产后尿失禁

2016-09-23 17:33 阅读: 编辑:sunyoung 来源:
标签: 产后尿失禁
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内容简介:妇人产后不能约束小便而尿自遗者,称为产后尿失禁。产后尿失禁是由于分娩时,胎儿先露部分对盆底韧带及肌肉的过度扩张,特别是使支持膀胱底及上2/3尿道的组织松弛所致。
       一、病因

  产后尿失禁并不少见,它是因为生产过程中胎儿经过产道时骨盆底的肌肉群(或曰提肛肌)被拉伤或是支配它们的神经血管受伤,而导致提肛肌的松弛、萎缩。

 
产后尿失禁

  分娩过程中,胎儿先露部通过产道,使盆底韧带和肌肉产生过度伸张作用,特别是初产妇及手术助产如臀牵引术、产钳助产术、胎头吸引器助产术等,可直接损伤盆底软组织产后体力劳动、持续性咳嗽、便秘等均为增加腹压的因素,可影响盆底组织恢复,使盆底组织松弛,导致尿道膨出,膀胱颈下降,尿道上段失去紧张度而变为漏斗形,尿道相对变短而宽,泌尿生殖隔及浅层肌肉损伤如会阴深Ⅱ度裂伤可影响尿道外括约肌的功能,由于这些因素的作用,容易发生产后尿失禁。

       二、治疗

  产后尿失禁是指妇人产后不能约束小便而尿自遗者,产后尿失禁是属于张力性尿失禁,现代医学认为,产后尿失禁是由于分娩时,胎儿先露部分对盆底韧带及肌肉的过度扩张,特别是使支持膀胱底及上2/3尿道的组织松弛所致,中医称“产后遗尿”。

  有关专家提出,产后尿失禁可作凯格尔运动来帮助复原,凯皮尔运动就是骨盆底肌肉的收缩运动。经由反覆的运动训练来复原及加强骨盆底肌肉的功能。骨盆底肌肉要怎么收缩?可先以中断尿液的感觉来体会一下。解尿解到一半时,试着让解尿中止,这时你会感觉会阴部收紧的感觉。多感觉几次,熟悉了之后就可以随时作这个运动,刚开始不确定自己是不是作对时,可以在运动时以手指头放在阴道内,如果感觉到收缩的力量,就表示作对了。

  一般产后尿失禁经由凯格尔运动后,多可在三个月内复原。若没有改善的话,应找妇产科或是泌尿科医师作进一步的检查及治疗。


       三、预防

       重在预防。首先要做好产前保健,正确处理分娩,不到子宫口开全就不要过早的用力。会阴切开或有裂伤时,要配合医生及时修补。产后避免过早负重和使用腹压,做好产后保健操,促进盆底组织的修复。

       一般在产褥期引起重视,正确对待,病情都会逐渐减轻以至自愈。如果产褥期内未愈者,以后可以手术修补。
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