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Pelvic Floor Dysfunction

Pelvic Floor Dysfunction

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Pelvic floor dysfunction is the inability to correctly tighten and relax the pelvic floor muscles to have a bowel movement. Symptoms include constipation, urine or stool leakage and a frequent need to urinate. Treatments include biofeedback, medication or surgery.

Although embarrassing or sometimes painful, pelvic floor dysfunction is a highly treatable condition. Talk with your doctor about your symptoms to get a proper diagnosis. There are several home remedies you can try before resorting to medication or surgery for treatment.

What Is the pelvic floor?

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Pelvic floor muscles (female)

What causes pelvic floor dysfunction?

Most causes of pelvic floor dysfunction are unknown. Traumatic injuries to the pelvic area, such as in an accident, and complications from vaginal childbirth can contribute to this condition. Some cases are due to a learned behavior (repeated actions of straining) that develop into a practice of muscle coordination that is incorrect.

What are the symptoms of pelvic floor dysfunction?

Several symptoms may suggest pelvic floor dysfunction. If you have any of these symptoms, you should discuss them with your physician. Some symptoms may also point to other conditions, but a complete physical exam should be able to determine what is causing your symptoms.

Symptoms of pelvic floor dysfunction may include:

  • The feeling that you need to have several bowel movements during a short period of time.

  • The feeling that you cannot complete a bowel movement.

  • Constipation, or straining pain with bowel movements.

  • Leakage of stool/urine with or without your awareness.

  • A frequent need to urinate. When you do go, you may stop and start many times.

  • Painful urination.

  • Pain in your lower back that cannot be explained by other causes.

  • Ongoing pain in your pelvic region, genitals, or rectum with or without a bowel movement.

  • Pain during intercourse (experienced by women).

Pelvic Floor Dysfunction: Diagnosis and Tests

The doctor will begin your exam by asking about your symptoms and taking a careful history. Questions he or she may ask may include the following:

  • Do you have a history of urinary tract infections?

  • Have you given birth to a child?

  • Do you have interstitial cystitis (a long-term inflammation of the bladder wall) or irritable bowel syndrome (a disorder of the lower intestinal tract)?

  • Do you have pain with intercourse?

Next, the doctor will do a physical examination to evaluate your ability to control your pelvic floor muscles. Using his or her hands, the doctor will check for spasms, knots, or weakness in these muscles. The doctor may also conduct an intrarectal (inside the rectum) or vaginal examination.

You may also have these tests:

  • The physician may test your pelvic muscle control by placing surface electrodes (self-adhesive pads) on the perineum (the area between the vagina and rectum in women, and between the testicles and rectum in men) or sacrum (the triangular bone at the base of your spine).

  • An anorectal manometry (a test that measures how well the rectum and anal sphincter are working) may also be performed to test the pressures and muscle strength and coordination.

  • Another test your physician may do is called a defecating proctogram. For this test, you will be given an enema of a thick liquid that can be detected with an X-ray. The physician will use a special video X-ray to record the movement of your muscles as you attempt to push the liquid out of the rectum.

  • Some physicians may also perform a uroflow test as you try to empty your bladder. If the flow of urine is weak or you have to stop and start as you urinate, it can suggest pelvic floor dysfunction. This test may be ordered when you complain of a urinary issue.

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