Pelvic floor muscle training (PFMT) practiced during pregnancy has proven protective effect against the development of UI. Nulliparous women who received PFMT at 20 weeks gestation were significantly less likely to have UI at 6 weeks and 6 months postpartum [82]. At 10 months postpartum, UI incidence decreased in 19% of women who received PFMT compared with 2% in the control group [83]. However, in a Cochrane Review, there were no sufficient data to determine the effect of physical therapies in preventing UI during pregnancy [84]. PFMT is an effective therapy for the treatment of UI and FI [85, 86]. Electrical stimulation and biofeedback are other well-established conservative treatments. A randomized controlled study shows a significant improvement in anal continence in women who had electrical stimulation compared with PFMT and biofeedback [87].

The choice of surgical technique depends on the type of UI. In women with SUI and anal sphincter defects, a midurethral sling or colposuspension and a sphincteroplasty can be performed concomitantly. Ross et al. [88] reported 46 cases of combined overlapping sphincteroplasty and laparoscopic colposus-pension with 89% cure of UI and 82% of FI at 1-year follow-up.

Sacral nerve neuromodulation (SNM) acts by stimulating the S3 sacral nerve roots using an implanted electrode. SNM is effective in the treatment of both urge UI [89] and FI [90].

Artificial sphincter and bulking agents have been used with poor results for the treatment of DI.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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