事件记录
Dr. 琼斯: What do Utah women who've had lots of babies have in common with female paratroopers? 这是博士. Kirtly Jones from Obstetrics and Gynecology from University of Utah Health Care. 如果你想知道答案，请继续关注the Scope.
什么是盆腔脱垂?
Dr. 琼斯: 那么那些通过阴道生了很多孩子的女性, 阴道分娩, 或者可能只有一个孩子, have in common with female paratroopers who haven't had any children? 这两组人患 盆腔脱垂. 这意味着他们的内部女性部分正在脱落. 阴道分娩和反复的创伤 盆底, 作为一名女伞兵, can cause the support to the uterus and the cervix to stretch and then drop a little lower in the vagina.
Commonly the cervix may be as low as at the entrance to the vagina and occasionally the cervix and uterus may actually be positioned outside the vagina. 这被称为盆腔器官脱垂. 不仅子宫可以下来, but the bladder can come down leading to urinary leaking or difficulty urinating. 这两种情况都会让人不舒服. Today in 范围 radio studio, we're talking with Jan Baker, a nurse practitioner in the 盆底门诊 犹他大学的教授. She specializes in the evaluation of pelvic organ prolapse and in the non-surgical management of this common problem. 简，欢迎来到范围.
简: 谢谢你，Kirtly.
Dr. 琼斯: 这有多普遍呢? Not very many female paratroopers, but a lot of people have had babies.
简: 好吧, it's likely more common than our statistics tell us because this is, 再一次。, one of those unspeakable problems that women don't want to talk about. 但人们认为这一比例约为1比1.8, almost 2 women per 1000 women have prolapse, some form of prolapse. But when we do studies of women with no symptoms of prolapse and they're examined, 高达50%的女性可能有脱垂. 虽然 it may not be where they're noticing it, but they have started to develop prolapse. 所以脱垂症状通常在60岁左右达到顶峰, but about half of the women that seek care for prolapse symptoms are usually between the ages of 30 and 60. 所以这很常见.
可能导致盆腔脱垂的条件
Dr. 琼斯: 那么什么情况会导致这种情况呢? We mentioned having births and we mentioned being a paratrooper.
简: The biggest risk factor is childbirth, then just getting older.
Dr. 琼斯: 哦,伟大的.
简: 因为, unfortunately, the longer you're alive, the more and more gravity has its effect.
Dr. 琼斯: 重力获胜. 重力总是胜利的.
简: 重力总是占上风，但肥胖， 更年期家族史，种族 . . . 拉丁裔和白人女性更容易脱垂, and a previous hysterectomy also seem to play a role in the development of prolapse.
早期症状
Dr. 琼斯: So what are the symptoms a woman might have that would suggest that they might have this problem?
简: 好吧, the most common early symptom is kind of this mild pelvic pressure or maybe a mild kind of a backache at the end of the day. 可能是轻微的尿频, maybe feeling like they need to go to the bathroom a little bit more frequently.
Dr. 琼斯: 后来?
简: 然后, 后来, 他们可能会开始注意到从阴道里冒出来的肿块, or they may start struggling with a bowel movement and that is usually what brings women to seek care.
Dr. 琼斯: 是的. 那么大发娱乐能做些什么呢?
看医生前的自我护理
简: 好吧, if the prolapse is not very bothersome, watchful waiting is a very good option. 然而，在这个时候，教育真的很重要. 因为, 虽然大发娱乐不确定, 该领域的许多专家认为，减肥, 管理便秘, 治疗慢性咳嗽, reducing high-impact aerobic exercises such as jumping or running or jumping out of an airplane, 或者蹦床, 在蹦床上跳. 使用阴道雌激素， 戒烟 and doing a 盆底 muscle exercise might slow down the progression.
So actually talking to women about these things, maybe that might make a difference. 你知道, these interventions make sense because you're not continually putting pressure on the 盆底, 但大发娱乐没有任何好的研究来支持它们的使用. But they do make sense and they don't have any side effects.
Dr. 琼斯: 嗯，那很好. 实际上, just knowing that what you have is there and it's common and it's not cancer, 这不是肿瘤. This is just life on the planet Earth and we can't move to a smaller planet with less gravity. So if a woman doesn't want surgery or isn't a good candidate for surgery because of her age or medical conditions, 有哪些非手术的选择呢?
简: So if the vaginal bulge has started to bother them, a vaginal pessary is a good option for her. And it's really good for those women who don't want to have surgery, who maybe cannot have surgery because they have medical problems that make it not a safe option.
Dr. 琼斯: Or they're going on a walking trip to Europe right now, no time for surgery. 在我回来之前大发娱乐能做什么?
简: 也许他们可以推迟, 他们想推迟手术, 但是他们想要舒适, 完全.
什么是阴道托?
Dr. 琼斯: 你能告诉我什么是子宫托吗?
简: 好吧, a pessary is a device that fits inside the vagina and it's made from rubber, 塑料或硅基材料. 有很多大小和形状. 我在诊所所做的就是为一个女人量身定做. 大发娱乐把子宫托放进去，看看是否合适. The only reason a woman would know that she has the pessary in place is that she doesn't have the vaginal bulge anymore. 她甚至不应该知道子宫托已经到位. And what's interesting is pessaries have been used before Christ. And what they used were pomegranates, and more recently, potatoes have been used. 虽然, we don't recommend those use now because we have pessaries that have been developed by scientists.
Dr. 琼斯: 稍微便宜一点, 虽然, but having said that I would rather have something that was made out of silicone than something that might sprout. 好吧，那它们的效果如何呢?
简: Sixty-three to 83% of women can be fit with a pessary and of those women that can be fit, 76%到80%的人对他们的子宫托满意.
Dr. 琼斯: 你能用多久?
简: 你想用多长时间就用多长时间.
更新日期：2020年10月22日
最初发布日期：2015年9月17日