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Pelvic Floor Disorders

The pelvis contains critical organs, including the bladder, intestines, rectum and urethra. In women the pelvis also holds the cervix, uterus and vagina. A group of muscles known as the pelvic floor acts as a hammock, supporting the pelvic organs so they may properly function. When connective tissue and muscles in the pelvic floor become injured or weakened, pelvic floor disorders can occur.

  • Types

    Depending on the location of the injury or weakness, pelvic floor disorders may be divided into subcategories, including:

    • Pelvic organ prolapse — In women, loosening in the pelvic floor causes one or more of the organs in the pelvis to sag and push into or outside of the vagina.
    • Urinary incontinence — Loss of bladder control may occur as a result of pelvic floor disorders, causing difficulty expelling urine from the body or overactive bladder.
    • Fecal incontinence — You may have difficulty passing stool as well as leakage of stool or mucus from the anus. 
    • Interstitial cystitis — This chronic condition creates sensations of pain and pressure in the bladder region.
    • Vaginal fistulas — These are abnormal openings on the vaginal wall that create a connection with another organ, such as the bladder, colon, rectum and small intestine.
  • Symptoms

    • Aching, fullness and heaviness in the vagina that worsens as the day progresses
    • Bulging out of the vagina
    • Constipation
    • Flatulence that you cannot control
    • Frequent infection of the urinary tract
    • Pain during urination
    • Stool leakage
    • Trouble starting and stopping the flow of urine
    • Urine leakage when coughing, exercising or laughing
    • While many of these symptoms may be embarrassing to discuss, you should not ignore your pelvic health. Proper diagnosis and treatment with one of our compassionate and knowledgeable healthcare providers can help manage the condition and improve your quality of life.
  • Prevention

    • Eat a diet rich in fiber to enhance regular bowel movements. Constipation can cause you to strain your pelvic muscles.
    • Lift from the legs. Try not to use your abdomen muscles and your back when picking things up.
    • Manage your weight. Excess pounds can cause pelvic muscles to weaken.
    • Practice Kegel exercises. To do these exercises, tighten and release the muscles that control the flow of urine.
  • Diagnosis

    • Symptom review. The provider will discuss with you any symptoms you are experiencing.
    • Pelvic examination. Your provider will conduct tests to determine muscle strength and weakness.
    • Functional tests. In some instances, your provider may also perform tests to examine strength and functionality in the bladder, rectal muscles and urethra.
  • Treatment

    • Conservative management. Options include injections to manage incontinence, Kegel exercises, prescription medications, or the use of a vaginal pessary provide support to the bladder, rectum, uterus or vagina.
    • A doctor may also recommend one of these pelvic floor reconstructive surgery options if your pelvic floor disorder is more serious:
    • Vaginal sacrospinous ligament fixation (SSLF). This procedure involves anchoring the top portion of the vagina to a ligament that connects the pelvis with the lower tailbone.
    • Vaginal uterosacral ligament suspension (ULS). This procedure involves securing the vagina by stitching it to a ligament connecting the tailbone with the lower part of the uterus.
    • Vaginal colpocleisis. This low-risk procedure involves closing the vagina.
    • Abdominal sacrocolpopexy. During this procedure, your doctor will anchor the vagina to the sacrum with stitches and surgical mesh or with a graft made with your own tissues.
    • Mid-urethral sling. Your provider can surgically place a mesh strap or a sling made with your own tissues into the body to support the urethra.
    • Colposuspension. Your provider can perform this procedure to support tissue that surrounds the urethra.
  • Follow-up Care

    • Regular visits with your provider can help ensure that you have selected the best treatment option to manage your unique condition.
    • Wearing absorbent pads or underwear can help keep you dry and comfortable.