Treatment of prolapse of the uterus at home
In the middle of the last century, the famous gynecologist from the USA A. Kegel proposed a simulator for effective recovery of the muscles of the perineum in women with postpartum urinary incontinence. He saw the cause of this disorder in a weakened urethro-vaginal sphincter. Exercises called Kegel gymnastics are common in information sources. Sometimes there may be doubts about their authenticity, since a number of sources recommend such an exercise as "straining", which can hardly be recommended by a doctor to his patients who have suffered from similar straining in childbirth.
The basic principles of gymnastics, declared by A. Kegel:
- Regular independent work of the desired muscles;
- Use of elastic load;
- Monitoring of the results obtained using a periometer.
Kegel exercises and urination. There is a wrong belief that the basis of Kegel gymnastics is interruption of urination. This is not entirely true, because starting and stopping urine is one of the many ways to train the muscles of the perineum. Only the bulbous-spongy muscle is involved in this process, while the doctor strongly recommended developing all the muscles of the pelvic floor.
Overuse of such an exercise can lead, according to the inventor of the method, "to anxiety, stress and loss of control." Many women see urinary interruption exercise as a test of their muscles' ability to recover from childbirth. If they cannot perform this exercise, then they agree to surgery. This practice gives surgeons the wrong reason to consider Kegel gymnastics useless.
The doctor identified 3 important steps in his method:
- The first step is a manual examination. During the external examination, the patient should lie on her back with legs bent at the knees. The doctor examines her ability to tighten the perineal tissue at will.
- The second step is a vaginal examination. Its goals are to assess the development of the pubococcygeal muscle, as well as to assess the patient's ability to find and correctly contract the desired muscles. The process alternately includes the muscles of the urethro-vaginal sphincter and the muscles of the anal region, the pelvic floor. You can not connect the muscles of the press, thighs, diaphragms that create intra-abdominal pressure.
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The third step is to insert a Kegel trainer into the vagina to measure the strength of contractions of the muscles in the vaginal region. The introduction of the periometer, invented by Kegel, is performed after five to ten correct contractions. This is the starting point for the third phase of the program.
Before the invention of the periometer, there was no analogous biofeedback instrument in world practice for assessing the strength of the perineal muscles. This device can be used both in medical practice and in its independent use by a woman at home.
Kegel exercises and feedback. Dr. Kegel was convinced of the need for biofeedback using a periometer. He repeatedly mentioned this in his works. Kegel was convinced from his own experience that different women have different ability to contract the muscles of the vaginal muscles. At the beginning of gymnastics, many patients cannot create pressure of a few millimeters. After strengthening the muscles of the perineum, the compression of the periometer reaches 60-80 mm Hg. Art. and even more than this value.
Kegel was convinced that occasional training would result in minimal gains, while hard training would lead to complete success. In addition, the visible changes measured by the periometer encourage the woman to continue exercising.
Subjectivity of manual research. Data from manual measurements of the force of perineal contractions at the present stage are considered approximate values that have a gross error. There are more accurate instruments for measuring the strength of the pelvic floor muscles, such as the VAGITON laser trainer. But such simulators are deprived of the main advantage of the Kegel simulator - the ability to create a load with elasticity. The very resistance of this resistance effectively pumps the muscles of the pelvic floor.
How much to do? On the recommendation of a doctor, it should be carried out with a periometer placed in the vagina for at least 60 minutes a day. To be more precise - only 300 contractions, three sets of 20 minutes. If you divide the total number of seconds (3600) by the number of repetitions (300), the remainder results in cycles of 12 seconds. According to Kegel's instructions, the cycle consists of 6 seconds of contraction and a 6 second break between contractions.
Total: The 6-week recovery course includes three 20-minute cycles daily, during which you need to perform at least 300 contractions of the vaginal muscles.
Dr. Kegel argued that a patient gets powerful motivation when she sees a daily increase in periometer readings by a few millimeters of mercury every day.
How effective is it? According to a 1950 study by a doctor in Los Angeles, out of 300 patients randomly selected, 93% of women completely got rid of pelvic floor muscle weakness and related problems using his exercises. For other doctors, this figure reached 91%. All these women were spared the need to undergo surgery.
Despite not impressive results, the Kegel technique is still not fully used. The use of the simulator proposed by the doctor allows you to train the muscles of the perineum, tracking the effectiveness of training using the feedback method.
Methodology for the correct execution of Kegel exercises:
The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist
Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.
