What You Need to Know About Pelvic Floor Dysfunction

Physical Therapy Can Help With Biofeedback

Doctor showing male patient a model of the abdomen
Photo: Jeannot Olivet/E+/Getty Images

Pelvic floor dysfunction (PFD) is a condition in which the muscles in the pelvis do not work properly. In this condition, you are unable to have a bowel movement or you only have an incomplete one because your pelvic floor muscles contract rather than relax. This is a treatable condition with the help of biofeedback and physical therapy.

The Pelvic Floor Muscles

The pelvic floor muscles support various pelvic organs, including the bladder, prostate, rectum, and female reproductive organs.

The muscles themselves are also involved in the functioning of the urinary and anal sphincters. When they are functioning normally, you are able to control your bowel and bladder movements by contracting and relaxing these muscles.

In order for the processes of urination and defecation to go smoothly, the various muscles within the pelvis need to act in a coordinated manner. In some cases, the muscles contract when they should be relaxing, or the muscles do not relax sufficiently to facilitate coordinated movement. Problems with the pelvic floor muscles can lead to urinary difficulties and bowel dysfunction. PFD is experienced by both men and women.

Symptoms Associated With Pelvic Floor Dysfunction

The following are some of the more common problems associated with PFD:

  • Needing to have several bowel movements over the course of a short time period.
  • Being unable to complete a bowel movement.
  • Frequent need to urinate, often with starting and stopping many times.
  • Urinary urgency, a sudden need to urinate.
  • Painful urination.
  • An unexplained pain in your lower back.
  • Ongoing pain in your pelvis, genitals, or rectum.
  • For women, pain during intercourse.

Conditions associated with pelvic floor dysfunction include:

  • Dyssynergic defecation (anismus): This is difficulty passing stool due to problems with the muscles and nerves of the pelvic floor. It can result in chronic constipation.
  • Fecal incontinence: Loss of bowel control, which leads to involuntary passage of stool.
  • Chronic pelvic pain: This is a chronic type of prostatitis, an inflammation of the prostate in men.

Causes of Pelvic Floor Dysfunction

PFD can be caused by injury to the nerves and muscles of the pelvic area through such things as surgery, pregnancy, and vaginal childbirth. In many cases, the cause of the dysfunction is unknown.

Treatment of Pelvic Floor Dysfunction

Biofeedback is now the most common treatment for pelvic floor dysfunction. It is usually done with the help of a physical therapist and it improves the condition for 75 percent of patients, according to the Cleveland Clinic. It is non-invasive, and after working with a physical therapist, you may be able to use a home unit to continue with this therapy.

Many physical therapists specialize in this type of treatment. They also may provide relaxation techniques, stretching, and exercises. In the past, it was thought that PFD would benefit from exercises to strengthen the muscles of the pelvic floor, but this has been changed in favor of biofeedback and retraining, which have a high success rate.

Other options include medication with a low-dose muscle relaxant.

Surgery may be needed in more severe cases.

Sources:

Disorders of the Pelvic Floor. International Foundation for Functional Gastrointestinal Disorders. http://aboutgimotility.org/learn-about-gi-motility/disorders-of-the-pelvic-floor.html.

Pelvic Floor Dysfunction. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/pelvic-floor-dysfunction.

Wang, et.al. Pelvic floor disorders and quality of life in women with self-reported irritable bowel syndrome. Alimentary Pharmacology & Therapeutics 2010 31:424-431.

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