Rehabilitation principles in the care of gynecologic and obstetric patients

Literature examining disabilities and rehabilitation in gynecologic and obstetric patients is limited. Among the musculoskeletal, vascular, neurologic, hormonal, and sexual problems described, pelvic floor laxity is the etiology for several dysfunctional states and is common to both parous and nonparous women. The focus of this paper is on one of the dysfunctional states--urinary stress incontinence--which in previous work had a reported incidence of 30% of all women and may affect up to 63% of postmenopausal women. This study, applying rehabilitation principles to diagnosis and treatment, found the incidence of stress incontinence to be 20 to 30% of women, pregnant or not, who did no specific pelvic floor exercise. A group of women, not pregnant, who did Kegel exercises for pelvic floor strengthening had only a 6% incidence of stress incontinence. There is a need to determine whether pelvic floor exercise, done effectively, could minimize this problem in postmenopausal women. Rehabilitation principles may be applied to the diagnosis and treatment of other disabling conditions in gynecology and obstetrics.