卫生保健与预防杂志

抽象的

Holistic Understanding of Pelvic Floor Support

Chew Heng Hai

Pelvic floor generally still a grey area in medical field. Chronic diseases in pelvic floor area: pelvic floor disorders and anorectal disorders are treated with relatively poor prognosis and associate with serious complications. Surgery removes the pathologic hemorrhoidal vein but not the cause, that why it keeps recurring. Gold standard surgery (lateral sphincterotomy) for chronic anal fissure, involve partial incision of anal sphincter exposes the patient to risk of permanent anal incontinence. Transvaginal sling surgery which is supposed to be gold standard treatment for urinary incontinence, on the other hand has caused serious complication lead to more than a hundred thousand of lawsuit globally. This sling surgery is based on relatively new integral theory (IT) which is contradicting with long established understanding of pelvic floor support. Even among urogyneacologists there were dispute about the IT right from beginning. As situation of sling complication worsens, more surgeon do not agree with IT. The sling complication happens everywhere. The risk of the complication is not significantly associated with any country, hospital, surgeon, or brand of the product. The world seems to be blaming on the material used to make the sling or mesh. But recent study on hernia mesh suggests the mesh material does not associate with the complication. With all these confusion, we should draw a conclusion: there is a clear need to revisit the current understanding of modern medicine on pelvic floor. Sharing in the presentation will be an innovative holistic understanding of pelvic floor based on old established simple support theory prior to IT. With this, the understanding of pelvic floor, anorectal and pelvic floor disorders and their interrelation between each other are better understood. This has been explored and show