Pelvic Floor Disorders

What are pelvic floor disorders?

In order to understand pelvic floor disorders, we first must understand what the pelvic floor comprises. In women, the pelvic floor is an area composed of of connective tissue and muscle that supports the uterus, bladder, vagina, and rectum. All of these parts are held together, within the pelvic floor, by a complicated system of supports including muscular components and fascia components and ligaments. Pelvic floor muscle exercises can increase pelvic floor support by strengthening the muscular components. However, if that muscular support is not strong enough, or the fascia components and ligaments are too weakened or damaged, the woman can experience problems with her pelvic floor. Thus, if there is a disorder within the pelvic floor, it can affect any of the aforementioned organs (uterus, bladder, vagina and rectum).

Pelvic organ prolapse is the dropping of the bladder, urethra, cervix and rectum caused by the loss of normal support of the vagina. The woman may feel bulging tissue protruding through the opening of the vagina.

Bladder control problems include the inability to hold urine long enough to reach the washroom, urinary frequency, and getting up at night to empty the bladder. There may also be urine leakage caused by increased abdominal pressure (coughing, sneezing and exercising).

Bowel control problems may include loss of normal control of the bowels that can lead to constipation, difficulty having a bowel movement, or even some fecal incontinence.

What are the most common symptoms of pelvic floor disorders?

There are three main symptoms of pelvic floor disorders. These are: urinary incontinence, bowel control issues, and pelvic organ prolapse (POP).

What is urinary incontinence?

Urinary incontinence is generally described as loss of bladder control. This can take many forms, from letting out small amounts of urine when you sneeze or cough, or if you have an urge to use the bathroom suddenly and are unable to make it to the restroom in time. Stress incontinence is the involuntary loss of urine with coughing or sneezing or increased intra-abdominal pressure such as with exercise. Urge incontinence is the involuntary loss of urine due to a strong bladder contraction occurring before you can get to the washroom.

What are bowel issues?

Bowels issues consist of pain, constipation, or straining during bowel movements, as well as fecal incontinence, which means a person is unable to control their bowel movements leading to involuntary stool leakage from the rectum. There may also be rectal urgency.

How can you treat pelvic floor disorders?

Pelvic floor disorders do not have to be a normal part of aging, although they are more common as women get older. These women do not have to suffer in silence or simply manage the pelvic floor disorder with incontinence pads. There are several nonsurgical and surgical treatment options. Pelvic floor disorders can be effectively treated by working with a urogynecology specialist to develop a treatment plan for your individual needs.

Treatment options may include:

Pelvic floor physiotherapy
Timed voiding and toileting strategies especially for fecal incontinence
Medications
Pessaries and other vaginal supports
Percutaneous tibial nerve stimulation
Surgical repair of the various anatomic defects particular to each patient
Innovative new strategies

If a woman is having symptoms of a pelvic floor disorders that are interfering with her quality of life then she should consider being evaluated in order to obtain an accurate diagnosis of the extent of her problem. An appropriate treatment plan can then be identified and she can meet informed decisions regarding her treatment choices.

Next Step

If you are concerned about pelvic floor disorders, speak with your family physician first to receive a referral to Dr. Douglas Waterman. At our New Westminster office, Dr. Waterman will provide a consult about your condition and possible treatment options. If you do not have a medicine provider, simply call our office at (604) 528-9042 for assistance in obtaining a referral.

*Individual results may vary; not a guarantee