Pelvic floor dysfunction

What is pelvic floor dysfunction?

The pelvic floor is a group of muscles below the pelvis which in women support the bladder, vagina, womb, and rectum (the lowest part of the bowel just above the anus) and in men the bladder, bowel, and prostate area.

A well functioning pelvic floor assists both bladder and bowel continence and has an impact on intercourse in both men and women.

In men the muscles of the pelvic floor can be weakened through constipation and straining to pass bowel motions, lack of exercise and being overweight, chronic coughing (e.g. due to smoking or asthma), diabetes, Parkinson’s Disease and other neurological conditions and prostate surgery.

This is similar for women, though an additional major factor in pelvic floor problems relating to women is pregnancy and childbirth.

Symptoms of pelvic floor dysfunction

General symptoms of pelvic floor dysfunction are associated with going to the toilet (having a bowel movement or going for a pee). In the bowel, these can include constipation or losing the feeling of needing to go. Feeling that the bowel hasn’t been properly emptied and having to make several visits to the loo in quick succession are also associated. Sometimes stool (poo) that hasn’t been passed properly can leak, this is known as faecal incontinence.

Diagnosis of pelvic floor dysfunction

Diagnosis is usually made through a defecating proctogram.  During this painless procedure, the patient is given a special liquid enema designed to show up on x-ray. A video x-ray is then taken while the rectum is working. The x-ray will show up signs of dysfunction with the pelvic floor and will also be able to pinpoint other internal problems that may be causing the symptoms, such as rectal prolapse or rectocele.

Treatment

Treatment options can be very effective for pelvic floor dysfunction. To help prevent it in the first place, special pelvic floor exercises can be practiced regularly and are now recommended for pregnant women, both before and after birth.

For individuals suffering straining and discomfort or pain when going for a poo (known as obstructive defecation constipation), a process called biofeedback can be effective. Biofeedback is done with the support of a therapist who will help to identify the particular muscles causing the problem and recommend specific therapies to counteract the poor working of the pelvic floor muscles.