[Pelvic floor disorders].
Fecal and urinary incontinence are frequently associated, together with pelvic organ prolapse. The most important risk factors for pelvic floor disorders are vaginal delivery and chronic constipation. Irrespective of the symptom prompting the patient to seek medical attention and the specialist consulted, symptoms in other compartments must be investigated because patients rarely report them spontaneously. Patients with pelvic floor disorders should be evaluated by a multidisciplinary group of specialists. Complete evaluation includes urodynamics, anal manometry, endoanal ultrasonography and neurophysiologic study of the pelvic floor and is recommended in most patients, given that pelvic floor disorders have a complex and multifactorial pathophysiology and that all anatomic and functional abnormalities must be detected to provide the most appropriate treatment. Conservative treatment resolves or improves the problem in a large proportion of patients with mild-to-moderate symptoms. Surgery should be indicated in selected patients with careful evaluation to identify preoperatively all anatomical and functional defects that can be surgically corrected. The identification of risk factors and better knowledge of the prevalence and pathophysiology of this health problem will allow preventive strategies to be established and improve therapeutic outcomes.
Lacima
Gloria
G
Unidad Motilidad Digestiva, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Barcelona, España. glacima@clinic.ub.es
Espuña
Montserrat
M
D003248:Constipation / Q000150:complications; D052858:Cystocele / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D036861:Delivery, Obstetric; D003952:Diagnostic Imaging; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D006801:Humans; D010298:Parity; D017773:Pelvic Floor / Q000473:pathology*; D010808:Physical Examination; D011247:Pregnancy; D015995:Prevalence; D012005:Rectal Prolapse / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D012307:Risk Factors; D014555:Urination Disorders / Q000209:etiology; D014596:Uterine Prolapse / Q000175:diagnosis / Q000209:etiology / Q000601:surgery