Perineal Re-Education Therapy

• Dr Khyati

Perineal Re-Education Therapy

What is the perineum? The perineum is the muscle that supports the organs located at the level of the pelvis. It is small in size and supports the weight of these organs, at the same time involved in the expulsion of feces, gases, and urine. In addition, thanks to him we can contract the vagina during sexual intercourse. For these and many other functions it is so important to keep the perineum muscular and toned.

Re-education … for whom?

The delivery, and more specifically the moment in which the baby is expelled, causes the muscles to soften. That is why it is recommended to all young women who have been moms a special re-education so that the perineum regains its elasticity and its ability to support. If you have doubts about it, you should only observe your body: loss of urine when making an effort, a sneeze, an attack of cough or laughter … indicate that the perineum does not perform at its best. Before these signals, it is necessary to react because it is not a problem that is solved with the passage of time. Such a mismatch is very common: 20% of women suffer from this discomfort right after giving birth or a few weeks later.

This re-education is necessary, especially if:

• it is not your first pregnancy

• the baby has weighed more than 3.7 kg

• its cranial perimeter exceeds 35 cm

• forceps have been used during childbirth

• an episiotomy has been performed

• For those who do not meet any of these conditions the slogan is “prevention is better than cure.” It would be a shame to be great at fifty and suffer urine leakage.

What is perineal re-education?

This type of re-education should be practiced by qualified professionals during the three months after delivery. Consult your gynecologist, he will know how to recommend you to a serious and competent professional, a kinesiotherapy with specific training, or a midwife.

Sessions

Usually prescribed automatically to women newly on maternity leave. It consists of 10-15 sessions of 20-30 minutes each, about 2-3 times a week. However, the first lasts about 45 minutes since the practitioner, with the help of anatomical schemes, informs you of the pelvic region, so that you become aware of the area and practice exercises that “wake you up”. These exercises are not performed for the purpose of “developing large muscles” but “intelligent muscles.”

There are 3 perineal re-education techniques:

Manual

It is a method of self-education that you can practice at home. During the first sessions you will learn to locate the area that you should treat and tone. The practitioner will perform a vaginal examination during which you must contract the muscles in response to the pressures he exerts.

Electrostimulation

It is an electrical stimulation technique that helps to become aware of the contraction of the perineum. Specifically, it involves inserting a tube into the vagina, which, through a very weak current, causes contractions. The patient feels them suddenly, unable to control anything. It is a good way to optimise work. You will experience an unpleasant tingling that should never be painful. If the stimulation lasts four seconds, the rest time will be eight. The program lasts fifteen minutes in total.

Biofeedback

It also consists of an electrostimulation system: the probe, located in the vagina, stimulates the muscle through a frequent current. In response, you will have to contract the muscle in a voluntary way. This contraction will cause a visual or auditory effect on the machine connected to the probe (depending on the device) and will indicate the intensity of your contraction. It is a very practical method since if you have the impression of contracting the perineum to the fullest, but the screen only indicates a small contraction, it will be detecting that you do not work the proper muscles.

And the women who have given birth by cesarean section?

The baby will also be supported on the perineum during the nine months, so women who have had a C-section are not excluded from this practice re-education.