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Definition

Pelvic floor dysfunction is when the pelvic floor muscles do not relax when urinating or passing stool. These muscles support the bladder, bowels, and sexual organs.

Causes

The exact cause is not known, but may be due to:

  • Trauma from an accident
  • Childbirth, especially with an episiotomy
  • Mental health problems
  • Nerve or muscle problems
Female Pelvic Organs
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Risk Factors

Things that may raise the risk of this problem are:

  • Childbirth—the risk increases with each birth
  • Obesity —causes extra strain on muscles
  • Prior pelvic surgery
  • Prior radiation therapy

Symptoms

Problems may be:

  • An urgent or frequent need to pass urine
  • Pain when urinating
  • Problems passing stool, such as, straining or pain
  • Pain in the lower back
  • Pelvic pain
  • Pain during sex (in women)

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Pelvic floor muscle control may be tested. This can be done with:

  • Electrodes on the area between the vagina and rectum or the area between the testicles and rectum to measure muscle activity or nerve function
  • A device placed in the vagina or rectum to measure pelvic floor muscle strength
  • X-rays of the bowel during a bowel movement
  • A urine flow test to measure the speed and force of urine

Treatment

The goal of treatment is to relax the pelvic floor muscles. Choices are:

  • Biofeedback to help train the muscles
  • Physical therapy to learn how to relax and coordinate the muscles
  • Relaxation methods to ease stress
  • Medicines, such as muscle relaxants

Prevention

The risk of this problem may be lowered by maintaining a healthy weight. This will ease stress on pelvic floor muscles.

RESOURCES

Family Doctor—American Academy of Family Physicians  http://www.familydoctor.org 

National Institute of Neurological Disorders and Stroke  http://www.ninds.nih.gov 

CANADIAN RESOURCES

Health Canada  https://www.canada.ca 

Public Health Agency of Canada  http://www.phac-aspc.gc.ca 

References

American College of Obstetrics and Gynecology (ACOG) and American Urogynecologic Society (AUGS). ACOG Practice Bulletin No. 185: Pelvic Organ Prolapse. Obstet Gynecol. 2017 Nov;130(5):e234-e250.

Pelvic floor disorders. The University of Chicago Medicine website. Available at: http://www.uchospitals.edu/specialties/pelvic/faq/pelvic-floor-disorders.html#P72%5F4797. Accessed February 15, 2021.

Pelvic floor dysfunction. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/health/diseases%5Fconditions/hic%5Fpelvic%5Ffloor%5Fdysfunction. Accessed February 15, 2021.

Pelvic floor dysfunction. Interstitial Cystitis Association website. Available at: http://www.ichelp.org/about-ic/associated-conditions/pelvic-floor-dysfunction. Accessed February 15, 2021.

Pelvic floor dysfunction expanded version. American Society of Colon and Rectal Surgeons website. Available at: https://www.fascrs.org/patients/disease-condition/pelvic-floor-dysfunction-expanded-version. Accessed February 15, 2021.

Pelvic organ prolapse. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/pelvic-organ-prolapse. Accessed February 15, 2021.

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