All about Pelvic floor

Pelvic Floor


What is  pelvic floor?

The pelvic floor muscles are shaped like a sling and hold your organs in the pelvis like uterus, vagina, bowel and bladder. These muscles are located in between your legs and spread from the pubic bone of your pelvis to the back, at the base of the spine.

What are the disorders of pelvic floor?

Pelvic floor disorders involve a dropping down (prolapse) of the bladder, urethra, rectum, small bowel, uterus, or vagina caused by weakness of or injury to the ligaments, connective tissue  and muscles of the pelvis. The weakness of the pelvic floor muscles can cause prolapse of your uterus, bladder, bowel and urethra

You may feel pressure or a sense of fullness in the pelvis or have problems with urination or bowel movements.

If you have pelvic floor disorder you may experience urinary problems such as leaking urine with coughing, sneezing, running etc. You may also develop urgency to urinate, painful urination or incomplete bladder emptying.

What are the common causes of pelvic floor disorders?

Pelvic floor disorders usually result from a combination of factors. The common causes are

Vaginal delivery- particularly if you have long labour, if your baby was  big.

Women who have had more vaginal deliveries, the risk increases with each delivery.

Being obese

Aging

Constant Straining during bowel movements

Lifting heavy weights

There are also other causes like fluid collection in abdomen(Ascites) , neurological disorders, tumors and connective tissue disorders. It can happen rarely from birth defects.

Symptoms you might be experiencing

Leaking of urine

Urgency

Frequency

Hesitancy

Nocturia (getting up at night to urinate)

Incomplete emptying

Stopping and starting of urine

Dribbling after emptying bladder

Constipation

Straining

Pain with bowel movements

Unexplained pain in Low back, pelvic region, genital area or rectum

Pain during and after intercourse

Types of Pelvic Floor disorders

Urinary Incontinence or lack of bladder control

Fecal Incontinence or lack of bowel control

Pelvic organ Prolapse, is a condition in which the uterus, bladder and bowel may drop in to the vagina and cause a bulge through the vaginal canal.

Types of urinary incontinence

Stress Incontinence

Urge incontinence 

Mixed incontinence (Stress incontinence and Urge incontinence)

Overflow incontinence

Stress Incontinence VS Urge incontinence

It is important to under the difference between stress Incontinence (SUI) and Urge incontinence (UUI) as they are treated differently.

While Stress Incontinence (SUI) is the leaking of urine while coughing, sneezing, running etc., it is not accompanied by the sensation of a sudden urge to urinate. Urge incontinence on the other hand, involves sudden and unstoppable loss of urine. The underlying cause for SUI is different from that UUI. SUI is caused by a weak sphincter muscle and/ or pelvic floor. UUI is caused by abnormal bladder muscle contractions, which means your bladder muscle contracts when it shouldn’t be contracting causing the urine to leak suddenly.

Mixed Incontinence

Some have both SUI and UUI, known as mixed urinary incontinence. This means you leak when you  cough, sneeze, or exert pressure on your abdominal muscles, but you also feel the urgent need to go to the toilet and may not make it in time.

Overflow incontinence

It occurs when you are unable to completely empty your bladder, this leads to overflow, which leaks out unexpectedly. You may or may not sense that the bladder is full. Urine left in the bladder can be a breeding ground for bacteria, which in turn leads to repeated urinary tract infection.

Fecal Incontinence

Inability to control bowel movements, causing stool (feces) to leak unexpectedly from the rectum. Also called bowel incontinence. Fecal incontinence ranges from an occasional leakage of stool while passing gas to a complete loss of bowel control.

Prolapse

Is a condition in which structures such as the uterus, rectum, bladder,urethra, small bowel or the vagina itself may begin to prolapse, or fall out of their normal positions.

Weakening of or damage to the pelvic muscles, which support the pelvic organs is the main cause of prolapse.

Types of prolapse

Uterine prolapse

A uterine prolapsed involves the descent of the uterus and cervix down the vaginal canal due to weak or damaged pelvic support .

Cystocele

A cystocele occurs when the tissues supporting the wall between the bladder and vagina weaken, allowing the bladder to slide down and press in to vaginal wall.

Urethrocele

A urethrocele occurs when the urethra descends and presses into the wall of the vagina.

Rectocele

A rectocele occurs when the tissues supporting the wall between the vagina and rectum weaken allowing the rectum to descend in to the vaginal wall.

Enterocele

It is the protrusion of small bowel or large bowel in to the vagina wall.