Pelvic Floor Dysfunction
Pelvic floor dysfunction often presents as an inability to coordinate pelvic floor muscles to go to the bathroom.

Pelvic floor dysfunction is a common condition characterized by an inability to relax and coordinate pelvic floor muscles to urinate or have a bowel movement.

In normal conditions, the body tightens and relaxes its pelvic floor muscles to void urine and stools. However, in cases of pelvic floor dysfunction, the body keeps tightening these muscles instead of relaxing them, leading to increased tension and symptoms, such as:

  • Constipation
  • Straining to defecate or having trouble evacuating stools
  • Incontinence (urine or stool leakage)
  • A frequent urge to urinate
  • Feeling a need to force out urine or stools
  • Unsatisfactory urine or bowel movements
  • A feeling of stopping and starting in the middle of urination
  • Pain during urination
  • Low backache with no other cause
  • Unexplained pain in the pelvic region (genitals, anus, or lower abdomen)
  • Pain during intercourse (women)
  • Erectile dysfunction (men)

What is the pelvis?

The pelvis consists of the bladder, uterus (in women), prostate (in men), and rectum. The pelvic floor has a group of several supporting muscles in the floor (base) of the pelvis.

The muscles of the pelvic floor have three basic functions:

  1. Support of the pelvic organs and intraabdominal contents
  2. Contribute to the continence of urine and feces
  3. Contribute to the sexual functions of arousal and orgasm in all genders

What causes pelvic floor dysfunction?

The exact cause of pelvic floor dysfunction is unknown. A few of the known factors that may contribute to the condition include:

  • Advancing age or aging
  • Traumatic injuries to the pelvic area (an accident or a fall)
  • Pregnancy
  • Overuse of the pelvic muscles (visiting the bathroom too often or pushing too hard)
  • Pelvic surgeries
  • Being overweight or obesity
  • Menopause
  • Neurological disorders, such as Parkinson's disease

Pelvic floor dysfunction can be a hereditary (running in families) condition, but researchers are still looking into a potential genetic cause of the medical condition.

How is pelvic floor dysfunction diagnosed?

Apart from questions about your current symptoms and careful medical history analysis, the healthcare provider may recommend the following tests:

  • Physical examination: To test for spasms, knots, or weakness in the pelvic muscles.
  • Surface electrodes: A painless test to examine pelvic muscle control using electrodes (self-adhesive pads) that are placed on the skin.
  • Anorectal manometry: A painless procedure to analyze pressure, muscle strength, and coordination of the anal sphincters.
  • Defecating proctogram: A special video X-ray is used to record the movement of muscles after an enema of a thick liquid is administered.
  • Uroflow test: A test to analyze the urine-emptying bladder capacity.


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How do you treat pelvic floor dysfunction?

Pelvic floor dysfunction can be treated with the following treatments:

Noninvasive treatments for pelvic floor dysfunction

  • Biofeedback: A physical therapist might use biofeedback (special sensors and video to monitor the pelvic floor muscles) to retrain pelvic muscles to improve muscle coordination.
  • Pelvic floor physical therapy: Done simultaneously with biofeedback therapy, wherein specific exercises are taught to stretch muscles and improve coordination.
  • Medications: Over-the-counter and prescription stool softeners help keep the stool soft and bowel movements regular.
  • Relaxation techniques: A physical therapist might recommend meditation, warm baths, yoga, or acupuncture.

Minimally invasive procedures for pelvic floor dysfunction

  • Transvaginal trigger-point injections: An anesthetic and steroid (anti-inflammatory) are injected directly into the spastic pelvic floor to significantly relieve symptoms.
  • Pudendal nerve blocks: Under sedation, an anesthetic and steroid are injected into the pudendal nerve to decrease nerve irritation and pain.

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Medically Reviewed on 11/17/2022
Image Source: iStock image

Pelvic Floor Dysfunction.

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Pelvic Floor Dysfunction.