Pelvic Floor Disorders

When the surrounding muscles are weak, your pelvic organs can't work correctly. You can protect your pelvic health by understanding the characteristics and activities that put you at risk for a pelvic floor disorder. This will also help you avoid disruptive and painful symptoms.

Your pelvic floor muscles can weaken from:

• Aging.
• Being overweight.
• Birth defects.
• Emotional stress.
• Enlarged prostate gland or treatment for another prostate problem.
• Heavy lifting.
• Menopause.
• Nerve damage from spinal cord injuries, diabetes, Parkinson's disease and multiple sclerosis.
• Overactive bladder.
• Pregnancy and childbirth.
• Smoking.
• Stool build-up in the bowels.
• Urinary tract infections.

While most people have the same symptoms, the severity can vary widely. We can help, whether your symptoms are very minor or are so severe they're affecting your quality of life. Talk with a doctor if you have:

• Constipation.
• Trouble urinating.
• Frequent or urgent urination.
• Leaking urine or feces.
• Pain in the lower back.
• Pain with intercourse.
• Pelvic pain or discomfort.
• Pressure or fullness in the pelvis.

When you have fecal incontinence, it means you can't hold your stool. Although it's not a normal part of getting older, you are more likely to have fecal incontinence as you age. It can also be caused by:

• Congenital problems.
• Diabetes.
• Diarrhea or constipation.
• Injuries from having a baby or being pregnant.
• Injuries or diseases of the spinal cord.
• Large hemorrhoids.
• Severe dementia.
• Severe inflammation.
• Surgery involving the anal sphincter.
• Tumors.

Pelvic organ prolapse happens when your pelvic floor becomes so weak a pelvic organ drops into your pelvis. Sometimes, these organs can even fall into or outside the vagina or anus.

There are different types of prolapse, including:

• Cystocele (bladder).
• Enterocele (small bowel).
• Rectocele (rectum).
• Urethrocele (urethra).
• Uterine (uterus).
• Vaginal vault (vagina).

Many people with pelvic organ prolapse don't have any symptoms at all. However, if symptoms are present, they may include:

• Bulging in the vagina.
• Feeling of heaviness, fullness, aching or pressure in the pelvis or lower belly.
• Frequent or urgent need to urinate.
• Frequent urinary tract infections (UTIs).
• Inability to completely empty the bladder.
• Inability to pass stool without laxatives.
• Lower back pain.
• Needing to push organs back up into the vagina to urinate or have a bowel movement.
• Pelvic pressure that gets worse when standing, lifting or coughing, or as the day goes on.
• Problems putting in tampons or vaginal applicators.
• Sexual dysfunction or pain during sex.
• Uncontrolled urine leakage.

Urinary incontinence — the loss of bladder control — is a problem many of us could face as we get older. Cases can range from mild (a bit of leaking when you cough or sneeze) to more severe (a sudden and urgent need to urinate without being able to hold it).

Learn more about urinary incontinence.

Behavioral therapy for pelvic floor disorders may include:

• Bladder training: You'll be taught ways to help you increase the amount of time between urinating and resisting the urge to urinate.
• Lifestyle changes: Many lifestyle changes can help you manage your symptoms. These include things like changing your diet, adjusting how much fluid you drink and limiting your caffeine and alcohol intake.
• Scheduled toileting: By scheduling your toilet breaks to prevent leaking, you can train your bladder to empty every two to four hours.

Nonsurgical treatments for pelvic floor disorders can include:

• Medicines: Your doctor may prescribe incontinence medicines or estrogen therapy.
• Pessaries: Made out of plastic or silicone and inserted into your vagina, these small, removable devices can keep your pelvic organs in place. Your doctor may recommend a pessary to help with stress incontinence or pelvic organ prolapse. There are different types of pessaries. If you need one, your device will be fitted to your body to make sure it's comfortable for you.

In some cases, physical therapy can help with pelvic floor disorders. This can include pelvic floor exercises such as kegels, and biofeedback.

Our pelvic floor physical therapists specialize in treatments that strengthen your pelvic floor. If you think you may benefit from pelvic floor physical therapy, talk to your doctor. You'll need a referral to begin pelvic floor physical therapy.

Learn more about pelvic floor physical therapy.

In some cases, surgery may be the only way to treat your pelvic floor disorder. If that's the case, our fellowship-trained surgeons will work with you to determine the best surgical option for you. to find the right treatments.

Many disorders can be treated with minimally invasive surgery, including robot-assisted procedures. The benefits of minimally invasive surgery include:

• Faster return to normal activities.
• Less blood loss.
• Less injury to tissue.
• Less pain.
• Shorter hospital stays.