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Pelvic Floor Dysfunction


Definition

Pelvic floor dysfunction is when the pelvic floor muscles do not relax when urinating or passing stool. These muscles support the bladder, bowels, and sex organs.

Causes

The exact cause is not known, but may be due to:

  • Trauma from an accident
  • Childbirth, especially with an episiotomy
  • Mental health problems
  • Nerve or muscle problems
Female Pelvic Organs
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Risk Factors

Things that may raise the risk of this problem are:

  • Childbirth—the risk increases with each birth
  • Obesity —causes extra strain on muscles
  • Past pelvic surgery
  • Past radiation therapy

Symptoms

Problems may be:

  • An urgent or frequent need to pass urine
  • Pain when passing urine
  • Problems passing stool (poop), such as, straining or pain
  • Pain in the lower back
  • Pelvic pain
  • Pain during sex (in women)

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Pelvic floor muscle control may be tested. This can be done with:

  • Electrodes on the area between the vagina and rectum
  • A device placed in the vagina or rectum to measure pelvic floor muscle strength
  • X-rays of the bowel during a bowel movement
  • A urine flow test to measure the speed and force of urine

Treatment

The goal of treatment is to relax the pelvic floor muscles. Choices are:

  • Biofeedback to help train the muscles
  • Physical therapy to learn how to relax and coordinate the muscles
  • Relaxation methods to ease stress
  • Medicines, such as muscle relaxants

Prevention

The risk of this problem may be lowered by maintaining a healthy weight. This will ease stress on pelvic floor muscles.

References

  • American College of Obstetrics and Gynecology (ACOG) and American Urogynecologic Society (AUGS). ACOG Practice Bulletin No. 185: Pelvic Organ Prolapse. Obstet Gynecol. 2017 Nov;130(5):e234-e250.
  • Pelvic floor disorders. The University of Chicago Medicine website. Available at: https://www.uchicagomedicine.org/conditions-services/pelvic-health/pelvic-floor-disorders.
  • Pelvic floor dysfunction. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/diseases/14459-pelvic-floor-dysfunction.
  • Pelvic floor dysfunction. Interstitial Cystitis Association website. Available at: http://www.ichelp.org/about-ic/associated-conditions/pelvic-floor-dysfunction.
  • Pelvic floor dysfunction expanded version. American Society of Colon and Rectal Surgeons website. Available at: https://fascrs.org/patients/diseases-and-conditions/a-z/pelvic-floor-dysfunction-expanded-version.
  • Pelvic organ prolapse. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/pelvic-organ-prolapse.
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