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Female pelvic floor diseases

 

Pelvic floor disorders (PFD) affect 1/3 of women and ½ of women aged > 55 years; moreover, 20% of women will undergo surgical treatment for PFD in their life.

Symptoms include: chronic constipation, incomplete evacuation, urinary incontinence and pelvic pain.

 

What is pelvic floor

Female pelvic floor is composed by muscles, ligaments, connective tissues and nerves that support bladder, uterus, vagina and rectum. These muscles support organs in your pelvis like a sling and help them to function properly. By contracting and relaxing these muscles, you control your bowel and bladder movements.

What is pelvic floor dysfunction

Pelvic floor dysfunction is due either to the prolapse of one of the pelvic organs (bladder and/or uterus and/or rectum) or to an inability to correctly control the pelvic muscles. In the latter case, people with pelvic floor dysfunction contract these muscles rather than relax them and cannot have a normal bowel movement, or just an incomplete one. In case of prolapse of one or more pelvic organs, the prolapse itself works as a mechanical obstacle and doesn’t allow feces to correctly proceed in the rectum with the same result of difficult or incomplete evacuation.

What causes pelvic floor dysfunction?

Traumatic of chronic injuries to the pelvic area, such as complications from vaginal childbirth, chronic constipation or wrong bowel habits can contribute to this condition.

What are the symptoms of pelvic floor dysfunction?

  • Chronic constipation or need to strain for having a bowel movements
  • Feeling that you cannot complete a bowel movement
  • Needing of spending a lot of time at the toilet in order to have a proper bowel movement
  • A frequent need to urinate and/or painful urination
  • Urinary incontinence
  • Pain in your pelvic region, genitals, or rectum, especially at the end of the day
  • Pain during intercourse

 

How is pelvic floor dysfunction diagnosed?

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

  • Have you given birth to a child? If yes, has been the delivery difficult?
  • Do you have frequent urinary tract infections?
  • Do you have continence problems?
  • Do you have pain with intercourse?

Next, she will do a physical examination to evaluate your ability to control your pelvic floor muscles and to detect eventual prolapsed organs.

If needed, especially when planning a surgical operation, the physician might prescribe you additional exams like defecating proctogram, endorectal ultrasound, rectal manometry or uroflow test.

 

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 or a nurse, under the guidance of your physician. This non-painful, non-surgical technique provides improvement in more than 75% of people with pelvic floor dysfunction. The therapist teach the correct way of contracting and relaxing the muscles and works with the patient on improving their muscle coordination. Special sensors and video to monitor the pelvic floor muscles are used.
  • In some cases, your physician may prescribe fibers supplementation, tablets and suppository helping to deal with hemorrhoids or drugs for urinary incontinence. Changing bad diet and bowel habits is also highly advised and the doctor will teach you how to do.
  • If your physician determines your pelvic floor dysfunction is the result of a rectal, bladder or uterine 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, especially during bowel movements.

 

Don’t be embarrassed, pelvic floor dysfunction is a very treatable condition, usually though the use of biofeedback and habits changing!

At Dr Rami Hamed Center there is a delicate team made of woman doctor and nurses able to help you! They are able to provide treatment for this debilitating condition with the latest minimally invasive techniques and improve your quality of life!


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