Kadınlarda Pelvik Taban Kas Egzersizleri ve Hemşirenin Rolü

Pelvik taban kas yapısı cinsel sağlık ve kontinansın sürdürülmesi açı- sından önemlidir. Pelvik taban kaslarının kasılması, digital palpasyon, perineometre, elektromiyografi , görsel muayene, vaginal kon, dinamometre, ultrason ve manyetik rezonans görüntüleme yöntemleri ile değerlendirilebilir. Pelvik taban kas gücünün artırılmasında egzersiz oldukça etkili olup, inkontinansın önlenmesinde ve tedavisinde öncelikli olarak düşünülmesi gereken davranışsal tedavi seçeneğidir. Egzersizler, kas gücü artışı sağlamasının yanında genital prolapsus olasılığını azaltır, bağırsak kontrolünü ve orgazmı artırır ve cinsel problemleri azaltır. Ayrıca aşırı aktif mesane tedavisinde, gebelikte ve doğum sonrası dönemde stres inkontinans tedavisinde de etkilidir. Pelvik taban kas egzersizlerinin etkili olabilmesi için doğru kasların kasılması ve belirlenmiş egzersiz programına uyulması önemlidir. Kadınlara kaslarını nasıl kasacağını, egzersizlerin ne kadar sıklık ve sürede yapılacağını öğretmek ve egzersize devam etme yönünde teşvik etmek multidisipliner ekibin en temel sorumluluğudur. Bu derlemede, pelvik taban kaslarının yapısı, kas gücünün değerlendirilmesi, pelvik taban kas egzersizlerinin kas yapısına etkisi ve egzersizlerin uygulanışı ve eğitim verilmesinde hemşirenin rolü literatür doğrultusunda incelenmiştir.

Pelvic Floor Muscle Exercises for Women and the Nurse s Role

Pelvic fl oor muscle structure is important for maintaining sexual health and continence. The contraction of pelvic fl oor muscles can be assessed by digital palpation, perineometer, electromyography, visual examination, vaginal cones, dynamometer, ultrasound and magnetic resonance imaging methods. Pelvic fl oor exercises are quite effective in improving muscle strength, and this behavioral treatment option should be considered as a priority for prevention and treatment of urinary incontinence. In addition to providing increased muscle strength, the exercises reduce the probability of genital prolapse, increase orgasm and bowel control and reduce sexual problems. They are also effective in the treatment of an overactive bladder and stress urinary incontinence during pregnancy and postpartum period. For pelvic fl oor muscle exercises to be effective, it is important to create a exercise program that will teach the ability to exercise the correct muscles. The essential responsibility of a multidisciplinary team is to teach women how to tighten muscles with correct frequency and duration and to encourage them to continue exercising. In this review, the structure of pelvic fl oor muscles, the assessment of muscle strength, the effect of pelvic fl oor muscle exercises, the application and teaching of exercises and the promotion of the nurse s role are examined according to the literature.

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