Q1. Which has more urinary incontinence?
A1. (A) Women
Q2. Which can be the cause of urinary incontinence?
A2. (B) Childbirth
The major cause of urinary incontinence is looseness of the pelvic floor muscle which supports the uterus and the bladder. The pelvic floor muscle becomes loose with age but the biggest cause is childbirth. At the time of childbirth, the pelvic floor muscle which is usually closed is opened forcibly, often damaging the muscle. Exercise for the pelvic floor muscle is recommended to recover from the damage. (Fig. 1)
A3. Which has more risk to loosen the pelvic floor muscle?
(A)A person who is overweight
(B)A person who is underweight
Q3. (A) A person who is overweight
The more the weight gains, the more fat is stored around the internal organs. The amount of visceral fat of a person whose BMI is 30 is as much as lard of 20 kilograms. Since this visceral fat always presses the pelvic floor muscle, the muscle is exhausted. As a result, urine leaks only by exerting themselves a little.
Urogynecology is a subspecialty within Obstetrics and Gynecology that focuses on disorders of the female pelvic floor such as pelvic organ prolapse (bulging out of the uterus and/or vagina), urinary incontinence, fecal incontinence and constipation.
Transvaginal Mesh Surgery (TVM surgery) is performed when the urinary incontinence is caused by severe prolapse of pelvic organs.
laparoscopes are inserted from 4 places such as side of the navel. After making space with the laparoscopes, 2 meshes are placed between the uterus and the rectum and between the uterus and the bladder to wrap the uterus. The meshes are sewn onto the wall of the vagina by the rectum and the bladder. The end of the meshes are tied to the ligament of the spine. With this surgery, not only the uterus but also the bladder and the rectum go back to the original position. TVM surgery has the advantage of less pain, faster recovery and very slight recurrence of pelvic organ prolapse for a long period of time. (Fig. 2-4)
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