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Bakgrund: Prolaps är ett tillstånd som drabbar en av tre kvinnor efter vaginal förlossning. Tillståndet kan leda till fysiska och psykiska nedsättningar som smärta, inkontinens, sexuella dysfunktioner och minskad livskvalitet. Syfte: Syftet med litteratursammanställningen var att undersöka effekten av pelvic floor muscle training och pelvic floor physical therapy vid pelvic organ prolaps efter graviditet, i jämförelse med utan aktiv intervention. Material och metod: En litteraturöversikt genomfördes för att sammanställa den aktuella kunskapen och forskningsläget. Sökningarna genomfördes mellan 31 januari 2023 och 13 mars 2023 i databaserna Pubmed, Svemed+ och Cochrane Library. Resultat: PFMT/PFPT hade en signifikant effekt på symtom av prolaps, muskelmassan och arean av M. levator ani. Signifikant färre kvinnor hade sökt vidare behandling efter att ha genomgått PFMT/PFPT. Kombinationen av PFMT och livsstilsråd resulterade i att deltagarna upplevde en ökad livskvalitet efter interventionens slut. Det fanns ingen signifikant skillnad i graden av prolaps eller grad av inkontinens efter interventionen. Konklusion: Det fanns en viss förbättring för de som utförde någon form av PFMT vid prolaps. PFMT/PFPT hade en viss effekt på pelvic organ prolaps, framförallt på känsla av symtom och muskelmassa. Det behövs ännu mer forskning för att i dagsläget kunna dra en vidare slutsats.

Ergebnisse der gynäkolgischen Descensuschirurgie unter Verwendung des GYNECARE PROLIFT® prolenemesh am Krankenhaus Agatharied Der Descensus genitalis ist eine der häufigsten gutartigen Erkrankungen der Frau, im Jahr 2010 waren mehr als 316 Millionen Frauen weltweit betroffen. Es besteht ein Lebensrisiko von 11,1% für eine chirurgische Intervention für eine 80jährige Frau. Die Gründe liegen v. a. in der Anzahl vaginaler (operativer) Geburten, Adiopsitas, Z.n. Hysterektomie, Überalterung und chronisch erhöhter intraabdominaler Druck. Die klinische Symptomatik besteht aus den typischen Senkungssymptomen wie Fremdkörper- und Druckgefühl, Ulcerationen mit Blutung, Fluor, Infektionen und Schmerzen. Außerdem kann es zu anorectaler Dysfunktion und Störungen der Blasenspeicher- und entleerungsfunktion kommen. Auch werden häufig Störungen der Sexualfunktion beschrieben. Die anatomiegerechte Beckenbodendefektbehebung mittels Polypropylene-Kunststoffnetzen (GYNECARE PROLIFT® prolenemesh) über den vaginalen Zugang wird zunehmend, neben den klassischen Descensusoperationen, zur Rekonstruktion des weiblichen Beckenbodens verwendet. Anhand der prä- und postoperativen Anamnese und Untersuchung nach dem POP-Q Schema einschließlich intra- und postoperativer Veräufe sowie 4 etablierter Fragebögen (PFDI-20, PFIQ-7, PISQ-12 und PGI-C) zu subjektiven Einschränkungen durch den Descensus erfolgt die Evaluation des Erfolges der Netzimplantation und ein Vergleich mit Ergebnissen anderer Methoden der Descensuschirurgie. Ergebnisse: Netzspezifische Komplikationen wie Exposition in die Scheide, Erosion in Nachbarorgane, Schrumpfung der Netze mit Schmerzen, Auftreten einer De Novo Belastungsinkontinenz oder einer Dyspareunie wurden im vorliegenden Kollektiv deutlich seltener als in der Literatur verzeichnet. Die Netzimplantation war in 81,5% (Stadium 0 oder 1) erfolgreich, es kam in 18,5% zu einem Rezidiv. Je nach Literatur und betroffenem Kompartiment liegen die Rezidivraten nach Mesheinlage zwischen 3,5 und 46% und bei 2 bis 42,5% nach klassischen Descensusoperationen. In allen 4 Fragebögen wurde eine Verbesserung der Lebensqualität, der sexuellen Zufriedenheit und der Speicher- und Entleerungsfunktion von Blase und Darm verzeichnet, jedoch war die Netzimplantation gleichwertig mit den klassischen Senkungsoperationen. / Introduction: Descensus genitalis is one of women’s most frequent benign diseases. In 2010, more than 316 Million women world-wide were affected. There’s an 11.1 % risk for an 80 year-old woman to undergo surgery within her life span. Above all, reasons lie in the number of vaginal births (including surgical intervention), hysterectomy, adipositas, high age and elevated intraabdominal pressure. Typical clinical descensus symptoms include foreign body and pressure sensation, ulceration with bleeding, fluor, infections and pain. Furthermore, anorectal dysfunction, bladder storage and emptying problems. Sexual dysfunctions are also frequently described. Apart from the usual descensus operation for the reconstruction of the female pelvic floor, implementing polypropylene mesh (GYNECARE PROLIFT® prolenemesh) through vaginal access has increasingly become an alternative. Material and methods: Success of the mesh implantation was compared with results of other methods of descensus surgery, using pre- and post-operative medical history, examination based on the POP-Q scale including intra- and post-operative developments as well as on four established questionnaires (PFDI-20, PFIQ-7, PISQ-12 and PGI-C) describing subjective restrictions caused by the descensus. Results/discussion: Mesh-specific complications, such as exposition into the vagina, erosion into adjacent organs, painful shrinking of the mesh, de novo stress incontinence or a dyspareunia were detected much less frequently in the current cohort than described in literature. Mesh implantation was successful in 81.5 % (stage 0 or 1), a recrudescence occurred in 18.5 %. Depending on the respective literature and specific cohort, the rates for recrudescence after mesh implementation lie between 3.5 and 46 %, while they range between 2 and 42.5% after usual descensus surgery. Each of the four questionnaires reported improvement of life quality, of sexual satisfaction as well as better bowel and bladder storage and emptying ability. However, results of mesh implantation showed no significant difference to those of the conventional descensus surgery.

The diploma thesis deals with the problem of global pelvic floor dysfunction in patients with cystic fibrosis. The theoretical part is devoted to individual components of dysfunction, thus urinary and fecal incontinence, prolapse and sexual issues. In particular, it focuses on the mechanism of formation and prevalence of individual components and also contains information on the musculoskeletal abnormalities most commonly found in patients with cystic fibrosis. There is also mentioned the impact of incontinence on the quality of life of patients. The experimental part describes a questionnaire survey, hypotheses derived from it and their results with comments. There is also statistical processing of the data and graphical representation of the results. Other important findings from the survey are also listed. The thesis follows the previous bachelor thesis and aims to draw attention to the given issue and break the wall of silence from the ranks of patients and health professionals.

Bakgrund  Majoriteten av alla förlossningar är så kallade vaginala förlossningar. Vården efter en förlossning innebär ofta en kort kontakt vilken avslutas runt tre månader postpartum. Under vaginal förlossning ådrar sig vissa kvinnor skador vilka kvarstår i över sex månader och upp till flera år postpartum. I vissa fall kan även problematik kopplat till sådana skador uppstå flera år efter en förlossning. Sådana långvariga förlossningsskador är: bäckenbottenprolaps, fekal- och urininkontinens, dyspareuni och bäckensmärta. Dessa skador medför bland annat sviktande basala kroppsfunktioner och smärta. Hälso- och sjukvården spelar en viktig roll i stötta dessa kvinnor för att bibehålla deras KASAM och livskvalitet.   Syfte Syftet var att belysa kvinnors upplevelser av att leva med långvariga förlossningsskador.   Metod Den metod som använts för detta arbete var en litteraturöversikt baserad på 16 vetenskapliga artiklar vilka analyserades enligt så kallad integrerad analys.   Resultat Kvinnor med långvariga förlossningsskador upplevde en låg hälsa och livskvalitet. Dessa kvinnor upplevde många begränsningar i vardagen och en påverkan på fysisk förmåga, psykiskt mående, relationer och sexuell hälsa. Många kvinnor var missnöjda med den vård de mottagit för sin skada, speciellt gällande bemötandet och erhållen information. Flertalet kvinnor var oroliga inför framtiden medan vissa var hoppfulla eller hade funnit acceptans inför sin situation.   Slutsats I denna litteraturöversikts resultatdel framkom det att omvårdnaden av kvinnor vilka lever med långvariga förlossningsskador är bristfällig, detta gällande främst bemötande och informatik. Två områden vilka är essentiella i sjuksköterskans yrkesutövande. För att förbättra kvinnors självupplevda hälsa och livskvalitet behöver dessa områden utvecklas i form av ett större fokus på personcentrerad omvårdnad och utökad information kring eventuella långvariga förlossningsskador i samband med förlossning. / Background  The majority of all deliveries are vaginal deliveries. After childbirth, the care often involves a short contact which is completed around three months postpartum. During vaginal delivery, some women suffer injuries that persist for over six months and up to several years postpartum. In some cases, problems associated with such injuries can also occur several years after giving birth. Examples of such long-term injuries are: pelvic organ prolapse, fecal and urinary incontinence, dyspareunia and pelvic pain. These injuries cause, among other things, failing basic bodily functions and pain. Health care plays an important role in supporting these women to maintain their sense of coherence and quality of life.   Aim The aim was to highlight women’s experiences of living with long-term maternal childbirth injuries.   Method The chosen method for this study was a literature review based on 16 scientific articles that were analyzed using integrated analysis.   Results Women with long-term maternal childbirth injuries experienced poor health and quality of life. These women experienced many limitations in their everyday life and an impact on physical ability, mental health, relationships and sexual health. Many women were dissatisfied with the health care they received for their injury, especially regarding the care and information received. Most women were worried about the future, but some women were hopeful or had found acceptance for their situation.   Conclusions In the results section of this literature study, it was found that the health care of women living with long-term maternal childbirth injuries is inadequate. This regarding how the health care staff treat the women and the information they receive. Two areas that are essential in the nurse's professional practice. In order to improve women's self-perceived health and quality of life, these areas need to be developed through a greater focus on person-centered care and broadened information about possible long-term birth injuries in connection with childbirth.

Background: A lot of women who goes through a vaginal delivery will contract injuries due to the delivery. These injuries are termed as tears, prolapse, dyspareunia, incontinence and the symptoms can affect the women in their daily life. The nurse will get in contact with these women in different contexts when the women seek help for her problems. There is an estimated number of unknown cases that are caused by injuries from the delivery due partly to the normalization in the society. It can also be linked to the ignorance and absence from the health care. Aim: The purpose of the literary survey was to describe how life is affected due to the experiences of injuries from delivery. Method: The literature survey has been based on ten scientific articles of both qualitative and quantitative methods. The authors obtained the articles by searches in the databases Pubmed and Cinahl Complete. Results: From the result three main themes was extracted that was the main findings of how the women experiences their life quality due to the injuries from the delivery. A non-working body, physical, psychological, sexual and social limitations and moving on with life. Summary: Suffering a birth injury can be associated with loss of vital functions, pain, discomfort, worry, anxiety and depression. These can lead to the body being perceived as dysfunctional and entail limitations physically, psychologically, sexually and socially. A good treatment from healthcare is important to get the right diagnosis, treatment and support to be able to move on in life. / Background: A lot of women who goes through a vaginal delivery will contract injuries due to the delivery. These injuries are termed as tears, prolapse, dyspareunia, incontinence and the symptoms can affect the women in their daily life. The nurse will get in contact with these women in different contexts when the women seek help for her problems. There is an estimated number of unknown cases that are caused by injuries from the delivery due partly to the normalization in the society. It can also belinked to ignorance and absence from the health care. Aim: The purpose of the literary survey was to describe how life is affected due to the experiences of injuries from delivery. Method: The literature survey has been based on ten scientific articles of both qualitative and quantitative methods. The authors obtained the articles by searches in the databases Pubmed and Cinahl Complete. Results: From the result three main themes was extracted that was the main findings of how the women experiences their life quality due to the injuries from the delivery. A non-working body, physical, psychological, sexual and social limitations and moving on with life. Summary: Suffering a birth injury can be associated with loss of vital functions, pain, discomfort, worry, anxiety and depression. These can lead to the body being perceived as dysfunctional and entail limitations physically, psychologically, sexually and socially. A good treatment from healthcare is important to get the right diagnosis, treatment and support to be able to move on in life.

Title: Methods of secondary prevention of the pelvic floor after childbirth Objectives: This is a theoretical work with a descriptive-analytical part. It includes an analysis of the literature from available sources, an analysis of active approaches in the secondary prevention of the pelvic floor and the creation exercise unit for further research. Methods: Literature analysis including processing of information from available sources. Results: Handbook of pelvic floor training with methodical descriptions. Keywords: Pelvic girdle, pregnancy, gynecological weaknesses after childbirth, incontinence, pelvic organ prolapse, sexual dysfunction, pelvic floor examination, Arnold Kegel method, Ludmila Mojžíšová method, Alexander method, Feldenkrais method, Cantienica, exercise unit