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[Functionality of pelvic floor in patients after vaginal and abdominal hysterectomy, valuation by EMG-Biofeedback according to Perfect Scheme].

OBJECTIVE
Our research deals with the efficiency of rehabilitation in patients after vaginal and abdominal hysterectomy. The activation of pelvic floor muscles has been evaluated and comparison of individual parameters according has been carried out. Also the occurrence of incontinence has been assessed. Subjects consisted of 66 women, out of which there were 21 women after vaginal hysterectomy and 45 women after abdominal hysterectomy.


TYPE OF STUDY
Prospective experimental study. METHODS USE: EMG-biofeedback has been used for the evaluation of the functionality of pelvic floor according to Perfect Scheme. For the quantification of leaked urine one hour PW test has been used. REHABILITATION METHODS: We applied the individual exercise on strengthening and relaxation of pelvic floor muscles with the aid of repeated, selective voluntary contractions or relaxation of pelvic floor muscles conducted two times a week, with the duration time of 15 minutes. Group exercise on strengthening and relaxation of pelvic floor muscles conducted two times a week, with the duration time of 30 minutes. Biofeedback (EMG-Module) as a therapeutic method was applied.


RESULTS
In patients after vaginal hysterectomy there was a higher occurrence of incontinence than in women after abdominal hysterectomy. In both groups a significant increase in pelvic floor muscle strength has been achieved after the therapy. In both of these groups there was no statistically significant relaxation of m. rectus abdominis after the therapy. The patients after abdominal hysterectomy had more statistically significant relaxed abdomen muscles before treatment than patients after vaginal hysterectomy. It means, that performed exercise in the right manner, with reduction of intra abdominal pressure. We suppose that this phenomenon may be related to the higher percentage of occurrence of incontinence in patients after vaginal hysterectomy.