With the aging of the society’s population, female pelvic floor dysfunctional disease (PFD) has become a common disease among middle-aged and older women. Although not a fatal disease, it seriously affects women’s health and quality of life, especially hindering their work and social activities. Some epidemiological surveys show that about half of women over 50 years of age are affected by the disease, and 11%-19% of them eventually require surgery, so what is PFD? Why does PFD occur? How can it be treated and prevented? Female pelvic floor dysfunctional disorders (PFD), also known as pelvic floor defects, or pelvic floor support tissue laxity, primarily include stress urinary incontinence and pelvic organ prolapse. Urinary incontinence (UI) is mainly divided into stress urinary incontinence (SUI), urge urinary incontinence (UUI), and mixed urinary incontinence (MUI). Stress urinary incontinence is a state in which involuntary flow of urine occurs when abdominal pressure increases (e.g., coughing, sneezing, laughing, exercising, etc.). Pelvic organ prolapse (POP) includes anterior vaginal wall prolapse, uterine prolapse, vaginal vault prolapse, posterior vaginal wall prolapse, and rectal prolapse. The main causes of pelvic floor dysfunction include: ① Pregnancy and childbirth: the gradually enlarging uterus during pregnancy can strain and weaken the supporting structures of the pelvic floor (including pelvic fascial ligaments and muscles), and the vaginal delivery process, especially difficult deliveries with forceps or fetal suction, can also damage the pelvic floor tissues by excessive strain. Premature participation in heavy physical labor after childbirth can also affect the recovery of pelvic floor tissue tone. ②Long-term increase in abdominal pressure: chronic cough, long-term constipation, frequent weight lifting, abdominal obesity, etc. can cause increased pressure in the abdominal cavity, resulting in pelvic floor dysfunction. (③) Ageing: the atrophy of pelvic floor support structures with age, especially after menopause, can also cause pelvic floor dysfunction. Treatment of pelvic floor dysfunction includes conservative treatment and surgical treatment. Conservative treatments include: pelvic floor muscle exercise (PFME), also known as Kegel exercise. The method consists of doing tightening of the anus for 5-10 seconds at a time, followed by relaxation for 5-10 seconds. Do it continuously for 15-30 minutes and perform it 2-3 times a day; or do PFME 150-200 times a day for 6-8 weeks as a course of treatment. Pelvic floor muscle training needs to be balanced with intensity, duration and repetitiveness. The use of Kegal training method can strengthen the pelvic floor muscles and reduce the occurrence of urinary incontinence and pelvic organ prolapse. It can be used not only for the treatment of mild pelvic floor organ disorders, but also for the prevention of pelvic floor organ disorders. It is simple and easy to perform in daily life and is suitable for a wide range of women, and the training is valuable for persistence. If you have the conditions, you can go to the hospital for biofeedback technology, electrical stimulation and other treatments, which can improve the therapeutic effect of pelvic floor rehabilitation treatment. Pelvic floor biofeedback therapy Biofeedback therapy converts information about muscle activity into auditory and visual signals through electromyography, pressure curves or other forms of feedback to patients, guiding them to perform correct and autonomous pelvic floor muscle training and forming conditioned reflexes. It effectively controls poor pelvic floor muscle contractions and improves and corrects this contractile activity. Electrical stimulation of the pelvic floor muscles Electrical stimulation increases neuromuscular excitability, awakens some of the nerve cells whose function has been suspended due to pressure, and promotes the recovery of nerve cell function. Electrical stimulation is performed by stimulating the contraction of the external urethral sphincter, which further enhances the contraction of the sphincter through the nerve circuit and strengthens urinary control and storage. Electrical stimulation therapy is an active means of promoting nerve function recovery after surgery and can passively exercise muscle strength, prevent muscle atrophy and restore nerve function. Before using a uterine support, one should go to the obstetrics and gynecology department of the hospital for an examination to exclude contraindications to upper support such as severe prolapse, vaginal inflammation, and suspected malignant lesions. The surgical route includes transvaginal, transabdominal and laparoscopic, etc. At present, the minimally invasive methods of negative or combined laparoscopy are generally used, and transabdominal has been used rarely. The traditional surgical treatment is mainly anterior and posterior vaginal wall repair and cathartic hysterectomy, which have significant effect in the near future, but have a certain recurrence rate in the long term. In recent years, with the introduction and understanding of the “holistic theory” of the pelvic floor, new concepts have been developed in the repair and reconstruction of the pelvic floor function, and the surgery has been developed in the minimally invasive aspects such as maintenance of anatomy or repair of defects, structural reconstruction and application of substitutes. Surgery requires specialist physicians to divide the unit by anterior, middle and posterior pelvic cavity and make adequate preoperative arguments for the choice of surgical approach: anterior pelvic reconstruction includes transvaginal paravaginal reconstruction, anterior vaginal wall repair with patch, repair with patch has higher cure rate and less postoperative recurrence than simple repair, but there is risk of mesh erosion and postoperative pain. Posterior pubic vesicourethral suspension and TVT are the gold standard for the treatment of stress urinary incontinence, with a success rate of approximately 90%. Mid-pelvic reconstruction includes sacrovaginal fixation: this procedure uses either a “Y”-shaped self-fascia or a synthetic polypropylene patch that is sewn to the anterior and posterior walls of the vaginal apex and to the anterior longitudinal ligament of sacrum 1 or sacrum 2 at the other end. Laparoscopic surgery makes it easier to separate and expose the vaginal rectal septum, the pararectal space and the anal levator muscle of the pelvic floor. A meta-analysis also shows a subjective cure rate of about 80% and an objective cure rate of 85% to 97.7%. The latter is suitable for patients with uterine prolapse and laxity of the main and sacral ligaments. It has the advantages of minimally invasive, maintaining the normal anatomical axis of the vagina, preserving the function of the vagina, restoring satisfactory sexual life and an overall cure rate of about 80%. There is also vaginal closure: vaginal closure is suitable for elderly women who are frail and have more internal diseases and no sexual life requirements, and it meets the requirements of simplicity, safety, effectiveness, economy, quick recovery and no recurrence. Posterior pelvic reconstruction: Posterior pelvic defects are mainly defects of the perineal body and rectal bulge, and the surgical methods include “bridge” repair of the posterior vaginal wall and posterior vaginal wall repair with mesh. For example, in patients with anterior, middle and posterior pelvic prolapse, total pelvic floor repair is the ideal option. Urinary incontinence requires urodynamic testing to understand the type of incontinence. Depending on the type, the specific treatment will be decided. Mild cases of stress incontinence can be treated with anal lifting exercises and biofeedback spot stimulation, while those with significant symptoms often require surgery. In daily life, prevention of pelvic floor dysfunction is even more important for women. They should follow the doctor’s advice during childbirth, not to overexert themselves too early, not to engage in heavy physical activities too early after childbirth, actively exercise the pelvic floor muscles after childbirth to promote recovery of pelvic floor function, actively prevent and treat constipation, cough and other diseases that increase abdominal pressure, and avoid heavy physical strength, weight lifting and other activities.