About this topic
Muscles and strong bands of tissues support all the organs in your pelvis. This is the pelvic floor. Some of these organs are the bladder and the large bowel as well as the womb in women and the prostate in men. If the muscles and tissues get weak, your organs may drop. When this happens, a number of problems may happen. ‚
You may have urine leaking with laughing, sneezing, or coughing. You may not be able to drain the bladder fully. If you are not able to control your bowel movements, this is bowel incontinence. ‚
The organs in your pelvis may fall out of their normal place. Then, they either bulge or drop out of an opening. This is pelvic organ prolapse. If the lower part of the large bowel called the rectum falls or swells into the vagina it is a rectocele. You may also notice pain or problems passing stool. When the bladder falls or swells into the vagina, it is a cystocele. Other organs or tissue may also drop into the vagina. ‚
Pelvic pain or pain during sex is also signs of pelvic floor dysfunction. There are many reasons for each of these. ‚
Surgery is done to help your signs. The doctors do this by putting your bladder and rectum back in place. They also take out any extra tissue that is bulging into your vagina. ‚
What are the causes?
Many things can cause each of these problems. Talk to your doctor to learn more about what is causing your pelvic floor dysfunction. A few causes are listed below. ‚
Incontinence: ‚
- Problems with the muscles that help you pass urine
- Other health problems like infections
- Having a baby
- Certain drugs
Prolapse ‚
- Giving birth, especially vaginal births
- Older age
- Hard physical activity
- Being overweight
Pelvic Pain ‚
- Trauma
- Chronic swelling of the bladder wall
- Health problems like pelvic inflammatory disease, endometriosis, fibroids or lumps, cancer
- Scar tissue
- Emotional problems
What can make this more likely to happen?
You are more like to have this problem if you are older, a woman, or have had a pelvic floor surgery in the past. ‚
What are the main signs?
- You may leak urine or stool. This may be worse when coughing, sneezing, laughing, lifting, or running.
- Feel the need to pass urine more often
- Not able to empty the bladder fully
- Feeling of heaviness, pressure, or pulling in the pelvic area which may be worse when coughing, sneezing, laughing, or standing
- Bulge into or out of the vagina, urethra, or anus
- Pelvic pain
- Lower back pain
- Trouble going to the bathroom
- Pain with sex
How does the doctor diagnose this health problem?
Your doctor will take your history. Your doctor will do an exam of the pelvic area. Based on the problem, your doctor may need to do both a pelvic and rectal exam. The doctor may order: ‚
- Lab tests
- Urine tests
- Urodynamic tests ¢ ˆ ’ The bladder is filled to test how the bladder and urethra work.
- Postvoid residual volume test ¢ ˆ ’ Looks at how much urine is left in the bladder after passing urine.
- Cystoscopy ¢ ˆ ’ A thin scope with a lens is put into the urethra and bladder.
- Stress test ¢ ˆ ’ Coughing with a full bladder
- Dye test ¢ ˆ ’ Dye is put in the bladder and a pad is worn to check for leakage of dye on the pad.
- Laparoscopy, colonoscopy ¢ ˆ ’ Ways to look into the belly, pelvis, or large bowel with a scope
How does the doctor treat this health problem?
Treatment will depend on what is causing the pelvic floor dysfunction. ‚
- Pelvic floor retraining ¢ ˆ ’ timed voiding
- Exercises
- Physical therapy which may include biofeedback, exercise, electrical stimulation, instruction in bladder retraining, manual therapy
- Pads and panty liners
- Collagen shots on all sides of the urethra to help lessen urine leakage
- Vaginal pessary ¢ ˆ ’ A tool that is put into the vagina to support the pelvic organs
- Urethral insert ¢ ˆ ’ A removable insert into the urethra to help stop urine from leaking
- Weight control
- Vaginal cones or weights
- Catheter
- Surgery
What drugs may be needed?
The doctor may order drugs to: ‚
- Help with pain and swelling
- Fight an infection
- Help with incontinence
- Loosen hard stools
What problems could happen?
- Infection
- Embarrassment
- Avoiding social settings
- Low mood
- Problems with sex
What can be done to prevent this health problem?
- Eat a high fiber diet to prevent hard stools.
- Get lots of fluids each day. Drinking too little can leave your urine more concentrated and bother the bladder. Drink 6 to 8 glasses of liquids each day.
- Avoid drinking fluids 2 to 3 hours before bedtime. Take only sips if needed at night.
Where can I learn more?
National Institute of Health ‚
http://www.nia.nih.gov/health/publication/urinary-incontinence ‚
The American College of Obstetricians and Gynecologists ‚
http://www.acog.org/~/media/For%20Patients/faq012.pdf?dmc=1&ts=20120620T0805531793 ‚
http://www.acog.org/~/media/For%20Patients/faq081.pdf?dmc=1&ts=20120702T1423157916 ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚