Abstract

YONIBHRANSHA-WEAK PELVIC FLOOR MUSCLES STRENGTH MEASURED BY PERINEOMETER –A CASE STUDY

Dr. Preeti Singh*, Dr. Sunita Kumari, Dr. Shikha Sharma and Dr Indu Shri

Abstract

Term Yoni as Tryavarta yoni, a genital tract which includes uterus, cervix, vagina & Bhransh means Prolapse. Yonibhransha is a common condition in which uterus slips down into or protrudes out of vagina. Under the broad spectrum of Yoni bhransha based on its severity, Prasamsini SU: U 38/13, PhaliniSu. U38/18, Andini Bha; Pra. Chi 70/14, and Mahayoni yonivyapada Cha. chi 30/32 are the different clinical presentation described in twenty yonivyapada by different acharyas in vrihattrai and Laghutrai of ayurvedic Literature, where Vata (body humor) is said to be most prominent contributing factor. In ayurveda general causes of yonivyapada are Mithyachar, Pradustartava, Beeja dosha and Daiva. Specific cause of Yonibhransha is Dukha Prasava (Dystocia) excessive straining during second stage of labour and Vegadharana. Anatomically it happens due to weakness of pelvic floor muscles (PFM) and uterine ligaments which provide support for the uterus to maintain its normal position. Common symptoms are feeling of something coming out of vagina, backache, pelvic pressure, difficulty in passing urine, incomplete evacuation, urgency and frequency of micturation, tention of urine, difficulty in passing stool. In uterine prolapse, depending on descent uterine parts, three degrees are described. In which these four yonivyapada Prasamsini shows 1st and 2nd degree prolapse, vatala shows uterosele, Mahayoni shows 3rd degree prolapse, Phalini shows cystocoele situation. Its prevelence is more than 50%f all gynecological condition. According to recent reports 40% of women between 45 and 85 years age have pelvic organ prolapse(POP) on examination but only 12% are symptomatic. The prevalence of symptomatic and anatomical uterine prolapse is 6. 6% (28) and 5. 9% (25), respectively.[1,2] For the management of Yonibhransha ayurvedic classical text advice sthanika chikitsa (local treatment) in support of oral medication. Which posses both local effect and general effect to improvement in patient condition. which can be observed as increased pelvic floor muscles strength. So in this study by measuring P. F. M strength with perineometer will help the clinician to know the relationship between degree of uterine prolapse and strength of pelvic floor muscles before and after the ayurvedic treatment and under follow up of three months.

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