What is Pelvic Floor Disorder?
Pelvic floor disorders refer to a range of conditions affecting the muscles, ligaments, connective tissues and nerves that make up the pelvic floor. These conditions can cause symptoms such as urinary incontinence, faecal incontinence, difficulty controlling bowels or bladder, pelvic organ prolapse and chronic pain in the area.
The pelvic floor in women is a group of muscles, ligaments and connective tissues that support the organs in your pelvis (including the bladder, uterus and rectum). It also helps you control your bowel movements and urination. When these muscles weaken over time or become damaged through injury, childbirth or surgery, they can lead to pelvic floor disorders.
Symptoms of Pelvic Floor Disorder
Symptoms of pelvic floor disorder varies from person to person including:
- Leaking urine when coughing or sneezing (urinary incontinence)
- Leaking stool (faecal incontinence)
- Difficulty controlling bowels or bladder during urination and/or defecation
- Pelvic organ prolapse (urinary, uterine or rectal)
- Pain during sex
- Chronic pelvic pain
- Frequent urge to urinate
- Difficulty emptying the bladder completely
Causes and Risk Factors
Pelvic Floor Disorder (PFD) can result from a variety of causes each contributing to the complexity of the condition. The causes of PFD includes:
- Childbirth: During childbirth, especially vaginal delivery, the pelvic floor muscles can experience significant stretching and strain. This process can lead to tears or weakening of the muscles, increasing the likelihood of PFD. The risk is higher with multiple births or when using instruments like forceps during delivery.
- Surgery: Surgical procedures that affect the pelvic area, such as hysterectomies, can disturb the support structures of the pelvis. This disruption can lead to weakened pelvic muscles and tissues, contributing to the onset of PFD.
- Injury: Traumatic injuries to the pelvic region, whether from accidents or other impacts, can directly damage the muscles and connective tissues that support pelvic organs. Such injuries can compromise their function and lead to disorders.
Risk Factors for Pelvic Floor Disorder
Pelvic Floor Disorder (PFD) is influenced by several risk factors, each contributing to the complexity of the condition. The risk factors for PFD includes:
- Age: As we age, the natural decline in muscle tone and elasticity can weaken the pelvic floor. This weakening makes older individuals more susceptible to PFD, especially in post-menopause when hormonal changes further affect muscle strength.
- Obesity: Excess body weight places additional pressure on the pelvic floor muscles. Over time, this persistent pressure can lead to stretching and weakening of these muscles, increasing the risk of developing PFD.
- Chronic Coughing: Conditions that cause chronic coughing, like asthma or smoking, exert repeated force on the pelvic floor. This consistent stress can eventually weaken the muscles, making them less effective in supporting pelvic organs.
- Lifestyle Factors: A sedentary lifestyle and lack of physical activity can contribute to weakened pelvic floor muscles. On the other hand, high-impact exercises without proper pelvic support can also strain these muscles.
Diagnosis of Pelvic Floor Disorder
The diagnosis of Pelvic Floor Disorder (PFD) involves:
- Physical Examination: A thorough physical exam is conducted to inspect the pelvic area for any abnormalities.
- Ultrasound: Scanning to rule out pelvic masses and urinary retention.
- Urinalysis: A test to analyse urine, which can help in diagnosing urinary tract-related pelvic floor disorders.
If you experience any of the symptoms associated with pelvic floor disorders, it is important to seek medical help. Your doctor will perform a physical exam and ask questions about your medical history. They may also recommend tests such as urine tests, ultrasound or even MRI scans, and certain specialised tests looking at organ function or dysfunction to confirm the diagnosis.
How are Pelvic Floor Disorders treated?
Lifestyle Change
- Dietary Changes:
- Add more fibre to your meals to prevent constipation.
- Enjoy a variety of fruits, vegetables, and whole grains to keep your digestive system healthy.
- Fluid Management:
- DRINK DEFINED AMOUNTS OF WATER (USUALLY UP TO 8 CUPS IN A DAY) throughout the day instead of drinking large amounts ALL at once to avoid OVERLOADING THE BLADDER, WITH frequent bathroom trips.
- Keep an eye on your fluid intake to stay hydrated without overwhelming your bladder.
- Avoiding Irritants:
- Cut down on caffeine and alcohol, as they can irritate your bladder and make you visit the restroom more often.
- Be mindful of other irritants like spicy foods or artificial sweeteners that might trigger symptoms.
- Maintaining a Healthy Weight:
- Stay active with regular exercise to help maintain a healthy weight.
Therapy Options
- Pelvic Floor Exercise Therapy:
- Focuses on exercises and techniques to both strengthen and relax the pelvic floor muscles.
- Involves a combination of specific pelvic floor exercises, stretches, manual manipulation, and sometimes electrical stimulation.
- The goal is to improve muscle control, reduce symptoms, and enhance overall pelvic health.
- Biofeedback Techniques:
- Uses ultrasound OR OTHER ELECTRONIC DEVICES TO TEACH AND TRAIN NEW HABITS.
- The goal is to help you understand your muscle responses and teach you how to control and strengthen your pelvic floor muscles more effectively.
Medications
- Anticholinergics:
- Help relax the bladder muscle, reducing symptoms like urinary urgency and frequency.
- They work by blocking certain nerve signals, which can help prevent bladder spasms.
- Beta-3 Adrenergic Agonists:
- Relax the bladder, but through a different mechanism than anticholinergics.
- They can help increase the bladder’s ability to store urine, thus reducing the number of bathroom visits.
- Topical Estrogen:
- Often prescribed for post-menopausal women, this medication helps strengthen the tissues in the urethra and vaginal area.
- It can improve urinary symptoms by enhancing the health of these tissues.
Surgical Procedures
When Pelvic Floor Disorder (PFD) symptoms are not adequately managed by lifestyle changes or medications, surgical procedures can be considered. Here are some procedures your doctor may recommend:
- Laparoscopic/OPEN Sacrocolpopexy:
- Treat pelvic organ prolapse by using a small incision and a camera to guide the surgeon.
- Benefits include reduced pain, minimal scarring, and a quicker recovery compared to traditional surgery.
- Sacrospinous Ligament Fixation:
- Long-term support for the vagina with the permanent sutures used, often combined with other pelvic floor reconstruction techniques to reduce recurrence of prolapse.
- Urethral Sling Procedure:
- Treat stress urinary incontinence, this involves placing a sling around the urethra to provide additional support.
- The procedure offers the benefit of improving bladder control with less invasive techniques.
- Advanced Surgeries:
- Pelvic Reconstruction:
- Addresses severe or multiple prolapses by reconstructing the pelvic floor.
- It aims to restore the normal anatomy and function of the pelvic organs, using techniques for effective outcomes.
- Pelvic Reconstruction:
Find Help for Pelvic Floor Disorders
For those seeking services to manage pelvic floor disorders in Singapore, please feel free to contact us. We specialise in the diagnosis and treatment of pelvic floor disorders. If you are experiencing symptoms of pelvic floor disorder, it is important to talk to your doctor to get a proper diagnosis and relevant treatments that will help improve your quality of life.
Conclusion
It is also important to remember that pelvic floor disorders are not necessarily a lifelong condition. Taking steps to manage the symptoms and living a healthy lifestyle can help you reduce your risk of developing pelvic floor disorders in the future. Pelvic floor disorders are a common condition affecting millions of people, but there are treatments available to help manage the symptoms. If you are experiencing any of the symptoms associated with pelvic floor disorder, it is important to talk to your doctor. They can diagnose the condition and recommend treatments that will help improve your quality of life.
Disclaimer: The information provided in this article is for general purposes only and should not be considered as a substitute for medical advice. Always consult with your healthcare provider before making any changes to your current treatment plan or starting any new medications.
