What are the “pelvic floor disorders” that plague middle-aged and older women?

  In life, many middle-aged and older women become incontinent and urinate when they laugh, cough, sneeze, or run. Especially as they age, they often experience discomfort in the lower abdomen, or even a drop in the vulva with a lump falling out. In fact, these symptoms are the clinical manifestations of pelvic floor disorders.  Pelvic floor disease refers to “pelvic floor dysfunctional disease”, including two specific conditions of stress incontinence and pelvic floor organ prolapse. People often think that it is normal to pee your pants when you get older, and that you can’t cure it without treatment, and women who suffer from this disease often suffer in silence for years. Although this type of problem is not fatal, but it seriously affects the quality of life of women, and with the aging of the population, the incidence is increasing year by year. According to statistics, more than half of women in China have experienced pelvic floor disorders.  Clinically, stress urinary incontinence and pelvic floor organ prolapse can be called a pair of “difficult brothers”, statistics show that patients suffering from stress urinary incontinence, the possibility of organ prolapse reached more than 50%; while suffering from organ prolapse, there is a 30% possibility of combined incontinence. This is related to the cause of pelvic floor disease, we can compare the female pelvic floor to a “hammock” composed of muscles, fascia and ligaments, and self-adjustment of tension according to environmental changes, but with age, by pregnancy, childbirth and estrogen decline and many other factors, the hammock support role gradually weakened, to the point of relaxation and collapse. However, as we age, the hammock becomes less supportive due to many factors such as pregnancy, childbirth and the decline of estrogen. The relaxation of the urethral sphincter, damage to the pubourethral ligament, and changes in the angle of the bladder and urethra can lead to frequent and urgent urination and various types of urinary incontinence.  The traditional treatment for pelvic floor organ prolapse is to remove the prolapsed uterus and bulging vaginal wall and repair the damaged fascia with sutures, or to do elective bladder fixation. This procedure not only shortens the length of the vagina by removing the uterus without lesions and is highly traumatic, but the suspended structures are still sutured to the already flaccid pelvic floor structures, resulting in a high recurrence rate.  Recently, with the development of surgical mesh materials, various mesh suspension systems have come into being, and the treatment of pelvic floor disorders has entered a new era of minimally invasive mesh implantation. For stress urinary incontinence, a tiny mesh sling is used to perform mid-urethral suspension, and the procedure takes only ten minutes with a success rate of more than 90%; for patients with pelvic floor organ prolapse, mesh is used to perform pelvic floor reconstruction, which has the advantages of no abdominal opening, little trauma, quick recovery, and less recurrence. This type of surgery has been used for many years in foreign countries and has achieved satisfactory clinical results. For women who suffer from pelvic floor disorders, this is undoubtedly a great boon to improve the quality of life.