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Pelvic Floor disorders


The pelvic floor is a group of muscles in your pelvic area. These muscles support the organs in your pelvis like a sling. The organs in this area include the bladder, uterus (women), prostate (men), and rectum (the area at the end of the large intestine where your body stores solid waste). By contracting and relaxing these muscles, you control your bowel and bladder movements.

When you are unable to control the muscles in your pelvic floor to have a bowel movement, it is called pelvic floor dysfunction. People with pelvic floor dysfunction contract these muscles rather than relax them. Because of this, they cannot have a bowel movement, or they have an incomplete one.

Most of the causes of pelvic floor dysfunction are unknown. Traumatic injuries to the pelvic area, such as in an accident, and complications from vaginal childbirth can contribute to this condition.

Several symptoms may suggest pelvic floor dysfunction. If you have any of these, you should discuss them with your physician. Some symptoms may also indicate other conditions, but a complete physical exam should be able to determine what is causing your symptoms.

Symptoms of pelvic floor dysfunction include:

  • The feeling that you need to have several bowel movements during a short period of time.

  • The feeling that you cannot complete a bowel movement.

  • Constipation or straining pain with bowel movements.

  • A frequent need to urinate. When you do go, you may stop and start many times.

  • Painful urination.

  • Pain in your lower back that cannot be explained by other causes.

  • Ongoing pain in your pelvic region, genitals, or rectum.

  • Pain for women during intercourse.

How is pelvic floor dysfunction diagnosed?

Your physician will begin your exam by asking about your symptoms and taking a careful history. Questions he or she may ask include:

  • Do you have a history of urinary tract infections?

  • Have you given birth to a child?

  • Do you have interstitial cystitis (a long-term inflammation of the bladder wall) or irritable bowel syndrome (a disorder of disorder of the lower intestinal tract)?

  • Do you have pain with intercourse?

Next, he or she will do a physical examination to evaluate your ability to control your pelvic floor muscles. Using his or her hands, the doctor will check for muscle spasms, muscle knots, or muscle weakness.


Another test your physician may do is called a defecating proctogram. For this test, you will be given an enema of a thick liquid that can be detected with an X-ray. Your physician will use a special video X-ray to record the movement of your muscles as you attempt to push the liquid out of the rectum.

Some physicians may also perform a uroflow test as you try to void your bladder. If your flow of urine is weak or you have to stop and start as you urinate, it can suggest pelvic floor dysfunction.


How is pelvic floor dysfunction treated?


Pelvic floor dysfunction can often be successfully treated without surgery. Treatments for pelvic floor dysfunction include:

  • Biofeedback. The most common treatment for pelvic floor dysfunction is biofeedback, done with the help of a physical therapist. This non-painful, non-surgical technique provides improvement in more than 75% of people with pelvic floor dysfunction.
    Physical therapists may take several approaches to biofeedback. These include using special sensors and video to monitor the pelvic floor muscles as the patient attempts to relax or contract them. The therapist then provides feedback and works with the patient on improving their muscle coordination.

  • Medication. In some cases, your physician may prescribe a low-dose muscle relaxant to deal with pelvic floor dysfunction.

  • Relaxation techniques. Your physician or physical therapist may recommend relaxation techniques such as warm baths, yoga, and exercises.

  • Surgery. If your physician determines your pelvic floor dysfunction is the result of a rectal prolapse or rectocele, surgery may be necessary. A rectal prolapse is when the tissue that lines the rectum falls down into the anal opening. A rectocele occurs in women when the end of the rectum pushes through the wall of the vagina. By using the defecating proctogram test, your physician should be able to determine if these conditions are causing your pelvic floor dysfunction.

Pelvic floor dysfunction is a very treatable condition, usually though the use of biofeedback and physical therapy. Seeing your physician if you have any symptoms of pelvic floor dysfunction can provide treatment for this often debilitating condition and improve your quality of life.