly, neurologically impaired patients and those with pelvic pain. New chapters cover quality of life, treatment of bladder and bowel dysfunction in children, the history of pelvic floor muscle exercise and manual therapy. The use of real-time ultrasound to evaluate pelvic floor muscle contractility is discussed, and a new section covers ethical issues in the management of incontinence. This is a useful reference and practical guide for health professionals dealing with incontinence and pelvic floor disorders.

"Regain control and embrace a life free from pelvic floor disorders." Discover the secrets to pelvic floor health and recovery with "Pelvic Floor Disorders: A Woman's Guide to Pelvic Floor Health and Recovery." This comprehensive guide dives deep into the world of pelvic floor disorders, helping women understand, diagnose, and treat the various conditions that can impact their daily lives. In the introduction, you'll learn about the importance of pelvic floor health and its functions. Then, explore the anatomy of the pelvic floor and the factors that contribute to dysfunction. The book delves into common pelvic floor disorders, including urinary incontinence, fecal incontinence, pelvic organ prolapse, pain during intercourse, and many more. Understand the causes of pelvic floor disorders, from pregnancy and childbirth to aging, obesity, and menopause. You'll also learn about diagnosis methods, such as pelvic exams, ultrasounds, X-rays, and MRI scans. The book discusses various treatment options, including pelvic floor exercises, biofeedback, electrical stimulation, medications, and surgery. Strengthen your pelvic floor with detailed exercises like Kegels, squats, bridges, lunges, and planks. Find out how to improve your pelvic health with diet and lifestyle changes, such as staying hydrated, maintaining a high-fiber diet, and avoiding irritants like caffeine and alcohol. Gain valuable insight into strategies for coping with pelvic floor disorders, including physical therapy, support groups, and mental health counseling. Learn about the prognosis and emotional impact of pelvic floor disorders, as well as effective coping strategies for patients and caregivers. Explore the role of diet and stress in pelvic floor disorders, and understand the risks and complications associated with untreated conditions. The book concludes with a section on living with a pelvic floor disorder, providing answers to frequently asked questions and guidance for managing daily life. "Pelvic Floor Disorders: A Woman's Guide to Pelvic Floor Health and Recovery" offers essential knowledge and support for those suffering from pelvic floor disorders. Empower yourself with this invaluable resource and begin your journey to better pelvic health today. Table Of Contents Introduction To The Pelvic Floor What Is A Pelvic Floor? Importance Of Pelvic Floor Health Functions Of The Pelvic Floor The Anatomy Of The Pelvic Floor The Causes Of Pelvic Floor Dysfunction Common Pelvic Floor Disorders Urinary Incontinence Fecal Incontinence Pelvic Organ Prolapse Pain During Intercourse Pain In The Pelvic Area Urinary Urgency And Frequency Constipation Other Disorders Causes Of Pelvic Floor Disorders Pregnancy And Childbirth Aging Obesity Menopause Hysterectomy Chronic Coughing Heavy Lifting High-Impact Exercises Genetics Diagnosis Of Pelvic Floor Disorders Pelvic Exam Ultrasound X-Rays Mri Urodynamics Testing Treatment Options For Pelvic Floor Disorders Pelvic Floor Exercises (Kegels) Biofeedback Electrical Stimulation Medications Surgery Exercises To Strengthen The Pelvic Floor Kegel Exercises Kegel Balls Squats Bridges Lunges Planks Diet And Lifestyle Changes For Pelvic Floor Health Hydration High-Fiber Diet Avoiding Irritants (Caffeine, Alcohol, Acidic Foods) Maintaining A Healthy Weight Avoiding Constipation Strategies For Coping With Pelvic Floor Disorders Pelvic Floor Physical Therapy Support Groups Mental Health Counselling What Is The Prognosis For Pelvic Floor Disorder Coping With A Pelvic Floor Disorder Emotional Impact Of A Disorder Pelvic Floor Coping Strategies For Patients And Caregivers The Role Of Diet In Pelvic Floor Disorders The Role Of Stress In Pelvic Floor Disorders What Are The Risks And Complications Associated With A Pelvic Floor Disorder What Happens If You Don’T Fix Your Pelvic Floor? Living With A Pelvic Floor Disorder Frequently Asked Questions. What Causes A Weak Pelvic Floor? How Do You Fix A Weak Pelvic Floor? How Do You Know If Your Pelvic Floor Is Strong? How Do I Know If My Pelvic Floor Is Weak? How Can I Tell If My Pelvic Floor Is Weak Or Tight? How Long Does It Take To Strengthen Pelvic Floor? Are Squats Good For Pelvic Floor? How Does A Physio Check Pelvic Floor? Is It Too Late To Fix My Pelvic Floor? How Many Times A Day Should You Do Pelvic Floor? How Should I Sit To Strengthen My Pelvic Floor? What Activities Strengthen Pelvic Floor? How Can I Strengthen My Pelvic Floor Without Kegels? What Does A Prolapse Feel Like Inside? Is It Normal To Pee Every 2 Hours? Does Sitting On The Toilet Weaken Pelvic Floor Muscles? Do Pelvic Floor Exercises Make You Poop? What Should I Expect At My First Pelvic Floor Physio? How Painful Is Pelvic Floor Therapy? Is Pelvic Floor Physio Worth It? Can You Strengthen Your Pelvic Floor After 50? What Organs Form The Pelvic Diaphragm? What Is The Difference Between Diaphragm And Pelvic Diaphragm? What Are The Two Parts Of The Pelvic Diaphragm? How Do You Release The Pelvic Diaphragm? Does Walking Strengthen Pelvic Floor Muscles? What Is The Pelvic Diaphragm Also Known As? What Are The Symptoms Of A Damaged Diaphragm? What Weakens Pelvic Floor Muscles? What Is The Best Sleeping Position For Tight Pelvic Floor? What Does A Tight Pelvic Floor Feel Like? Does Walking Relax The Pelvic Floor? Is It Ever Too Late To Start Pelvic Floor Exercises? What Is The Best Position To Do Pelvic Floor Exercises? What Are The 4 Diaphragms Of The Body? Can You Repair A Damaged Diaphragm? What Does Diaphragm Pain Feel Like? What Causes Diaphragm Problems? Does Diaphragm Weaken With Age? What Kind Of Doctor Treats The Diaphragm? What Happens If Your Diaphragm Is Weak? Can Poor Posture Affect Your Diaphragm? What Causes Weak Pelvic Floor? How Long Does It Take To Strengthen Your Pelvic Floor? What Does A Weak Pelvic Floor Feel Like? How Do You Know If Your Pelvic Floor Is Weak? Can You Reverse A Weak Pelvic Floor? How Common Is Weak Pelvic Floor? What Does A Strong Pelvic Floor Feel Like? How Do You Test If You Have A Strong Pelvic Floor? Should I Go To The Doctor For Weak Pelvic Floor? What Exercises Strengthen Your Pelvic Floor? What Does A Pelvic Floor Physiotherapist Do? How Long Does It Take To Restore Your Pelvic Floor? Does Lifting Weights Tighten Pelvic Floor? Does Weak Pelvic Floor Cause Weak Glutes? How Do You Tell If Your Bladder Has Fallen? What Are The Most Common Pelvic Floor Disorders? How Can I Strengthen My Pelvic Floor Naturally? Can You Fix Pelvic Floor Dysfunction At Home? When Should You See A Pelvic Floor Physiotherapist? What Is Done During Pelvic Floor Therapy? Can Squats Damage Your Pelvic Floor? How Does Doctor Check For Pelvic Floor Dysfunction? How Do You Massage Your Pelvic Floor Internally? Can A Gynecologist Treat Pelvic Floor Dysfunction? When Is It Too Late For Kegels? How Do You Fix Pelvic Floor Dysfunction? What Triggers Pelvic Floor Dysfunction? What Does Pelvic Floor Pain Feel Like? Where Do You Feel Pelvic Floor Dysfunction? Does Pelvic Floor Dysfunction Ever Go Away? How Do You Test For Pelvic Floor Dysfunction? Can You Reverse Pelvic Floor Dysfunction? What To Avoid With Pelvic Floor Dysfunction? How Common Is Pelvic Floor Dysfunction? How Long Does It Take To Fix Weak Pelvic Floor? Is Walking Good For Tight Pelvic Floor? How Painful Can Pelvic Floor Dysfunction Be? What Medication Is Used For Pelvic Floor Dysfunction? What Exercises Weaken Pelvic Floor? Can Stress And Anxiety Cause Pelvic Floor Dysfunction? Does Drinking Water Help With Pelvic Floor? What Age Does Pelvic Floor Dysfunction Occur? What Does Pelvic Floor Physiotherapy Include? What Is The Best Sleeping Position For Pelvic Floor? What Is The Best Sleeping Position To Relax Pelvic Floor? What Position Should I Sleep In For Pelvic Pain? Can Pelvic Floor Dysfunction Happen Suddenly? Does Pelvic Floor Dysfunction Make You Tired? Can Pelvic Floor Dysfunction Be Hormonal? What Is The Best Vitamin For Pelvic Floor? What Supplements Help Tight Pelvic Floor? Do You Have To Undress For Pelvic Floor Therapy? Do I Need To Shave For Pelvic Floor Physical Therapy? What Is A Pelvic Floor Massage? Is Pelvic Floor Physical Therapy Embarrassing? How Do You Fix Pelvic Organ Prolapse? How Serious Is Pelvic Organ Prolapse? What Is The Most Common Cause Of Pelvic Organ Prolapse? How Do I Check Myself For Pelvic Organ Prolapse? Can I Push My Pelvic Prolapse Back Up? Can You Push A Prolapse Back Into Place? What Happens If You Don't Fix A Prolapse? At What Age Does Pelvic Organ Prolapse Occur? How Do You Know If Your Pelvic Floor Has Dropped? Can You Naturally Fix A Pelvic Prolapse? Will Walking Make Prolapse Worse? Can You Fix A Pelvic Prolapse Without Surgery? How Common Is Vaginal Prolapse? What Does Vaginal Prolapse Feel Like? Can You Feel A Uterine Prolapse With Your Finger? Is Walking Good For Prolapse? Can A Tampon Help Prolapse? Can You Be Intimate With A Prolapse? Can A Prolapse Burst? How Do You Get Rid Of A Prolapse Without Surgery? How Do I Know If My Prolapse Is Severe? What Is A Stage 3 Prolapse? What Causes A Vaginal Prolapse? Does A Prolapse Happen Suddenly? At What Stage Of Prolapse Require Surgery? What Can Be Mistaken For Prolapse? What Is The Most Common Organ To Prolapse? Are Squats Good For Prolapse? What Is The Best Sleeping Position For Pelvic Organ Prolapse? What Are 4 Types Of Urinary Incontinence? How Do You Fix Urinary Incontinence? What Are 3 Treatment Options For Incontinence? Does Urinary Incontinence Go Away? What Triggers Incontinence? What Are The First Signs Of Incontinence? Will Drinking More Water Help With Urinary Incontinence? What Is A Good Home Remedy For Incontinence? What Is The Most Effective Treatment For Incontinence? What Can A Gp Do For Incontinence? How Do Doctors Treat Incontinence? What Vitamin Helps With Bladder Control? What Is Average Age Of Incontinence Start? What Happens If Incontinence Is Left Untreated? When Should I See A Doctor About Incontinence? Why Can't I Hold My Pee All Of A Sudden As A Woman? Is Incontinence A Symptom Of Stress? Can Incontinence Be Repaired? What Makes Incontinence Worse? What Not To Drink When You Have Incontinence? Which Medications Cause Incontinence? How Long Does Incontinence Last? Does Incontinence Get Worse With Age? What Is The First Line Of Treatment For Urinary Incontinence? Does Magnesium Help With Incontinence? What Drinks Are Good For Your Bladder? What Is The Best Sleeping Position For Overactive Bladder? Can You Be Incontinent And Not Know It? How Do They Fix Female Urinary Incontinence? Should I Be Worried If I Can't Hold My Pee? How Do You Fix Bowel Incontinence? What Causes Bowel Incontinence? What Are The 4 Types Of Bowel Incontinence? How Do You Stop Bowel Incontinence Naturally? When Should I Be Concerned About Bowel Incontinence? Is Bowel Incontinence Life Threatening? Can Faecal Incontinence Be Cured? Why Do I Constantly Wipe After Bowel Movement? What Is It Called When You Can T Control Your Bowel Movements? How Common Is Bowel Leakage? How Do I Tighten My Sphincter Muscle? What Foods Can Cause Bowel Incontinence? How Can I Prevent Bowel Incontinence In Old Age? Is Bowel Incontinence A Normal Part Of Aging? What Cancers Cause Bowel Incontinence? How Do You Know If You Have Bowel Incontinence? Why Do I Get Skid Marks No Matter How Much I Wipe? How Far Should You Wipe After Pooping? How Long Should You Wipe After Pooping? What Are The Best Pads For Faecal Incontinence? What Kind Of Doctor Do You See For Bowel Incontinence? How Do You Know If Your Sphincter Is Damaged? Can A Loose Sphincter Muscle Be Repaired? What Are The Symptoms Of A Weak Sphincter Muscle? Is Bowel Incontinence Psychological? 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This volume builds on the success of the first edition of Imaging Pelvic Floor Disorders and is aimed at those practitioners with an interest in the imaging, diagnosis and treatment of pelvic floor dysfunction. Concise textual information from acknowledged experts is complemented by high-quality diagrams and images to provide a thorough update of this rapidly evolving field. Introductory chapters fully elucidate the anatomical basis underlying disorders of the pelvic floor. State of the art imaging techniques and their application in pelvic floor dysfunction are then discussed in detail. Additions since the first edition include consideration of the effect of aging and new chapters on perineal ultrasound, functional MRI and MRI of the levator muscles. The closing sections of the book describe the modern clinical management of pelvic floor dysfunction, including prolapse, urinary and faecal incontinence and constipation, with specific emphasis on the integration of diagnostic and treatment algorithms.

Pelvic floor disorders are a very important subject in public health, with a major impact on quality of life. In USA for instance, epidemiology data indicate that between 11 and 19% of women may suffer at least one such surgical procedure. This field is in continuous change and there is not a consensus yet in therapeutic approach. This book provides a general overview on the pelvic pathology, concentrating on clinical aspects – diagnostic, physiopathology and treatment. Worldwide known authors have been gathered in order to present a high scientific reference. The most important thing in this book is that it offers a systematic approach on surgical techniques. Most of them are described by the surgeons who invented them and the aim of this book is to provide a strong basis for young doctors who want to operate in this field. Clinicians encounter obstacles in correctly diagnosing some patients. The physiopathology is sometimes not so obvious and except for a few surgical techniques that are accepted as golden-standards, the rest are still in debate. This book offers a unitary view in this field. It provides an algorithm diagnostic based on Integral Theory System by Peter Petros and also extensive therapeutic solutions. Key features: this book offers a comprehensive overview on pelvic floor disorders; it approaches some strongly debated issues; it proposes some new clinical entities such as “posterior vaginal fornix syndrome” the book is easy-to-read for young doctors who do not have a great experience in this field. surgical techniques are presented in a step-by-step manner, highly illustrated; many of those techniques are described by their inventors The book is divided in 10 chapters, trying to offer a comprehensive view in this field. 1. General considerations In the first chapter there is a short review regarding the importance of this topic. 2. Evolution of “Pelvic floor disorder” concept Pelvic floor disorders include a wide variety of perineal affections that seem to have, as a common denominator, an acquired laxity of the musculoskeletal system, which makes up the pelvic floor. This concept is new and it tries to comprise all the anatomoclinical entities in a standardized way, to facilitate, on one side, the description of the lesions and on the other, to favor scientific communication. 3. Classical anatomy of perineum Broadly, the perineum is anatomically made up of all the soft parts, which caudally define the pelvic excavation. These are represented by fascias, muscles, vessels and nerves, and are crossed by ducts of the urogenital and digestive systems, structures that offer a complex biomechanics, whose understanding is indispensable in a judicial therapeutic approach. 4. Perineal physiology and physiopathology Prof. Peter Papa Petros in collaboration with Prof. Ulf Ulmsten from the University in Uppsala have set the theoretical bases of “Integral Theory System”. As the name suggests, the “Integral Theory System” creates a dynamic and interconnected anatomical background to understand the function and dysfunction of perineum. The “Integral Theory System” defines the pelvic floor as a syncytial system, based on vector equilibrium in which muscles and connective tissue take part and which has a nervous component. The newly formed system represents the sum of all the elements involved. Among them, the connective tissue is the most vulnerable. 5. Clinical and paraclinical diagnosis of pelvic floor disorders Diagnosis of perineal affections, though easy at first sight, implies some subtleties. According to the principles of the Integral Theory System and respecting a principle stated by Mircea Eliade that “there are no illnesses, but only ill people”, each case must be evaluated according to the symptoms that bring the patient to the doctor and these should be correlated with the clinical signs observed during the examination. 6. Conservative treatment of pelvic floor disorders Conservative treatment of pelvic floor disorders practically overlaps the conservative treatment of effort urinary incontinence. Broadly, it also addresses other urinary disorders that can benefit more or less efficiently from conservative therapy. In this chapter following, we will focus on the treatment of effort urinary incontinence. 7. Surgical treatment of pelvic floor disorders The treatment of pelvic floor disorders implies a careful prior assessment. Selection of cases with surgical indication is sometimes problematic, in terms of both postoperative results and comorbidities. Young female patients with minimal anatomical defects and whose symptoms are not very noisy, who eventually want more children, can benefit from conservative treatment. Moreover, alternative treatment options must be sought for elderly patients, who have been treated and in whom surgery is contraindicated. Regardless of the outcome of the objective examination, the most important element is the patient’s perception of her own suffering and consequently the extent to which her quality of life is affected. Surgical treatment should be applied when there is a sufficient degree of morbidity. Complementary measures, such as the treatment of chronic associated diseases, weight loss, smoking cessation, and local estrogen treatment can be considered both conservative treatment and preoperative preparation. 8. Postoperatory complications It is widely accepted that no surgical technique lacks complications and therefore the same can be affirmed about the pelvic floor disorders surgical corrections. We can distinguish two major categories of complications, regardless of the approach: complications related to synthetic materials used and complications regarding the surgical technique used. There are a number of complications whose aetiology is unclear and which are presented in the form of symptoms difficult to classify. A last distinct category, called syndrome of vaginal tightness, will be treated separately, having a specific etiology and pathophysiology. 9. 20th century perspectives The direction in which perineal surgery will develop is hard to predict. In the last ten years, the surgery of uterine prolapse and effort urinary incontinence has seen an important boost. This textbook is trying to open new windows to the future. 10. Bibliography

Bridging the gap between evidence-based research and clinical practice, Physical Therapy for the Pelvic Floor has become an invaluable resource to practitioners treating patients with disorders of the pelvic floor. The second edition is now presented in a full colour, hardback format, encompassing the wealth of new research in this area which has emerged in recent years. Kari Bø and her team focus on the evidence, from basic studies (theories or rationales for treatment) and RCTs (appraisal of effectiveness) to the implications of these for clinical practice, while also covering pelvic floor dysfunction in specific groups, including men, children, elite athletes, the elderly, pregnant women and those with neurological diseases. Crucially, recommendations on how to start, continue and progress treatment are also given with detailed treatment strategies around pelvic floor muscle training, biofeedback and electrical stimulation. aligns scientific research with clinical practice detailed treatment strategies innovative practice guidelines supported by a sound evidence base colour illustrations of pelvic floor anatomy and related neuroanatomy/ neurophysiology MRIs and ultrasounds showing normal and dysfunctional pelvic floor

The remarkably complex pelvic floor and its disorders comprise one of the most interesting -- and challenging -- areas of physical therapy. And recently, common problems once considered taboo, such as incontinence, have become mainstream issues. More than ever before, a solid understanding of the structure and function of the manifold problems of the pelvic floor is vital to successful treatment. This groundbreaking work brings together an international team of world-renowned experts in the treatment of urinary and fecal incontinence, as well as sexual dysfunction, to provide a comprehensive guide to the structure and function of the muscles of the pelvic floor. Using concise text and clear illustrations and helpful photographs, the authors present all phenomena associated with pelvic floor dysfunction. The authors begin with a detailed overview of the anatomy and physiology of the pelvic floor, and then discuss all state-of-the-art diagnostic and treatment strategies, from biofeedback and manual therapy to the causes of different types of pain and psychosocial problems. Detailed discussions of the specific issues associated with children, women, and men, as well as with rectal and anal dysfunction, follow. With its thorough coverage, this highly practical text is essential reading for all health care professionals who wish to provide their patients suffering from disorders of the pelvic floor with the best care available.