Fronteras compartidas: Revisión interdisciplinaria gineco-urológica sobre el manejo integral de la disfunción del piso pélvico femenino

Autores/as

Palabras clave:

Incontinencia urinaria; Prolapso pélvico; Rehabilitación del piso pélvico; Uroginecología; Biofeedback

Resumen

DOI: https://doi.org/10.46296/gt.v8i16.0316

Resumen

La disfunción del piso pélvico femenino, que incluye afecciones como la incontinencia urinaria y el prolapso de órganos pélvicos, es común en mujeres posparto y posmenopáusicas, afectando su calidad de vida y función sexual. Una evaluación adecuada combina el examen clínico con técnicas de imagen (ultrasonido dinámico y resonancia magnética), las cuales aportan información anatómica y funcional complementaria. El tratamiento inicial es conservador, basado en ejercicios del piso pélvico (ejercicios de Kegel) como primera línea; a menudo se potencia con biofeedback o guía por imágenes para mejorar la activación muscular y reducir la incontinencia. Las intervenciones quirúrgicas, como las cintas suburetrales para la incontinencia de esfuerzo y las cirugías de corrección de prolapso, logran altas tasas de éxito funcional cuando están bien indicadas. La colaboración interdisciplinaria entre ginecología y urología (uroginecología) resulta fundamental para un abordaje integral que contemple simultáneamente la continencia urinaria, el soporte de los órganos pélvicos y la satisfacción sexual de las pacientes. La evidencia reciente respalda que un manejo uroginecológico integrado optimiza la recuperación funcional y la calidad de vida, resaltando la importancia de los equipos multidisciplinarios en la atención de estos trastornos.

Palabras claves: Incontinencia urinaria; Prolapso pélvico; Rehabilitación del piso pélvico; Uroginecología; Biofeedback.

Abstract

Female pelvic floor dysfunction, including conditions such as urinary incontinence and organ prolapse, is common in postpartum and postmenopausal women, affecting their quality of life and sexual function. Proper evaluation combines clinical examination with imaging techniques (dynamic ultrasound and magnetic resonance imaging), which provide complementary anatomic and functional information. Initial treatment is conservative, centered on pelvic floor muscle exercises (Kegel exercises) as first-line therapy; this is often enhanced with biofeedback or imaging guidance to improve muscle activation and reduce incontinence. Surgical interventions, such as mid-urethral slings for stress incontinence and prolapse repair surgeries, achieve high functional success rates when appropriately indicated. Interdisciplinary collaboration between gynecology and urology (urogynecology) is essential for a comprehensive approach addressing urinary continence, pelvic organ support, and patients’ sexual satisfaction. Current evidence supports that an integrated urogynecological management optimizes functional recovery and quality of life, underscoring the importance of multidisciplinary teams in the care of these disorders.

Keywords: Urinary incontinence; Pelvic organ prolapse; Pelvic floor rehabilitation; Urogynecology; Biofeedback.

Información del manuscrito:
Fecha de recepción:
20 de septiembre de 2025.
Fecha de aceptación: 15 de noviembre de 2025.
Fecha de publicación: 15 de diciembre de 2025.

Descargas

La descarga de datos todavía no está disponible.

Citas

Xergia SA, Tsekoura M, Fousekis K, et al. Effectiveness of pelvic floor muscle exercise with biofeedback in women with urinary incontinence: a systematic review. Appl Sci. 2023;13(23):12743. mdpi.commdpi.com

Kopańska M, Torices S, Czech J, et al. Urinary incontinence in women: biofeedback as an innovative treatment method. Ther Adv Urol. 2020;12:1756287220934359. mdpi.com

Tosun OC, Solmaz U, Ekin A, et al. Assessment of the effect of pelvic floor exercises on pelvic floor muscle strength using ultrasonography in patients with urinary incontinence: a prospective randomized controlled trial. J Phys Ther Sci. 2016;28(2):360-365. jstage.jst.go.jpjstage.jst.go.jp

Höder A, Stenbeck J, Fernando M, Lange E. Pelvic floor muscle training with biofeedback or feedback from a physiotherapist for urinary and anal incontinence after childbirth: a systematic review. BMC Womens Health. 2023;23(1):316. ouci.dntb.gov.ua

Sacomori C, Cardoso FL. Predictors of improvement in sexual function of women with urinary incontinence after treatment with pelvic floor exercises: a secondary analysis of a randomized trial. J Sex Med. 2015;12(3):746-755. pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov

Petre I, Furău C, Vacaru V, et al. Pelvic floor muscle training vs. vaginal vibration cone therapy for postpartum dyspareunia and vaginal laxity. Medicina (Kaunas). 2025;61(1):23. mdpi.com

Lai W, Wang G, Zhao Z. Advancements in magnetic resonance imaging for the evaluation of pelvic organ prolapse: a comprehensive review. Acad Radiol. 2025;32(8):4689-4704. pubmed.ncbi.nlm.nih.gov

Barakat B, Schweda D, Laali A, Afzal A. Comparison of magnetic resonance defecography with pelvic floor ultrasound and vaginal inspection in the urogynecological diagnosis of pelvic floor dysfunction. Urol Ann. 2020;12(2):150-155. pmc.ncbi.nlm.nih.govpmc.ncbi.nlm.nih.gov

Kapoor DS, Thakar R, Sultan AH. Establishing a multidisciplinary pelvic floor clinic: rationale, design, and outcomes. Int Urogynecol J. 2015;26(12):1739-1747.

Jallad K, Barber K, Gurland B, Ridgeway B. Better together: multidisciplinary approach improves adherence to pelvic floor physical therapy. Int Urogynecol J. 2020;31(5):887-893. ics.orgsciencedirect.com

Neacșu A, Martiniuc AE, Dumitrescu D, et al. Surgical treatments for women with stress urinary incontinence: a systematic review. Life (Basel). 2023;13(7):1480. mdpi.com

Maher C, Feiner B, Baessler K, Schmid C. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2016;(4):CD004014.

Woodley SJ, Boyle R, Cody JD, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2020;(5):CD007471. pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov

Dumoulin C, Cacciari LP, Hay‐Smith EJ. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018; (10):CD005654.

Nunes EFC, Sampaio LMM, Biasotto-Gonzalez DA, et al. Biofeedback for pelvic floor muscle training in women with stress urinary incontinence: a systematic review with meta-analysis. Physiotherapy. 2019;105(1):10-23. mdpi.com

National Institute for Health and Care Excellence (NICE). Urinary incontinence and pelvic organ prolapse in women: management (NICE Guideline NG123). London: NICE; 2019. nice.org.uknice.org.uk

McAchran SE, Hanno PM. Urology, gynecology collaboration addresses rising demand. Urology Times. 1 Jan 2017;45(1):15-17. urologytimes.comurologytimes.com

Villani F, Furău C, Mazzucato B, et al. Understanding pelvic organ prolapse: a comprehensive review of etiology, epidemiology, comorbidities, and evaluation. Soc Int Urol J. 2025;6(1):6. mdpi.commdpi.com

Glazener CM, Cooper KG, Freeman RM, et al. Surgical prolapse treatment with or without a midurethral sling in women with occult stress incontinence: a randomized trial. Lancet. 2017;389(10067):381-392.

Fatton B, de Tayrac R, Costa P. Stress urinary incontinence and overactive bladder in women: a review of impact on sexual function and management. Nat Rev Urol. 2014;11(10):565-578.

Publicado

2025-12-15

Cómo citar

Arias-Gutiérrez, A. F., Espinosa-González, I., Alvarez-Arias, Y. C., Montiel-Vásquez, L. M., Rueda-Ospina, J. A., Chaparro-Basto, J. H., Navarro-Perdomo, J. G., & Valencia-Rodríguez, N. (2025). Fronteras compartidas: Revisión interdisciplinaria gineco-urológica sobre el manejo integral de la disfunción del piso pélvico femenino. Revista Científica Arbitrada En Investigaciones De La Salud GESTAR. ISSN: 2737-6273., 8(16), 1261-1281. Recuperado a partir de https://www.journalgestar.org/index.php/gestar/article/view/282