Pelvic Floor Dysfunction

By Alejandro Miranda-Sousa, MD and Alison Glassman PA-C

What is Pelvic Floor?
In women, the pelvic floor is comprised of the muscles, ligaments, connective tissues, and nerves. The pelvic floor supports the bladder, uterus, ovaries, vagina, and rectum. Men have similar pelvic floor components, but they support the prostate, urethra, reproductive organs, and rectum.

What is Pelvic Floor Dysfunction?
This condition occurs when these supporting structures develop spasms or cramps that affect the normal ability to contract or relax. This can significantly impact a person’s quality of life. This condition can be acute or chronic; we have seen cases that have lasted several decades. This condition is commonly mistaken for prostatitis in males, recurring UTI’s and interstitial cystitis in females.

Signs and Symptoms of Pelvic Floor
Dysfunction:
Pelvic floor dysfunction is a poorly understood area in medicine, leading to under diagnosis and lack of treatment.

Common findings/symptoms are:
• Urinary problems such as urgency, frequency, hesitancy, painful urination, incontinence, or incomplete emptying of bladder
• Pain with intercourse
• Pain with ejaculation
• Low back pain, testicular pain, groin pain, suprapubic pain
• Fecal incontinence or constipation
• Pain or pressure in vagina or rectum
• Muscle spasm in pelvis
• Recurrent “UTI’s”

How is Pelvic Floor Dysfunction Diagnosed?
History and physical exam are key in diagnosing this condition. Imaging is not necessary for diagnosis; however, it aids in ruling out other conditions.

Treatment for Pelvic Floor Dysfunction:
Pelvic floor dysfunction is a treatable condition. The most effective treatment is pelvic floor therapy or pelvic floor rehabilitation. This therapy uses a device that assists in the relaxation of the pelvic floor muscles and improves the functionality. Physical therapy is a non-painful, nonsurgical option that is performed with the assistance of a trained health care provider. Over a number of treatments, the therapist will provide feedback and works one-on-one with the patient to help improve their muscle coordination, relaxation and strength. Additionally, learning how to relax pelvic floor muscles with the proper use of home physical therapy can significantly improve the lives of most patients suffering with this condition.

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