Some patients suffer for years with symptoms of pelvic floor disorders before they seek help. Symptoms could include feelings of pain or heaviness, difficulty using the bathroom, leaking of urine, bowel control problems, or constipation.
At some point in their lives, between 20 and 40 percent of women will suffer from a pelvic floor disorder.
Perhaps more important, 80-90 percent of women who seek treatment will be cured or see a significant improvement in their symptoms. Just in the last several years, there have been huge advances in the treatment of pelvic floor disorders. It’s life changing for patients who have suffered with symptoms.
What Is the Pelvic Floor?
The pelvic floor refers to the muscles, ligaments, and connective tissue that form a hammock across the lowest part of the pelvis. It holds the pelvic organs, including the bladder, uterus, vagina, bowels, and rectum, in place and helps them function correctly.
Common Pelvic Floor Disorders
Disorders are caused by a weakness in the muscles or tears in the connective tissue of the pelvic floor. When the pelvic floor is damaged, it can’t provide the support to pelvic organs.
• Pelvic organ prolapse: Patients with prolapse often feel a heaviness in the vagina. They may also have difficulty urinating or having a bowel movement, have urine or stool leakage, and/or bulge coming out of their vagina.
• Urinary incontinence: There are three types of urinary incontinence, which is the accidental leakage of urine.
o Stress incontinence refers to leaking when you cough, sneeze, exercise, or undergo strenuous activities.
o Urge incontinence is when you feel like you have to urinate and can’t get to a bathroom in time or you have to urinate frequently during the night.
o A combination of stress and urge incontinence.
• Bowel control problems: This includes the involuntary loss of liquid or solid stool; the involuntary loss of gas; and constipation.
Am I at Risk of a Pelvic Floor Disorder?
Vaginal childbirth, genetics, menopause, age, smoking, obesity, and extensive heavy lifting or exertion can all contribute to raising your risk.
Who Should I See?
Many general gynecologists can treat pelvic floor disorders. If your gynecologist can’t significantly improve your symptoms or you have had previous treatment or complications from surgery for a disorder, you should see a urogynecologist. Urogynecologists specialize in pelvic floor disorders and have training and expertise in treatment options. You do not need a referral to make an appointment.
How Are Pelvic Floor Disorders Treated?
After diagnosis, your doctor will recommend treatment, which can range from non-invasive therapies to surgery. Non-invasive treatments include pelvic floor exercises; pelvic floor physical therapy, which helps you isolate and strengthen the correct muscles; and medical devices that are inserted into the vagina to support the pelvic organs.
For urge incontinence, treatment may also include dietary and lifestyle changes such as reducing caffeine and losing weight, training the bladder to go on schedule, and medication. If these treatments don’t help, other options include Botox injections into the bladder or neuromodulation, which calms the nerves involved in urination with a mild electrical current.
In some cases, surgery is the best treatment. For example, for bowel movement control, surgery may be necessary to repair the rectum, sphincter muscle, or other structures.
Surgery may also be needed to restore the pelvic floor or repair damaged muscles or tissues. Today’s minimally invasive procedures, which can be done vaginally, laparoscopically, or robotically, have a short recovery time and an 80-90 percent long-term success rate.
If you have symptoms of a pelvic floor disorders, your doctor can help determine treatment options to help you resume life without the discomfort or embarrassment that can accompany these disorders.
Dr. Timothy Chase was the first board certified urogynecologist in southeastern North Carolina and has performed more than 3,000 urogynecologic and robotic procedures. He is also board certified in OB/GYN and welcomes patients at Glen Meade Center for Women's Health - NHRMC Physician Group.