UROGYNECOLOGICAL SURGERY CURRENT APPROACHES AND TREATMENTS FOR INCONTINENCE

Urogynecological_Surgery_Kapak

PELVIC FLOOR REHABILITATION

Narin Ece Rol

Zeynep Kamı̇ l Women and Chı̇ ldren Dı̇ seases Tranı̇ ng and Research Hospital, Department of Gyneclogy and Obstetric, İstanbul, Türkiye

Rol NE. Pelvic Floor Rehabilitation. In: Balsak D, Çim N, Ege S editors. Urogynecological Surgery Current Approaches and Treatments for Incontinence. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.313-318.

ABSTRACT

The pelvic floor is a complex structure composed of muscles and connective tissues that plays a fundamental role in maintaining the healthy function of the female urogenital and gastrointestinal systems. Physiological events such as pregnancy, childbirth, and menopause can lead to weakening of these muscles, predisposing women to pelvic floor dysfunctions. Such dysfunctions commonly manifest as urinary incontinence, pelvic organ prolapse, or defecation difficulties, significantly reducing patients’ quality of life. Conditions like pelvic organ prolapse and stress urinary incontinence often reach a severity that necessitates surgical intervention. However, while surgery restores anatomical integrity, maintaining long-term functional continuity requires supportive rehabilitation.

Postoperative pelvic floor rehabilitation should be planned in alignment with the tissue healing process. Protective measures and gentle awareness exercises in the early phase help control edema and inflammation, while structured muscle strengthening programs are gradually introduced in later stages. Kegel exercises, isometric contractions, and breathing-coordinated pelvic activations are among the commonly used methods. The type of surgery, the use of synthetic materials, and patient-specific comorbidities necessitate individualized protocols. For example, the presence of mesh or advanced age may require modifications in rehabilitation progression.

Effective strengthening of the pelvic floor muscles is also a cornerstone of conservative management. Targeting the correct muscle groups, supported by biofeedback and, when necessary, electrical stimulation, enhances motor control. Biofeedback educates patients on proper muscle contractions, while electrical stimulation can be beneficial for those unable to generate voluntary contractions. Studies show that integrating these technologies with conventional exercises improves recovery speed and quality.

In conclusion, pelvic floor rehabilitation is an indispensable component of both surgical and conservative treatments. Multidisciplinary team support, patient education, and regular follow-up are key factors that enhance treatment outcomes. With the advancement of sensor-based feedback systems and digital platforms, patient adherence has improved, adding a new dimension to clinical practice. Keeping knowledge up to date in this field is essential for women’s health professionals to ensure sustained treatment success.

Keywords: Urinary incontinence; Pelvic floor disorders; Pelvic organ prolapse; Postoperative care; Interdisciplinary communication

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