Pubic blowout in middle-aged women is effectively treated with pelvic floor rehabilitation training

(Disclaimer: This article is for general use only, and the information in the following content has been processed to protect patient privacy) Abstract: The patient came to the clinic after resuming sexual life at the end of pregnancy, as she often experienced exhaustion, leading to sexual disharmony. A pelvic floor function assessment was performed to suggest vaginal laxity and pelvic floor dysfunction, and the exhaustion symptoms disappeared after pelvic floor rehabilitation treatment was given in the outpatient clinic. The outcome of this disease depends on the time of the patient’s consultation, so it is important to visit the obstetrics and gynecology department early. The patient reported that her vaginal laxity and pelvic floor dysfunction disappeared and her sexual life satisfaction improved. The patient reported that she had 2 abortions and 2 normal deliveries in the past, and the first delivery went smoothly in May 2014. In October 2021, the patient stopped breastfeeding, and the number of sexual intercourse between husband and wife increased compared with before, but still could not reach orgasm, and vaginal exhaust occurred frequently during sexual intercourse, which made the couple feel embarrassed and affected their relationship, so they went to the hospital for consultation. She was given outpatient treatment for vaginal laxity and pelvic floor dysfunction after outpatient assessment of pelvic floor function. II. Treatment history The outpatient clinic was perfected for pelvic floor function assessment, including pelvic floor 3D ultrasound and pelvic floor function measurement. The ultrasound suggested increased anterior chamber bladder neck mobility, open posterior horn of the vesicourethra, bulging bladder, mild mid-chamber uterine prolapse, and pelvic floor function measurement suggested poor pelvic floor muscle strength and significant fatigue. According to the examination results, the patient currently has pelvic floor dysfunction, specifically including vaginal laxity, bladder bulge, and mild uterine prolapse. This disease is related to the patient’s multiple pregnancies and deliveries, especially emergency deliveries that easily lead to vaginal laxity and uterine prolapse, plus the patient has a history of postpartum bleeding, indicating postpartum weakness, which is not conducive to the recovery of pelvic floor tissues and organs after delivery, and leads to the patient’s vaginal laxity and vaginal emptiness The patient was advised to undergo pelvic floor rehabilitation treatment, and the patient expressed her understanding and agreed to the treatment. Subsequently, the patient was arranged to undergo a course of 12 sessions of electrical stimulation and biofeedback therapy in the outpatient clinic, twice a week, plus daily vaginal dumbbell exercises, but the treatment should be suspended during menstruation. After the patient completed the first course of treatment, she was rechecked with 3D pelvic floor ultrasound and pelvic floor function measurement, and all data were improved compared with those before treatment. Due to the patient’s multiple pregnancies and deliveries and her failure to undergo pelvic floor rehabilitation treatment 42 days after delivery, the patient did not achieve satisfactory results after one course of treatment, and was advised to continue the second course of treatment. After the patient felt the effect of the first course of treatment, she was confident and insisted on completing the second course of treatment. The second course of electrical stimulation and biofeedback therapy was given 10 times, twice a week, together with daily vaginal dumbbell exercises. Precautions 1. We are glad that the patient’s symptoms of pubic blowing were relieved after the treatment. However, after treatment, patients should avoid lifting heavy objects and doing strenuous exercises, especially those using abdominal pressure, and avoid prolonged child holding, long-term coughing and constipation, otherwise recurrence may still occur after treatment; 2. After treatment, patients are advised to pay attention to strengthening nutrition and actively replenishing blood to correct anemia; 3. In order to consolidate the treatment effect, patients can insist on pelvic floor muscle exercises at home, such as anal lifting and pubic reduction exercises In order to consolidate the treatment effect, patients can insist on pelvic floor muscle exercises at home, such as anal lift and pubic reduction exercises, gluteal bridge training, etc. It is recommended to practice for 15 minutes every day, and the effect of continuous exercise is better; 4, in addition to sex, there are many ways to enhance the relationship between husband and wife. V. Personal insight Women with impaired pelvic floor function are prone to pubic blowing, pelvic organ prolapse, urinary leakage and sexual disharmony, and pregnancy and childbirth are the most common causes of impaired pelvic floor function in women. The key period for pelvic floor function recovery is from 42 days to 1 year after delivery, so you must go to the hospital as soon as possible after delivery to improve the pelvic floor function assessment. For lighter damage, you can insist on daily pelvic floor muscle exercises at home, such as Kegel training, anal lifting exercises and pubic reduction exercises, which can effectively improve pelvic floor muscle function. For people with more serious injuries like this case, they should go to the hospital as soon as possible to undergo pelvic floor rehabilitation therapy under the guidance of a doctor.