Home Blog

Pelvic floor dysfunctions are a series of disorders affecting millions of Americans and yet go undiagnosed and untreated in several cases. It is estimated that 1 out of 5 Americans will suffer from pelvic floor dysfunction at some point in their lives. It is a disorder that affects almost 50% of all women but can also affect men and children.

Pelvic function dysfunction (PFD) is a disorder that affects the muscles of the pelvis. These muscles support the various organs in the pelvic girdle including the bladder, the prostate, the rectum, and female reproductive organs. The urinary and the anal sphincters also function with the help of these muscles.

The symptoms of pelvic floor dysfunctions depend upon the type of the dysfunction and the muscles which are affected. Some of the different types of pelvic floor dysfunctions and their symptoms include:

• Uterine Prolapse: This condition occurs when the muscles and ligaments supporting the uterus weaken and the uterus descends into the vaginal canal. Symptoms include difficulty and pain during sexual intercourse, urinary incontinence, lower back pain, fleshy parts of the uterus protruding from the vagina, chronic bladder infections, vaginal bleeding, increased discharge from the vagina and a heavy feeling in the pelvis.
• Urinary Incontinence: This condition can be caused by a number of conditions including a weakening of the muscles which control the valve of the bladder. It results in a frequent urge to urinate. Other symptoms include pressure on the bladder and a feeling that the bladder has not been completely emptied.
• Fecal Incontinence: This condition is characterized by a loss of bowel control which leads to the involuntary passage of stools. It may be classified as passive incontinence where the person passes stools without being aware of it or urge fecal incontinence in which the person is aware of the need to pass stools but cannot control their passage.
• Dyssynergic Defecation: This is a condition where the muscles and nerves of the pelvic floor do not function properly resulting in an inability to pass stools, otherwise known as constipation. Associated symptoms include a bloated feeling, a feeling of incomplete evacuation, hard stools, excessive straining and being unable to have a bowel movement regularly. This dysfunction may also cause narrow stools.

Pelvic floor dysfunctions have many causes. Injury to the muscles and nerves of the pelvic floor may be caused by age, surgery and in the case of women, pregnancy and natural childbirth. In many cases the exact causes remains unknown.

A diagnosis of pelvic floor dysfunctions will usually begin with a history of the patient followed by a physical examination. A commonly used tool to aid in diagnosis is a study known as a defecating proctogram. It can help identify the exact location of the dysfunction. During the procedure, the patient is given an enema using a liquid that is visible in an x-ray. A device records the video image of the muscle movement in the pelvic floor region. With this study the doctor is able to see whether or not the pelvic floor muscles are functioning properly. It can help identify cases of rectal prolapse and rectocele, which is the formation of small pouches in the rectum.

Treatment of pelvic floor dysfunction range from physical therapy involving exercises to strengthen the pelvic floor muscles, to surgery depending on the cause and the severity of the condition. Treatment options include:

• Biofeedback: The therapist teaches the patient ways to coordinate the use of abdominal and pelvic floor muscles. This is known as pelvic floor retraining and is said to be effective in almost 70% of all cases.
• Pelvic Floor Exercises: A set of exercises known as Kegel exercises helps to strengthen the pelvic floor muscles. These exercises can be performed at any time and help to improve bladder control as well as anal sphincter control. They can be combined with biofeedback for greater effectiveness.

Kegel Exercises for Women

These exercises can be performed while sitting, standing or lying down.

Contract the pelvic floor muscles. These are the same muscles you would use to stop yourself from urinating. You will feel your urethra and anus being squeezed by these muscles. Squeeze them for three seconds and then relax them.

Repeat this 10 to fifteen times per session, gradually increasing the time spent squeezing the muscles. You will need to do at least three sets a day on a daily basis. The longer and more frequently you perform these exercises, the more effective they will be.

Kegel Exercises for Men

Kegel exercises in men involve the squeezing and the tightening of the anus, stopping the flow of urine and the lifting of the scrotum. Perform all three actions simultaneously. Hold the contraction for as long as you can before slowly releasing. Gradually increase the time so that you can hold it for ten seconds. Repeat this for up to ten times per set and perform at least 3 sets every day.

Other forms of treatment include medication and surgery in the more severe cases. Consult your doctor if you have any problem urinating or defecating.

Reference

1. http://obgyn.ucla.edu/body.cfm?id=194
2. http://www.nichd.nih.gov/health/topics/pelvic_floor_disorders.cfm