PELVIC FLOOR DYSFUNCTION

SYMPTOMS

The symptoms of pelvic floor dysfunction can vary depending on the specific structures involved and the underlying cause. Common symptoms may include:

• Urinary Symptoms: Urinary urgency, frequency, hesitancy, incomplete emptying, urinary incontinence (stress, urge, or mixed), nocturia (nighttime urination), and recurrent urinary tract infections (UTIs).
• Bowel Symptoms: Chronic constipation, straining during bowel movements, fecal incontinence, incomplete evacuation, and urgency or difficulty controlling bowel movements.
• Pelvic Pain: Chronic pelvic pain, discomfort, or pressure in the pelvis, perineum, or lower abdomen, often exacerbated by sitting, standing, or certain activities.
• Sexual Dysfunction: Painful intercourse (dyspareunia), decreased libido, erectile dysfunction (in men), or difficulty achieving orgasm may occur due to pelvic floor muscle dysfunction or nerve damage.

Additionally, individuals with pelvic floor dysfunction may experience symptoms of pelvic organ prolapse, such as a sensation of bulging or pressure in the vagina or rectum.

DIAGNOSIS

Diagnosing pelvic floor dysfunction typically involves a comprehensive evaluation by a healthcare provider, which may include:

• Medical History: Gathering information about the patient’s symptoms, medical history, surgical history, childbirth history, and lifestyle factors that may contribute to pelvic floor dysfunction.
• Physical Examination: Palpation of the pelvic floor muscles, assessment of muscle tone and strength, evaluation for signs of pelvic organ prolapse, and digital rectal or vaginal examination to assess for abnormalities or tenderness.
• Diagnostic Tests: Additional tests such as urodynamic studies, cystoscopy, defecography, anorectal manometry, or pelvic MRI may be performed to evaluate bladder and bowel function, pelvic organ support, and pelvic floor anatomy

TREATMENT

Treatment of pelvic floor dysfunction aims to address the underlying causes, alleviate symptoms, improve pelvic floor muscle function, and enhance quality of life. Treatment options may include:

• Pelvic Floor Physical Therapy: Specialized physical therapy techniques, including pelvic floor exercises (Kegel exercises), biofeedback, manual therapy, and behavioral modifications, to improve pelvic floor muscle strength, coordination, and relaxation.
• Medications: Pharmacological therapy may be prescribed to manage symptoms such as urinary urgency, frequency, or incontinence, including anticholinergic medications, alpha-blockers, or tricyclic antidepressants.
• Behavioral Interventions: Lifestyle modifications such as dietary changes, fluid management, bowel training, and bladder retraining to optimize bowel and bladder function and reduce symptoms of pelvic floor dysfunction.
• Surgical Intervention: In cases of severe pelvic organ prolapse or refractory symptoms, surgical procedures such as pelvic floor reconstruction, prolapse repair, or sacral neuromodulation may be considered.