After pregnancy, a woman's perineum was strained.

This can result in particular in organ descent, urinary or anal incontinence.

To avoid these symptoms, Sylvie Bellicocq, physiotherapist, insists at the microphone of "Sans Rendez-vous" on the importance of pelvic floor rehabilitation.

It also returns in detail on the course of the latter.

These are certainly the most difficult ordeals on a woman's body: pregnancy and childbirth.

These two stages, essential for giving life, can strain the perineum and lead to many inconveniences.

Because the perineum is "the whole of the musculature which will come to close the pelvis", details at the microphone of "Without Rendez-vous Sylvie Bellicocq, physiotherapist and president of the Scientific Council of the French Association of Reeducation in pelvi-perineology.

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Factors that can generate troubles

However, the ravages of time, weight gain, anorexia, pregnancy and childbirth are all factors that will promote disorders of what is also called pelvic floor, and can lead to a descent of organs, urinary or anal incontinence.

And this is all the more true during childbirth: this "will generate both a stretch of the perineal muscle, but also a compression of the latter".

The combination of these two factors can then lead to muscle damage and pelvic floor disorders.

The importance of a postpartum checkup

This is why Sylvie Bellicocq insists on the need to do a pelvic-perineal assessment, generally between the sixth and the eighth week after childbirth.

But this deadline is not set in stone, far from it.

In the event of "very important symptoms, they must be taken care of as quickly as possible. Especially since incontinence is one of the symptoms of postpartum depression".

The specialist nevertheless wants to be reassuring and recalls that "85% of postpartum urinary incontinence resolve spontaneously within three months" following childbirth. 

But the pelvic-perineal assessment also has another utility: to detect anatomical abnormalities.

Because in 75% of cases, "moderate organ descents, which are relatively frequent after childbirth, are asymptomatic", indicates the physiotherapist. 

Concretely, this examination takes place in two stages.

First of all, "the patient is asked about the symptoms and the severity" of the abnormalities is determined.

Then comes the clinical examination itself.

The physiotherapist or midwife then proceeds in particular to a vaginal examination.

After this assessment, the specialist determines whether rehabilitation is necessary. 

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Rehabilitation to "control voluntary contraction"

Head to the office of a physiotherapist who will set up a personalized rehabilitation program reimbursed by Social Security.

Here, the woman must (re) learn to "control the voluntary contraction [of her perineum] before she can strengthen it".

To do this, in addition to the "manual techniques which are the basis" of the process, it is possible to use the technique known as biofeedback.

Thanks to a vaginal probe connected to a screen which records the activity of the perineal muscles during the contraction, we obtain a real-time trace of the muscular activity ". This allows the patient" to become more easily aware of a relaxation muscle for example ".

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Once the voluntary contraction has been mastered and a few exercises taught, it is time for real rehabilitation.

"We learn at the office and we re-educate at home", summarizes at the microphone of Europe 1 Sylvie Bellicocq.

And in fact, the patient will have to perform short or sustained contractions in everyday situations such as walking or public transport.

One of the best-known exercises in this area is certainly the so-called "stop pee", which consists, as its name suggests, in stopping voluntarily during urination.

But it is a counter-productive exercise because "we disrupt the bladder emptying", explains the physiotherapist.

It is however possible to perform this exercise when you are not urinating. 

"There is no age" to exercise your perineum

"Extremely important" point raised by Sylvie Bellicocq, "there is no age" to exercise your perineum.

Old age is one of the factors of perineum disorders, training the latter can be a good idea.

Especially since "older women can expect the same benefits as younger women," says the expert.