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DIAGNOSTIC VALUE OF ULTRASOUND IN DETECTING DAMAGE TO THE
PELVIC FLOOR MUSCLES AFTER VAGINAL BIRTH
Abbosova Parvina Abbosovna
The 1st year Master's degree resident of the Department of Obstetrics and Gynecology Nº3
Samarkand State Medical University
Shavazi N.N.
Scientific supervisor, DSc
https://doi.org/10.5281/zenodo.14671479
Objective
: Pelvic organ prolapse, various types of urinary and fecal incontinence, chronic
cystourethritis and sexual dysfunction remain one of the most common diseases in urogynecology.
74 patients of different ages were observed The prevalence of pelvic organ prolapse and prolapse
reaches 30%, and in 47.3% of cases, genital prolapse is accompanied by stress urinary incontinence
[1, 2]. Currently, pelvic ultrasound is widely used to assess pelvic mobility. The advantages of this
method include its availability, the absence of ionizing radiation and its non-invasiveness. In
addition, no special preparation of the patient is required. Typically, perineal scanning is used to
determine pelvic mobility.
Materials and methods of research:
Pelvic floor muscle dysfunction occurs for a number
of reasons: age, heredity, birth trauma, large births, heavy physical activity associated with
increased intra-abdominal pressure, etc. Recently, there has been a tendency to "rejuvenation" of
these disorders [26]. The occurrence of prolapse of the genital organs in young and parous women
indicates the role of connective tissue dysplasia in the development of the disease. The
combination of organic pathology and pelvic organ prolapse determines a variety of clinical
manifestations: sensation of a foreign div in the vagina, involuntary urge to urinate, urinary
incontinence with urgency and physical exertion, night and day, a feeling of incomplete emptying
of the bladder, a feeling of squeezing. discomfort, heaviness in the perineum and lower abdomen.
Many patients have sexual dysfunction and / or dyspareunia. Delayed urination or a feeling of
incomplete bladder emptying is often associated with anterior vaginal wall prolapse. Clinical
manifestations can develop during reproductive age and throughout life, dramatically reducing
quality of life [1,29].
Research results:
74 patients of different ages were observed Urinary incontinence in
women is the most common disease in the structure of pelvic organ dysfunction. Approximately
50% of women aged 45 to 60 years have experienced urinary incontinence at least once. Its
prevalence among women is 33.6-36.8%. The situation worsens with age. So, if in the age group
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25 to 34 years this figure reaches 8.7%, then in the age group 55 and older this figure exceeds
34%. Stress urinary incontinence occurs in 70% of cases in women over 50 years, which confirms
the social significance of the problem [3]. The actual prevalence of urinary incontinence may be
even higher, since women are embarrassed to tell their doctors about this disease and consider it
an integral part of aging [4]. In 30-40% of cases, the stress component is combined with the
urgency component, that is, a mixed form of urinary incontinence occurs. The prevalence of this
type increases with age and reaches 56% after 60 years of age [5]. Urinary incontinence
questionnaires are used in urogynecological practice: Urogenital Distress Inventory (UDI-6),
Incontinence
Impact
Questionnaire
(IIQ-7),
International
Incontinence Consultation
Questionnaire (ICIQ-SF), International Index of Quality of Life Assessment for Urinary
Incontinence, Questionnaire Life SF-36, King's Questionnaire, etc. A standard questionnaire for
assessing pelvic organ prolapse and/or female sexual function. Urinary incontinence is considered
a component of the Pelvic Organ Prolapse and Urinary Sexual Function Questionnaire (PISQ-31).
The PISQ-12 is a shorter version and is recommended for use in clinical practice. The most
common method for diagnosing sexual dysfunction is the Female Sexual Function Index (FSFI).
In women without prolapse, the increase in its volume during pelvic scanning was 28%, which
indicated normal pelvic mobility. At the same time, the studied indicator in patients with
asymptomatic pelvic organ prolapse reached 75%. Pathological pelvic mobility, starting from an
increase in the volume of the prolapse of 52%, requires further dynamic monitoring of preventive
measures to strengthen the pelvic floor muscles (biofeedback technique (BFB)).
Conclusion
: Among the new diagnostic equipment, the innovative Vaginal Tactile Imager
device is worth noting, which guarantees a quantitative and qualitative assessment of the condition
of the pelvic floor muscles. With the help of this device, the pressure, strength and stiffness of the
muscles are measured, their condition is monitored during labor and after birth. The latest
technology, using a sensitive silicone sensor, allows you to convert tactile sensations into a
computer image in real time. The device diagnoses pelvic floor muscle weakness, vaginismus,
vulvodynia, prolapse, muscle ruptures during labor and after childbirth, and other pathological
changes in the pelvic floor [11,30].
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