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¿PéŽrdidas de orina? Fortalece el suelo pŽélvico

Cuando al toser, estornudar o al hacer algún esfuerzo sufrimos pérdidas de orina podemos tener algún problema con el suelo pélvico. Según explica el Dr. Gustavo Sevilla, nuestro especialista del Servicio de Rehabilitación, las principales disfunciones o alteraciones del suelo pélvico por las que se acude a la consulta son variadas, aunque la principal es la incontinencia urinaria tanto en mujeres como en hombres. Otras alteraciones menos frecuentes van a ser la incontinencia anal, el dolor pélvico, la presencia de prolapsos o celes (vejiga, útero…) y disfunción sexual secundaria.

Y los signos de alarma son los comentados, a los que hay que añadir el dolor en las relaciones de pareja tras comenzar las mismas tras el parto o la aparición de algún «bulto» que asoma a través de la vagina (cele o prolapso), con una sensación de ocupación de espacio.

Y es que estas alteraciones acompañan a la mujer durante el embarazo, en el post- parto, sobre todo si ha sido traumático, y en la menopausia. En el caso del hombre, suele ser después de la cirugía de próstata.

Problemas de orina

Prevención

Para prevenir su aparición, se cuenta con los ejercicios llamados de «Kegel», bautizados así por el ginecólogo que los describió. Se trata de una serie de ejercicios para fortalecimiento de la musculatura de suelo pélvico, que habitualmente se vienen incluyendo en las clases de preparación al parto, ya que el embarazo y el parto van  generar una situación especial que puede implicar un daño  para el suelo de la pelvis al poner en máxima tensión las distintas estructuras que lo componen.

«Si los músculos están en buen estado antes del parto, tendrán menos tendencia a los desgarros y otras lesiones, y la recuperación postparto de esta región será más rápida, evitando a medio plazo los problemas de incontinencia y/o disfunción sexual. Además, ayudan a las mujeres embarazadas a soportar mejor el aumento de peso y presión por el crecimiento del bebé en el interior del útero», asegura el Dr. Gustavo Sevilla.

Por eso, hay que preparar esta zona para el momento del parto. Los ejercicios del suelo pélvico se basarán en la contracción repetida de los músculos del elevador del ano y abdominales profundos transversos. También se pueden hacer ejercicios abdominales hipopresivos, siempre y cuando no se tenga hipertensión arterial ni se esté embarazada. Con los conos vaginales o bolas chinas hay que tener cuidado y siempre deben
ser valorados por un profesional adecuado.

Ejercicios para fortalecer el suelo pélvico

De forma general, tal y como explica nuestro especialista en rehabilitación, los ejercicios deben realizarse tumbada al ser la postura más confortable: rodillas flexionadas y con los pies apoyados en el suelo. En esta postura, se trata de imaginar que los músculos que rodean la vagina tiran hacia arriba. Esto sería la contracción del músculo.

Una vez que sabemos contraer, solo queda repetirlas de dos formas:

Lentas

  • Se realiza la contracción del músculo intentando mantenerla durante cinco segundos, y relajando después el músculo lentamente durante 10-15 segundos
  • Hacer tres series de 10 repeticiones, tres veces al día

Rápidas

  • Se contraen y relajan los músculos tan rápidamente como se pueda
  • Se comienza con tres series de 10 repeticiones de tres a cuatro veces al día, aumentándolas hasta hacer 20-30 repeticiones cada serie, tres veces al día.
Contenido validado por el Dr. Gustavo Sevilla, del Servicio de Rehabilitación del Hospital Universitario de Torrejón


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