Pelvic Floor Disorders

What is pelvic floor disorder?

A group of muscles and connective tissues make up your pelvic floor. When your pelvic floor weakens, it can cause problems. You may have bladder- or bowel-control problems (incontinence). It can cause constipation or painful urination. A weakened pelvic floor can even cause pelvic organ prolapse (when an organ slips forward or down).

Pelvic floor disorder symptoms

Symptoms of pelvic floor disorders vary. Pelvic floor disorders are commonly associated with women. But men can also have pelvic floor disorders.

There are many ways to tell that you may have pelvic floor disorder, according to the National Institutes of Health (NIH). Common symptoms include:

• Feeling of heaviness, fullness, pulling, or aching in the vagina that gets worse by the end of the day or during a bowel movement
• Seeing or feeling a “bulge” or “something coming out” of the vagina
• Having a hard time starting to urinate or completely emptying your bladder
• Having frequent urinary tract infections
• Leaking urine when you cough, laugh, or exercise
• Feeling an urgent or frequent need to urinate
• Feeling pain while urinating
• Leaking stool or having a hard time controlling gas
• Being constipated
• Having a hard time making it to the bathroom in time

What causes pelvic floor disorders?

There are many things that can damage your pelvic floor muscles. For women, childbirth is a common way those muscles lose their shape. Being overweight can also cause more stress on those muscles, pushing them out of shape. Or simply age can cause the muscles to wear down over time. This is especially true if you do not exercise them.

How are pelvic floor disorders diagnosed?

Your doctor will diagnose your pelvic floor disorder. After discussing your symptoms, they may perform a pelvic exam. During the exam, your doctor will check for muscle weakness.

Depending on the extent of your symptoms, your doctor may also order additional tests. Each of these can help define the level of weakness in your pelvic floor and how best to treat it. Some tests focus on rectal muscles. Other tests target how well your bladder and urethra are working.

Can pelvic floor disorders be prevented or avoided?

Pelvic floor disorders are caused by strain. This can be strain over time or strain from a specific event. So sometimes, there may be nothing you can do to prevent it.

In other situations, you may be able to prevent pelvic floor disorders from happening. Or at the very least, you may be able to ensure that they don’t happen prematurely. Being proactive about pelvic floor disorders can also limit their severity.

To help prevent pelvic floor disorders, you should:

• Maintain a healthy weight. Being overweight can put strain on your pelvic floor muscles.
• Exercise your pelvic muscles. These exercises, called Kegels, can strengthen your muscles. This can help with future incontinence.
• Decrease constipation. Eat foods with fiber that can help prevent constipation. Avoiding constipation can help with pelvic muscle strain.
• Learn to lift the right way. Use your legs to lift heavy items. Avoid using your back or abdomen muscles.

Pelvic floor disorder treatment

There are surgical and non-surgical treatments for pelvic floor disorders. Your treatment plan will depend on the severity of your disorder.

Non-surgical treatments

These treatments are the least invasive. They can help mild forms of pelvic floor disorders.

• Kegel exercises. These exercises help strengthen your pelvic floor muscles. Exercising these muscles can help incontinence, but do not correct organ prolapse.
• Prescription medications. There are medicines that can help with bladder control and prevent frequent bowel movements. Relieving these symptoms is often seen as a priority for people who suffer from pelvic floor disorders.
• Injections. If your main symptom of pelvic floor disorders is urinary incontinence, you may be able to solve it with injections. Your doctor can inject bulking agents to thicken tissues. This helps close the bladder opening.
• Vaginal pessary. A vaginal pessary is a plastic device that fits into your vagina to help support your uterus, vagina, bladder, or rectum. It helps with urinary incontinence and even prolapse.

Surgical treatments

If you don’t get relief of symptoms using non-surgical methods, you may need to consider surgery. There are several types of surgery used to correct pelvic floor disorders. The type of surgery you have will depend on how severely your pelvic floor is damaged. It will also depend on your symptoms. Surgeries for urinary incontinence focus on adding support for the bladder. Correcting prolapse involves surgery to build back a support system for your pelvic floor. Bowel incontinence may call for surgery to repair your sphincter muscle.

Living with pelvic floor disorders

Managing incontinence every day can be a challenge. There are products to help you with daily hygiene. There are absorbent pads, disposable underwear, reusable underwear with built-in pads, and more. You have choices, even if your incontinence is moderate to severe. You can use these products in the short-term as you work to rehabilitate your pelvic floor muscles. You can also use them long-term as a solution for your mild or moderate incontinence.

Know that it is also important to care for your skin when you are incontinent. Change soiled pads or briefs as soon as possible. This will minimize the amount of wetness against your skin. Keep your skin clean and dry. Wash your genital area with mild soap and water when you shower.

If your incontinence prevents you from having dry skin most of the time, you may need to use a barrier cream. These creams can protect you from rashes and irritation.

You may feel alone in your battle with incontinence. You should know that millions of men and women share your struggle.

Questions to ask your doctor

• What kind of pelvic floor disorder do I have?
• Could a medicine be contributing to my incontinence?
• Will Kegel exercises help correct my pelvic floor disorder?
• Am I doing Kegel exercises the correct way?
• What treatment is right for me?
• Can I prevent my incontinence from getting worse as I age?
• Can a physical therapist help with pelvic floor exercises?

Resources

National Institutes of Health: Pelvic Floor Disorders

National Institutes of Health, MedlinePlus: Pelvic Floor Disorders