pelvic floor spasm syndrome
Introduction
Introduction to pelvic floor syndrome Sastic Pelvic Floor Syndrome refers to a functional disease in which the pelvic floor muscles contract without loosening during forced bowel movements. The disease is more common in women, the ratio of male to female is about 1:2; there are symptoms such as difficulty in bowel movement, discomfort and pain; defecation is performed once every 2 to 3 days. May have bloating, blood in the stool and long-term constipation, the perineal nerve may be damaged at the same time; other secondary changes (such as intestinal fistula, visceral droop, etc.) may occur, and the rectal prolapse, rectal prolapse, mucosal relaxation or internal hemorrhoids and external hemorrhoids may occur. Wait. basic knowledge The proportion of illness: 0.012% Susceptible people: women are more common, the ratio of men to women is about 1:2 Mode of infection: non-infectious Complications: blood in the stool, hemorrhoids
Cause
Causes of pelvic floor syndrome
Cause:
The cause of this syndrome is not well understood and may be related to congenital anomalies, inflammation, and abuse of laxatives. This dysfunction is likely to be a normal muscle dysfunction, rather than a persistent paralysis of abnormal muscles, as both anal manometry and electromyography demonstrate that the function of the external sphincter is normal when the anus is still and tight. In some patients, the faecal colon has a delayed passage of time, and subtotal colectomy has no benefit. Therefore, the delay in the smooth passage of patients with pelvic floor sputum condensation should be regarded as the retention of feces caused by export obstruction, instead of The power of the colon is declining.
In 1993, Stelzner found that persistent constipation in patients with pelvic floor syndrome was associated with increased sphincter activity. Pelvic floor syndrome may also be associated with neurological dysfunction because pelvic floor syndrome can be treated by stimulation at the level of the receptor. The mechanism of action may be to depolarize the conductive tactile nerve fibers, especially the A fibers, and the A fibers produce presynaptic inhibition, inhibiting the transfer to the spinal motor neurons, thereby causing the muscles to produce relaxation. Like all functional diseases, pelvic floor syndrome may be associated with psychological factors.
Prevention
Pelvic floor syndrome prevention
Exercise properly and actively prevent constipation. All patients with pelvic floor syndrome should report to the hospital. It is best to follow up with the hospital for a long time. More importantly, the regular review in 2 is for early detection of malignant transformation, but sometimes there may be residual blister blocks. Patients should take effective contraceptive measures for at least 2 years, and should be reviewed monthly for the first half of the year. If irregular vaginal bleeding, hemoptysis, headache or other discomfort occurs, they should go to the hospital immediately.
In addition to asking whether menstruation is normal, you should also pay attention to the above symptoms. Check should pay attention to whether the uterus is well-recovered. Vaginal vulva has purple-blue nodular chest (preferably chest film) with shadows.
The pregnancy test is very important in the follow-up, and about 60% of the moles are completely removed. If the patient is negative for more than 40 days after the pregnancy test is negative for 30 days, the patient should be highly suspected of malignant transformation or still have blister-like blocks.
Pregnancy test has been turned into a negative gynecological re-diagnosis, such as non-pregnancy should be highly suspected of malignant transformation, such as the original urine positive dilution test. The dilution test in the negative referral has turned positive again, especially those with increased dilution should also be highly suspected of malignant transformation.
Complication
Pelvic floor syndrome complications Complications, blood in the stool, hemorrhoids
Concurrent intestinal fistula, visceral drooping and so on.
Symptom
Pelvic floor syndrome symptoms common symptoms constipation abdominal distension blood in the stool
More common in women, the ratio of male to female is about 1:2; there are symptoms of difficulty in defecation, discomfort and pain; bowel movements 2 to 3 times a day, may have abdominal distension, blood in the stool and long-term constipation, the perineal nerve may be damaged at the same time; Other secondary changes (such as intestinal fistula, visceral drooping, etc.) may occur, and the rectal prolapse has rectal prominence, mucosal relaxation or internal hemorrhoids and external hemorrhoids.
Examine
Examination of pelvic floor hernia syndrome
X-ray angiography: characterized by "goose levy", that is, the side sitting position is pendulum (the pubic symphysis is facing upwards), the whole image resembles a goose swimming in the water; the rectum is estimated to be the goose head, the anal tube is the goose mouth, The narrower rectum is the gooseneck, the proximal part of the rectum and the distal part of the sigmoid colon are the goose and the tail. The appearance rate of the "goose sign" is 100%.
Diagnosis
Diagnosis and differentiation of pelvic floor hernia syndrome
The diagnosis is mainly based on clinical symptoms and X-ray examination for "goose sign". Other auxiliary tests include: anal manometry, pelvic floor electromyogram and colonic transit time, etc., and the diagnosis can be established after the difficulty of excluding organic defecation.
Identification with puborectal syndrome.
