Pelvic Floor Relaxation or Animus(uterovaginal prolapse )
Introduction : Up to half of the normal female population will developed uterovaginal prolapse or (PFR) during their lifetime. Twenty percent of these women will be symptomatic and need treatment. As the population of the world continues to increase in age, the prevalence of pelvic floor dysfunction is likely to increase.
Definition•"Absence of normal relaxation of pelvic floor muscles duringdefecation, resulting in rectal outlet obstruction".•"Malfunction (a focal dystonia) of the external analsphincter and puborectalis muscle during defecation".• failure of [the external anal sphincter and puborectalis]muscle[s] to relax, resulting in maintenance of the anorectalangle and the difficulty with initiating and completing bowelmovements".• failure of relaxation (or paradoxic contraction) of thepuborectalis muscle sling during defaecation, attempteddefaecation or straining.
factors have a significant influence onpelvic floor support:1.CONGENITAL.2.AGE3.CHILDBIRTH INJURY.4.ENDOCRINE.
•Congenital differences in collagen behaviour are clinicallyevident in women who have increased joint elasticity.•Age :The fascia of the pelvic floor will provide weakersupport with advancing years.•Childrenbirth:Most women recognize that their pelvic flooris different after vaginal delivery.•Endocrine: The menstrual cycle, pregnancy and themenopause are the most significant endocrine events whichmay influence pelvic floor fascia. be secondary to higherprogesterone levels increasing fascial elasticity.
Symptoms:•Straining to pass fecal material•Tenesmus (a feeling of incomplete evacuation)•Feeling of anorectal obstruction/blockage•Digital maneuvers needed to aid defecation•Difficulty initiating and completing bowelmovements
Classification:Type I: paradoxical contraction of the pelvic floor musclesduring attempted defecation Dislocation of the urethra—theurethra is displaceddownwards and backwards off the pubis. It may be alsodilated becoming an urethrocoele•Type II: inadequate propulsive forces during attempteddefecation (inadequate defecatory propulsion) Cystocoele—hernia of the bladder trigone•Type III: impaired relaxation with adequate propulsionUterine prolapse—descent of the uterus and cervix.
Type III: 3rd degree vaginalprolapse (procidentia)
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Presented by : Ali Fakih Fatima Ra7al Presented to :S.F. Lina AmroThe ppt found in www.slideshare.net