Pelvic Floor Disorder

Types of pelvic floor disorders include:

• Fecal incontinence – the inability to control bowel movements
• Urinary incontinence
• Pelvic organ prolapse – a condition that occurs when the muscles and tissues supporting the pelvic organs weaken and begin to slip
• Obstructive defecation – a condition in which a person is unable to properly release their bowels

Causes of pelvic floor disorder

A pelvic floor disorder typically occurs when the pelvic muscles become weakened or the connective tissue tears. When the pelvic floor becomes damaged, it can’t support the pelvic organs properly. As a result, the bowel, bladder, uterus, vagina and rectum can be affected.

Some of the most common causes of pelvic floor disorders include:

• Childbirth – as a woman has more children, her risk of developing a pelvic floor disorder increases
• Obesity
• Repeated heavy lifting
• Straining from chronic constipation
• Pelvic surgery can damage nerves in the pelvic floor

Women at risk for a pelvic floor disorder can do pelvic floor exercises to improve muscle tone and prevent the need for more invasive treatments

Risks factors for pelvic floor disorder

Approximately 25 percent of women over 20 years old suffer from a pelvic floor disorder. Risk factors will vary based upon the stage of life you are in as well as what type of pelvic floor disorder you have.

Risk factors of a pelvic floor disorder may include:

• Genetics – Some people are born with weak pelvic floor muscles, which increases their likelihood of developing a pelvic floor disorder later in life.
• Race – Caucasian women are more likely to develop urine leakages from coughing and sneezing, while African American women are more likely to leak urine from urgency.
• Ethnicity – Mexican American women are more likely to develop urinary incontinence than other Latino women.
• Obesity – Obese women are more likely to develop urinary incontinence due to the pressure constantly placed on the bladder.
• Diet – Women who eat diets low in fiber, water, caffeine, alcohol or other foods that irritate the bladder are more likely to develop a pelvic floor disorder.
• Smoking – Women who smoke are more likely to develop urinary incontinence.
• Older women – The pelvic floor deteriorates as you age, so older women are more likely to develop a pelvic floor disorder.
• Women in menopause – The pelvic floor starts breaking down during menopause.
• Vaginal childbirth – Vaginal childbirth dramatically increases a woman’s likelihood of developing a pelvic floor disorder.

Symptoms of pelvic floor disorder

Symptoms of pelvic floor disorders may include:

• Constipation
• Pain in the rectum
• Pelvic muscle spasms
• Abnormal pressure in the pelvis or bulge in the rectum

Diagnosis of pelvic floor disorder

Your doctor can diagnose a pelvic floor disorder. Steps in the diagnostic process include: taking a full medical history, conducting a physical exam and ordering diagnostic testing.

Diagnostic tests that may be ordered include:

• Pelvic ultrasound
• Genitourinary radiology
• Cystoscopy
• Anal ultrasound – evaluates the anus for injury
• Urodynamics – measures bladder function
• Magnetic resonance imaging (MRI) – evaluates the urogenital compartment, pelvic floor organs and examines the sphincter.
• Anorectal manometry – examines the anal sphincter muscles and checks how well the rectum is functioning.

Treatment of pelvic floor disorder

Treatments for pelvic floor disorders may differ based on what disorder you have. In many cases, they can be treated with conservative treatments as first-line therapy. The goal of treatment is to relax the pelvic floor muscles to give you more control over your bowel movements.

Pelvic floor treatments may include:

• Kegel exercises – Kegel exercises help strengthen the pelvic floor muscles. During Kegel exercises, you will repeatedly contract and relax your pelvic muscles over many days, weeks or months.
• Biofeedback – Biofeedback allows your doctor to monitor how you contract and relax your pelvic muscles. After the test, your doctor will give you instructions on how to improve the strength of the muscles.
• Nutrition – Eating smaller meals and avoiding alcohol and caffeine can help relax your pelvic floor muscles.
• Medication – There are some prescription and over-the-counter medications that can slow the bowel.
• Surgery – Surgery can help repair damaged anal sphincter muscles in order to restore bowel function.