The World Health Organization considers urinary incontinence a public health problem. This condition affects both men and women and, like anal incontinence, genital prolapse, sexual dysfunction, and pelvic pain, has a significant negative impact on patients' quality of life. Previously, these conditions were seen as a natural consequence of aging, and people adapted to the changes it entails. Modern society and increased life expectancy have led people to become more concerned about their quality of life and well-being, increasingly seeking treatment for these conditions at an earlier age.
The lack of perineal rehabilitation protocols that respected the progression of treatment and the individuality of each patient led me to develop the " Active Perineal Rehabilitation " protocol. This protocol aims to rehabilitate the perineal muscles so that they can perform their functions. The only movement resulting from perineal contraction is its elevation cephalad and forward movement toward the pubic symphysis. Rehabilitation of these muscles is achieved through their contraction , relaxation , and stretching .
RPA is based on exercise physiology, taking into account the cognitive, neuromuscular, and metabolic changes caused by rehabilitation. It is indicated for muscular rehabilitation in the treatment of female and male urinary incontinence, male and female sexual dysfunction, anal incontinence, constipation, genital prolapse, and pelvic pain. When these conditions are more advanced and surgery is necessary, perineal rehabilitation is recommended before and after surgery, serving as a complementary treatment to surgery.
Laira Ramos
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