Post partum pelvic floor changes

Ylenia Fonti1, Rosalba Giordano, Alessandra Cacciatore

  • 1Department of Obstetrics and Gynecology of "S. Bambino" Hospital. University of Catania, Italy.

Pelvic-perineal dysfunctions, are the most common diseases in women after pregnancy. Urinary incontinence and genital prolapsy, often associated, are the most important consequences of childbirth and are determined by specific alterations in the structure of neurological and musculo-fascial pelvic support.Causation is difficult to prove because symptom occur remote from delivery.Furthermore it is unclear whether changes are secondary to the method of childbirth or to the pregnancy itself.This controversy fuels the debate about whether or not women should be offered the choice of elective caesarean delivery to avoid the development of subsequent pelvic floor disfunction.But it has been demonstrated that pregnancy itself, by means of mechanical changes of pelvic statics and changes in hormones, can be a significant risk factor for these diseases. Especially is the first child to be decisive for the stability of the pelvic floor.During pregnancy, the progressive increase in volume of the uterus subject perineal structures to a major overload. During delivery, the parties present and passes through the urogenital hiatus leading to growing pressure on the tissues causing the stretching of the pelvic floor with possible muscle damage, connective tissue and / or nervous.In this article we aim to describe genitourinary post partum changes with particular attention to the impact of pregnancy or childbirth on these changes.

Related Concept Videos

Muscles of the Pelvic Floor and Perineum01:26

Muscles of the Pelvic Floor and Perineum

The muscles of the pelvic floor and perineum are crucial for supporting the pelvic organs, controlling continence, and aiding in sexual function, childbirth, and core stability. They are typically divided into the superficial perineal layer and the deep pelvic floor layer.
Perineal Layer
The perineum is a diamond-shaped area below the pelvic diaphragm, divided into an anterior urogenital triangle that contains the external genitals and a posterior anal triangle housing the anus. The urogenital...
Urinary Bladder01:23

Urinary Bladder

The urinary bladder is a hollow, muscular sac that temporarily stores urine before it is expelled from the body. It can hold approximately 600 mL of urine prior to micturition. The bladder is retroperitoneal and located behind the pubic symphysis in the pelvic floor.
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...
Menses Phase01:18

Menses Phase

The uterine cycle begins with the menstrual phase, which is considered day one of the cycle and typically lasts about five days. This phase is characterized by the degeneration and shedding of the stratum functionalis, the functional layer of the endometrium.
When fertilization does not occur, the corpus luteum deteriorates, causing a significant drop in the levels of estrogen and progesterone in the body. This hormonal decrease triggers the release of prostaglandins, which cause the uterine...
Proliferative Phase01:20

Proliferative Phase

The proliferative phase typically occurs after menstruation and lasts between 6 to 13 days in a standard 28-day cycle. This phase involves the reconstruction of the endometrium, guided by estrogen produced by the developing ovarian follicle.
Notably, the stratum basale, the basal layer of the endometrium, including the basal parts of the uterine glands, remains unaffected by menstruation. Stem cells in this layer undergo mitosis, regenerating the stratum functionalis and thickening the...
Uterus and Cervix01:18

Uterus and Cervix

The uterus, commonly called the womb, is a vital reproductive organ in females designed to provide a nurturing environment for the implantation and growth of an embryo. It is shaped like a hollow pear and positioned between the urinary bladder and the rectum. The uterus's structure allows it to support and protect a developing fetus throughout pregnancy.
The uterus is securely anchored within the pelvic cavity by paired broad ligaments on either side. It is further stabilized by three pairs of...
Imaging Studies II: Ultrasonography01:24

Imaging Studies II: Ultrasonography

IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...