Dysfunction of the pelvic floor muscles, affecting their normal function and causing symptoms such as urinary incontinence, fecal incontinence, and pelvic pain.
Pelvic floor dysfunction, a type of pelvic organ disorder, affects millions of people worldwide, causing a range of symptoms such as pelvic pain, difficulty urinating or passing stool, and pain during sexual intercourse. This condition occurs when the muscles of the pelvic floor become weak or tight, causing organs within the pelvis to drop and press down on the rectum and bladder.
Several factors can contribute to the weakening of the pelvic floor, including age, systemic diseases, lasting health issues that cause increased pressure in the abdomen and pelvis, pregnancy, trauma during delivery, multiple deliveries, large babies, operative delivery, and collagen disorders.
Fortunately, treatment options for pelvic floor dysfunction are plentiful. The first line of defence often involves pelvic floor physiotherapy, a specialised form of physical therapy focused on strengthening, relaxing, and improving the coordination of pelvic floor muscles. Techniques may include Kegel exercises, stretching exercises, biofeedback therapy, electrostimulation, and the use of vaginal dilators for pain relief or tissue stretching. Pelvic floor physical therapists also provide education on bladder and bowel habits and proper posture during elimination.
Lifestyle changes, such as diet modification, bladder training, weight management, and posture improvements, can also help reduce strain on the pelvic floor. In some cases, medications may be used adjunctively to alleviate muscle spasm, pain, or urinary issues.
Devices like pessaries can provide mechanical support for pelvic organ prolapse or other structural issues. Surgery is reserved for severe cases where conservative measures fail, correcting anatomical defects contributing to dysfunction.
Early intervention is crucial to prevent worsening symptoms, and treatment plans are ideally tailored to individual needs and comfort, often coordinated between physicians and pelvic floor therapists. This comprehensive approach addresses the wide range of pelvic floor dysfunction symptoms, including urinary/bowel incontinence, pelvic pain, prolapse, and sexual dysfunction.
While some family doctors may not be familiar with pelvic floor dysfunction, specialists such as colorectal doctors, urologists, and gynecologists can help diagnose the issue and recommend the best course of action. In all cases, it is essential to consult a healthcare provider before attempting any treatment.
References: [1] American College of Obstetricians and Gynecologists. (2018). Pelvic Floor Disorders in Adults. Retrieved from https://www.acog.org/womens-health/faqs/pelvic-floor-disorders-in-adults [2] National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Pelvic Floor Disorders. Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/pelvic-floor-disorders [3] National Women's Health Network. (2018). Pelvic Floor Dysfunction. Retrieved from https://www.nwhn.org/pelvic-floor-dysfunction/ [4] Mayo Clinic. (2018). Pelvic Floor Disorders. Retrieved from https://www.mayoclinic.org/diseases-conditions/pelvic-floor-disorders/symptoms-causes/syc-20354182 [5] International Continence Society. (2018). Definitions, Classification, and Terminology for Pelvic Floor Disorders. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/ics.13288
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