臨床婦人科産科73巻1号

2019年01月発行

合併増大号　今月の臨床 エキスパートに学ぶ　女性骨盤底疾患のすべて 疾患各論：骨盤臓器脱

骨盤臓器脱の保存療法

著者： 関口由紀¹ 中村綾子¹ 重田美和¹ 増田洋子¹

所属機関： ¹女性医療クリニックLUNA ネクストステージ

ページ範囲：P.52 - P.60

●骨盤臓器脱に対する骨盤底トレーニングは，脱自体の重症度を改善させるには至らないが，外陰部不快感・過活動膀胱症状・便秘などの自覚症状を改善させる．

●日々の運動・姿勢・呼吸などの生活習慣是正も，骨盤臓器脱の保存管理には大切である．

●骨盤臓器脱に対する腟ペッサリーの自己着脱療法は，一生涯続けなけらばならないという制約を除けば，患者の生活の質を十分に向上させるよい治療法である．日本で利用可能な腟ペッサリーの種類も増加している．

参考文献

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2）Petros PEP：Reconstructive pelvic floor surgery according to the integral theory. In The female pelvic floor-function, dysfunction and management according to the integral theory, 2nd ed. pp83-167 Springer, 2007

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5）Nakamura R, et al：Outpatient mid-urethral tissue fixation system sling for urodynamic stress urinary incontinence：3-year surgical and quality of life results. Int Urogynecol 28：1733-1738, 2017

6）Wiegersma M, et al：Effect of pelvic floor muscle training compared with watchful waiting in older women with symptomatic mild pelvic organ prolapse：randomised controlled trial in primary care. BMJ 349：g7378, 2014

7）Dumoulin C, et al：Conservative management for female urinary incontinence and pelvic organ prolapse review 2013：summary of the 5th International Consultation on Incontinence. Neurourol Urodyn 35：15-20, 2016

8）関口由紀，他：女性外来の骨盤底筋トレーニング．宝島社，2014

9）Crawford B：A program of functional movement for pelvic floor exercise compared to traditional Kegel exercise.（Data not published）

10）Crawford B：Lower body plyometric exercise and pelvic floor muscular engagement. Society for Urodynamics and Female Urology, 2011 Winter Meeting. Neurourol Urodyn 30：204-279, 2011

11）ven Greeln JM, et al：Where to for pelvic organ prolapse treatment after the FDA pronouncements? A systematic review of the recent literature. Int Urogynecol J 24：707-718, 2013

12）Portman DJ, et al：Genitourinary syndrome of menopause：new terminology for vulvovaginal atrophy from the International Society for the Study of Women's Sexual Health and the North American Menopause Society. J Sex Med 11：2865-2872, 2014