Understanding Pelvic Floor Disorders

Understanding Pelvic Floor Disorders

The pelvic floor is composed of several muscles, connective tissues, nerves, tendons and ligaments that:

  • They support our organs (bladder, uterus and colon)
  • Helps sexual function
  • Help maintain continence

Pelvic floor disorders can result from pregnancy and childbirth, heavy lifting, chronic exertion or coughing, physical activity.

Types of Pelvic Floor Disorders

Pelvic floor disorders or diseases may include:

  • Pelvic organ prolapse
  • Urinary and fecal incontinence
  • Painful bladder syndrome

What is pelvic organ prolapse?

Pelvic organ prolapse occurs when the pelvic organs (uterus, bladder, rectum) descend into the vagina due to weakness of connective tissue and muscles. It is a common problem that may or may not have symptoms. Some people may have a feeling of fullness in the vagina, be able to touch a bulge of the tissue at the vaginal opening, have dryness or irritation due to the rubbing of the tissue against clothing, or have to push the tissue up to have a bowel movement or to empty the bladder completely. The diagnosis is made with a pelvic examination.

Treatment options

Treatment options to check with a professional may include watchful waiting if the prolapse is not bothersome, a pessary (a device placed in the vagina to support prolapsed tissue), physical therapy at certain stages, and surgery.

What is urinary incontinence?

Urinary incontinence is the involuntary loss of urine, it can be from exertion, from urgency and incontinence from extravasation. A condition called overactive bladder includes urgency, frequency (day and night) and extravasation incontinence. Stress urinary incontinence affects many women over the age of 45. Causes include childbirth, strenuous exercise, chronic cough, smoking, obesity and genetics. Stress incontinence occurs when you cough, sneeze, or jump. Pressure on the bladder and urethra causes urine to leak.

Treatment options

Fortunately, treatments to keep the pelvic organs in place have excellent healing rates. The first recommended treatment is a low-risk midurethral sling. Your doctor may recommend a vaginal pessary or bladder support. Physical therapy can help you learn to contract your pelvic floor when you cough or sneeze.

Urge incontinence and overactive bladder increase with age. A sudden or strong urge to urinate can cause incontinence if you can't get to the bathroom quickly enough. An urgency repeated even for small amounts of urine, even several times during the night. Typically this is because the brain and bladder do not communicate well.

Treatment may include behavioral and dietary changes, such as reducing or eliminating carbonated drinks, coffee, tea and alcohol. It is often recommended to retrain the bladder, that is, to do breathing with a timer, to increase the amount of urine that the bladder can hold and help the muscles of the bladder to adapt to larger volumes.

What is painful bladder syndrome?

This condition, formerly known as interstitial cystitis, can cause painful bladder symptoms. It affects women over the age of 40, but often goes undiagnosed. Symptoms may include discomfort, pressure, sensitivity or pain in the bladder, lower abdomen and pelvic area. These vary from person to person, can come and go, and can be random over time. Many women also suffer from migraines, fibromyalgia, dyspareunia, depression or irritable bowel syndrome. The cause of dyspareunia is unknown.

Treatment options

Treatments vary greatly, but should include education, stress management, and dietary changes. Depending on the severity of your symptoms, your doctor may suggest other treatment options.

To learn more about UPMC Salvator Mundi's multidisciplinary unit that deals with pelvic organ disorders, click HERE.