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If you’re experiencing pelvic floor pressure, incontinence or a number of other uncomfortable symptoms, you’re not alone. In fact, according to the National Institutes of Health, nearly a quarter of all women in the U.S. suffer from some form of pelvic floor disorder. But what causes it and what can be done to prevent or treat it? We spoke with board-certified obstetrician and gynecologist Angel Gonzalez, MD to find out what advances are being made in the field of pelvic floor dysfunction.
Symptoms of Pelvic Floor Disorders
- Constipation or straining pain with bowel movements
- Feeling like you can’t finish a bowel movement
- Feeling like you need to have several bowel movements during a short period of time
- Painful urination
- The frequent need to urinate
- Having to stop and start urinating many times
- Painful sexual intercourse for women
- Pain in your lower back that isn’t caused by any other condition
- Chronic pain in your pelvic area, genitals, or rectum
Causes of Pelvic Floor Pressure
“Pelvic floor disorders typically occur in women over the age of 50,” explains Dr. Gonzalez. “They are caused by the weakening of the pelvic muscles that act like a sling holding your organs where they’re supposed to be. A common, benign variety is pelvic organ prolapse, where one or more aspects of the vagina, or the uterus descends. More severe cases are caused by organs hemorrhaging through the vaginal walls and can cause incontinence, difficulty or the inability to have a complete bowel movement, which is known as a voiding dysfunction, discomfort during sexual intimacy, and occasional back pain.”
In most cases, pelvic floor dysfunctions were caused by vaginal childbirth or from complications during childbirth. Accidents and other traumas to the pelvic region may also cause pelvic floor dysfunction.
Conservative Management and Prevention
“There are several things that can be done to manage pelvic floor pressure and help prevent it,” says Dr. Gonzalez. “Pelvic floor muscle exercises, like Kegels, can be used to strengthen the pelvic muscles, gain coordination and control over them, increase muscle endurance, and may help alleviate some symptoms. Our team of specialized physical therapists can teach you these exercises that you can do at home.”
Utilizing the latest advances in technology, our specialists apply targeted, rehabilitative techniques, including pelvic floor therapy, relaxation and strengthening techniques, computerized biofeedback, and patient education with tailored at-home programs.
Physical therapy is recommended as the first step toward your pelvic health, as well as after surgery, if required. Having strong and healthy muscles and connective tissue before going into surgery promotes faster healing and better coordination and control before and after surgery. Some symptoms of PFD, like constipation, can be caused by bad habits that you’ve picked up over the years and learning how to properly use your muscles may alleviate your symptoms.
Another way of managing pelvic organ prolapse is by using pessaries. A pessary is a silicone device that’s inserted in the vagina to hold your organs in their natural position and decrease symptoms. Using pessaries requires maintenance and regular visits to your gynecologist and does not treat the disorder.
“If conservative management has failed to provide the relief that you need, it may be time to consider your surgical options,” says Dr. Gonzalez. “Surgery is the only fix for pelvic organ prolapse and is also recommended for those suffering from significant voiding dysfunction if physical therapy provides no relief.”
There are two varieties of surgery for pelvic floor dysfunction: reconstructive and obliterative.
Obliterative surgery is generally reserved for older patients who no longer have any interest in sexual intercourse, due to the nature of the surgery. In an obliterative surgery, the problem areas are removed therefore preventing any future ability to have sexual intercourse.
Reconstructive surgery comes in two variants — N.T.R. or native tissue repair, and graft augmented. Depending on your symptoms and anatomy, either may be right for you but your doctor will likely have a preference based on their expertise and your individual case.
These surgeries generally only take an hour or two to perform and you’ll likely only have to stay one night in the hospital for observation, afterward. The recovery time is six to eight weeks with regular check-ups at two weeks, six weeks, four months, and one year. Your recovery may include physical therapy, as well.
See an Expert
If you’ve been experiencing pelvic floor pressure or think you may have pelvic floor dysfunction, please contact us to make an appointment to speak with one of our specialists.