The patient is a woman of 46, who started running three years ago. After three quarters of an hour of running she gets urgency feelings and some stool also leaks out.
Seven years ago she gave birth with snip (episiotomy) and vacuum. At the time she had unintentional loss of stool a few times, but after that not anymore, really.
The last time running, already after 10 minutes she had loss of stool and as much as three times she involuntary passed great amounts of stool. She now uses an anal tampon when running, afraid it will go wrong again.
Lately, while putting on a sprint, she is leaking some urine. Afterwards she noticed her panty liner was full. She had never experienced urinary incontinence before, not even while exercising.
But now she sometimes notices at work that she cannot hold her water as well as before. She then has a feeling of pressure she finds very uncomfortable.
All in all, for her a good reason to do something about it.
Examination
The findings of the rectal touch were as follows:
- The Puborectalis has an even basic tension, very little function, no pain, little movement.
- The External Anal Sphincter has better function.
- It seems there is an avulsion of the Puborectalis on the right side ventrolaterally.
Diagnosis with the MAPLe
After that the patient was measured anally with the MAPLe.
The MAPLe grids (circles) show the average values over the entire measurement.
- The Rest value is 5.7 µV. You can see that the front side and the left side are slightly weaker and superficially an overactivity is clearly visible.
- The MVC measurement shows a peak of 14.5 µV. The muscle activity at the top and deep is moderate.
- The Endurance measurement shows little strength.
Treatment
The treatment was as follows:
- Relaxation exercises with focus on relaxation of the superficial muscles
- Pelvic floor muscle exercises
- Exercises with the MAPLe in lying, sitting and standing position
This patient had a total of nine treatment sessions.
Values after treatment
After treatment, the values were as follows:
- The Rest value has improved considerably: the overcapacity is as good as gone and the average value fell to 3.0 µV.
- The MVC shows more strength with a peak value of 24.0 µV.
- The Endurance has improved considerably: the average value increased from 8.0 µV to 15.9 µV, which is also shown in the line graph.
Result
The patient is now doing much better. She does not suffer from defecation while running any longer. She can now run without an anal tampon. This is tremendous progress. In addition, she also has hardly any loss of urine now.
With the MAPLe you can provide a specific and targeted training, not only superficially but also deep or on a particular side. This produced great results in a short time. The therapy is ended and the patient’s quality of life has greatly improved.
This would not have been achieved with the current equipment.
