Pediatric urology is a specialty that deals with kidney, ureter, bladder, urethra and external genitalia (urinary system) diseases in the pediatric age group up to the age of 18.
What is Pelvic Floor Dysfunction?
Urinary incontinence problem occurs in 15-20% of children around 5 years old; It occurs in about 3% of children around the age of 12. Daytime urinary incontinence is twice as common in girls as in boys, but affects approximately 8-10% of children aged 5 to 12 years. Nocturnal urinary incontinence is more common in boys.
What is the Pelvic Floor?
Pelvic floor muscles are a horizontal muscle group at the base of our pelvis. The urethra and anus pass through the pelvic floor muscles. While these muscles are able to hold pee and poop by contracting, they relax and ensure a healthy urination and defecation. Apart from this, a certain amount of pelvic floor muscles are actively working in daily life activities such as walking, running, weight bearing, climbing and descending stairs.
The urinary bladder (bladder), uterus, The pelvic floor is the muscle layer that provides support for the rectum, which is the last part of the ovary and large intestine, to perform its normal functions. This muscle group hangs like a hammock between the anterior part of the pelvis and the lower part of the spine.
What Causes Pelvic Floor Dysfunction in Children?
Pelvic floor dysfunction occurs due to weakness or tension in the pelvic floor muscles. Children cannot contract or adequately control this muscle group in coordination with each other. Urinary-poop incontinence in children may be normal until the age of 4-5, but in later ages they need to be dry both day and night. Children who experience these problems after the age of 5 should be treated soon. Bedwetting)
- growth and developmental abnormalities,
- genetic factors (connective tissue diseases),
- constipation-constipation,
- muscular stimulation Many reasons such as weakening of nerves and
- sedentary life cause weakness in the pelvic floor muscles.
How to Diagnose Pelvic Floor Disorder?
Scientific studies show that only 10% of urinary incontinence is caused by psychological causes, the remaining 90% is physiological. proved to be the cause of the problems. Therefore, it is important to evaluate the child in detail and completely in the diagnosis.
- Clinical history and physical examination,
- Urine examination and culture,
- Kidney and bladder ultrasound,
- Magnetic resonance imaging (MRI) of the spine,
- uroflowmeter with EMG,
- Urodynamic studies,
- Urine and bowel movement diary,
- Urine volume (for determining maximum voiding volume),
- Bristol stool chart,
- Dysfunctional Voiding Scoring System (DVSS).
How to Treat Pelvic Floor Muscles?
Pelvic floor disorders that develop due to certain reasons form the basis of urological problems. These urological problems, which seem to be very simple; It can cause recurrent urinary tract infections, urinary retention in the bladder, back-flow of urine into the kidneys, and permanent damage to the kidneys. More importantly, these permanent damage to the kidney can lead to kidney failure after a while. It is treated with a urotherapy approach when there is no underlying pathological condition determined by various urological tests. In the treatment of pelvic floor diseases
- patient information,
- bladder diaries,
- manual therapy (a form of therapy using the hands)
- posture and respiratory training
- thoracolumbal (trunk-lumbar region) exercises
- pelvic floor exercises
- techniques to facilitate urination and defecation
- relaxation techniques
- behavioral therapy
- Methods such as EMG-biofeedback are applied.
Pelvic Floor Exercises Why?
Pelvic floor exercises, also known as Kegel exercises, are applied to strengthen weak muscle groups. The muscle group in the pelvis is contracted and relaxed in a certain number and intervals. The purposes of these exercises are:
- To increase the strength to be obtained from the muscle in a single contraction,
- To ensure that a single contraction can be sustained for a longer time or to create consecutive contractions
- Reestablishing the coordination in the pelvic floor.
How to Perform Pelvic Floor Muscle Exercises?
Finding the right muscles: Determining the pelvic floor muscles to be exercised in the first place correctly must. For this, the muscles used to prevent gas formation while sitting on the toilet and the muscles that stop you from urinating while urinating are detected. Afterwards, Kegel exercises are performed by contracting and relaxing the identified muscles. The pelvic floor muscles are kept contracted for 3 seconds and then relaxed for 3 seconds. While doing this movement, it should be felt that the pelvic floor muscles are pulled up and "loosened" when the muscles are released. It is sufficient to apply the tightening process for a maximum of 8 seconds. These tightening-relaxation phases form an exercise set. Kegel exercises, which are started to be done correctly while lying down, can be repeated during the day while sitting, standing and walking.
Concentration: For best results, concentrate only on tightening the pelvic floor muscles. Exercises should be done without the use of abdominal, thigh or hip muscles. Breathing should not be held, breathing should be continued.
Repetition is required during the day: The aim is to repeat 10 times a day in 3 sets. There is no need to allocate special time for exercises. Pelvic floor exercises can be performed even during daily tasks once you learn to do them using the right muscles. Practicing pelvic floor exercises for men includes the same principles and stages. In order to get positive results of Kegel exercises in adults and children, women and men, first of all, they should be done regularly. It is necessary to work out the right muscle groups and exercise the right muscle groups. When these conditions are met, the positive effects are felt within a few weeks to a few months.
You can find detailed information about urinary incontinence in women and treatment approaches at the address Urinary Incontinence.
What you wonder about pelvic floor disorders in children Grup Florence Nightingale Hospitals 's expert team, you can ask for suggestions about your question. You can use the contact form on our website to reach us.
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