Pelvic Floor Dysfunction
What is Pelvic Floor Dysfunction?
The pelvic floor is a group of muscles and tissues located in the base of the pelvis that provide support to the pelvic organs, including the bladder, uterus (in women), and rectum. These muscles also play a crucial role in controlling bowel and bladder function and are involved in sexual function. Pelvic floor dysfunction refers to a wide range of conditions that affect the pelvic floor muscles, ligaments, and connective tissues, leading to problems with the normal functioning of the pelvic floor. They can be caused by age, trauma, surgeries, repeated strain, poor posture, childbirth and neurological conditions (such as spinal cord injury and multiple sclerosis).
What Are Symptoms of Pelvic Floor Dysfunction?
Pelvic floor dysfunction can manifest in several ways and may include the following:
- Pelvic organ prolapse occurs when one or more pelvic organs, such as the bladder, uterus, or rectum, bulge or drop down into the vaginal or rectal area due to weakened pelvic floor muscles and ligaments. Patients may feel heaviness, pain, or a lump sensation since the area's muscles, connective tissues and ligaments can't support those organs.
- Urinary urgency or overactive bladder is a frequent or sudden urge to urinate that is difficult to control.
- Urinary incontinence is the involuntary leakage of urine and can result from weak or overactive pelvic floor muscles. There are different types of urinary incontinence, including stress incontinence (leakage with activities like coughing or sneezing) and urge incontinence (sudden and strong urge to urinate).
- Stress incontinence – This occurs as the pelvic floor is not usually trained to take on the stress of running, sneezing, jumping, coughing or even walking. This occurs gradually with possible weight gain and/or in post-pregnancy, after vaginal deliveries.
- Urge incontinence – This is the result of an unstable bladder. This may be seen in television advertisements, showing women (or men) needing to go “right now.”
- Mixed incontinence – This is a combination of both types of urinary incontinence.
- Fecal incontinence is similar to urinary incontinence but is the inability to control bowel movements, leading to the accidental passage of stool.
- Chronic pelvic pain is ongoing pain in the pelvic area, which can be associated with muscle tension and spasms. When pelvic pain lasts for 6 months or longer, doctors consider it to be chronic, even if the problems come and go. You might feel pelvic pain in the abdomen, under your bellybutton. Health conditions such as vaginismus, vulvodynia, vestibulitis, interstitial cysts, coccydynia, uterine fibroids or anismus can cause pain in the vaginal or rectal area. A person may experience pain while sitting, during intercourse or general pain in the lower abdomen and hips.
- Dyspareunia is painful sexual intercourse and can also be a symptom of pelvic floor dysfunction. This can include vulvodynia, vestibulitis, interstitial cystitis and coccydynia.
- Difficulty emptying the bladder or bowels is when weak or overly tense pelvic floor muscles can lead to difficulty in fully emptying the bladder or bowels or cause constipation.
- Postpartum musculoskeletal dysfunctions related to pregnancy.
Pelvic floor dysfunction can be caused by numerous factors, including pregnancy and childbirth, aging, obesity, surgery, chronic constipation, or heavy lifting. Diagnosis typically involves a physical examination, and treatment options may include pelvic floor therapy, lifestyle modifications, medications, and in some cases, surgical interventions.