Pelvic floor is formed by a group of muscles and ligaments in the pelvic region. They stretch like a band and contract as needed from front to back or side to side. Pelvis contains soft organs such as bladder, rectum, uterus (in women) , prostate etc. The muscles around these organs support and hold them in place. The contraction and relaxation of the pelvic muscles ensures proper functioning of these organs such as urination, bowel movement and control, sexual intercourse (in case of women) etc.. In cases when the pelvic floor muscles do not relax or contract as required (even on receiving signal from the brain), the supported organs fail to function normally resulting in pelvic floor dysfunction.
What causes Pelvic Floor Dysfunction?
While the precise answer is yet to be researched and published, in majority of the cases, the dysfunction is caused by ‘weakened pelvic muscles’. The next question that begets is, ‘What causes pelvic floor muscles to weaken’? Following are known causes that result in weakened pelvic floor muscles:
- Childbirth in case of women. Right from conceiving, the pressure these muscles handle until delivery is enormous.
- Injury to the pelvis region due to fall or accident or due to some surgical procedure that was not properly performed.
- Obesity – A leading cause of many problems in men and women. Obese women are at high risk of developing pelvic floor dysfunction.
- Nerve Damage
- Repeated weight lifting and putting stress on pelvic muscles.
- Genetic Disorder can also be a reason for condition.
- Chronic constipation – In this case, heavy pressure has to be put on pelvic muscles to pass out the stools. This hurts and damages the pelvic muscles.
Symptoms of pelvic floor dysfunction
As the muscles in pelvis region doesn’t contract or expand as required, that results in
- Constipation where more pressure has to be put to tighten the muscles around the rectum.
- Pain and or heaviness in rectum area
- Muscle spasms in the pelvis region
- Painful urination or urinary incontinence
- Lower back pain
Pain or discomfort while having sex (in case of women).
Diagnosis of pelvic floor dysfunction
When you see your urologist with any of these symptoms, a physical examination will be performed. You will be asked for your complete medical history including child delivery (in case of women), surgeries performed in the pelvis region, any medicines that you are taking at that time etc. Your doctor will check the muscles in the region for spasms.
A small device called ‘Perineometer’ will be inserted into the vagina or rectum. This device can sense the muscle contractions and help the doctor to understand how weak the muscles are. As a non-invasive alternative, a device may be placed in the perineum region to learn about the muscle contraction and relaxation. (Perineum is the region between the anus and vagina or testicles).
Treating pelvic floor dysfunction problem
Your urologist’s aim will be to relax the pelvis muscles and relieve your symptoms. This can be achieved in different ways depending on the severity of the condition. Always, surgery will be the last option when life style changes and medications are of not much help.
- Medicine prescription – Muscle relaxing medicines can be given to help the muscles in pelvis region to relax.
- Kegel exercise – This is a very effective way of dealing with weakening pelvic muscles. Especially in the case of women who give birth vaginally, kegel exercise is highly recommended.
- Lifestyle changes – Avoid lifting heavy weights, maintain optimum body weight, relaxing muscles through simple stretches or yoga etc.
- Surgery – If rectal prolapse is the reason for pelvic floor dysfunction, surgery has to be done to put back the rectum in it’s place. Know more about rectal prolapse and it’s treatment by clicking this link.
When you should see your urogynecologist?
When you are experiencing any of the symptoms as mentioned above and if you had a recent vaginal delivery or are overweight, please do NOT self medicate or try home remedies for pelvic floor dysfunction. You must rush to a trained and experienced urogynecologist to address your problem. You don’t have to feel any shame or hesitate to discuss about the issue with the doctor. This condition is very common in many people.