Treat Pelvic Floor Dysfunction

PELVIC FLOOR DYSFUNCTION (PFD)

Pelvic Floor Dysfunction can lead to a number of symptoms and complaints. These symptoms may occur in men and up to one-third of women. Many of these conditions lead to poor self-esteem, withdrawal from physical activity and maybe most significantly withdrawal from social situations and personal relationships.

PFD may be “idiopathic,” meaning that no cause is identified; however risk factors that can increase the risk of PFD include:

  • Age
  • Prior Surgery (for example hysterectomy in women, prostate surgery in men)
  • Obesity
  • Smoking
  • Menopause
  • Child birth
  • Diet
  • Pelvic trauma

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What is Pelvic Floor Dysfunction (PFD)?

The pelvis is similar to a bowl made of bone with the bottom cut out. The bottom of the bowl is composed of a group of muscles known as the pelvic floor. The pelvic floor acts like a hammock and the organs of the pelvis (bladder, rectum, vagina/uterus (women), prostate (men)) rest on the pelvic muscles. The muscles and nerves of the pelvic floor are responsible, in part, to normal function of expelling both urine and feces. When these muscle and nerves are functioning incorrectly it may lead to the following urinary symptoms:

  • Urinary frequency
  • Urinary urgency
  • Urinary incontinence
  • Hesitancy to start the urine stream
  • Incomplete emptying of the bladder
  • Pain with bladder filling
  • Pain with urination

The dysfunction may lead to the following bowel complaints:

  • Fecal urgency (the inability to delay a bowel movement)
  • Fecal frequency
  • Fecal incontinence (the uncontrolled loss of stool-“soiling underwear”)
  • Constipation and straining to have a bowel movement
  • Feeling of incomplete emptying of bowels or inability to complete a bowel movement
  • Painful bowel movements

In addition, abnormal function of these pelvic floor muscles can lead to problems with the genitalia (sex organs) in both men and women. Female patients may report pain with intercourse or even pain with a gynecological exam, in addition to pelvic pain or spasm. Pain may occur with orgasm as well. Male patients may have been diagnosed with prostatitis and their symptoms persist despite antibiotic treatment. Male patients may also report chronic testicular pain (orchalgia).

Patients with pelvic floor dysfunction may have been previously diagnosed with the following conditions

  • Interstitial cystitis
  • Irritable bowels
  • Overactive bladder

Pelvic floor dysfunction is evaluated and diagnosed by history and physical exam. Other tests may be required to rule out other potential reasons for the patient’s symptoms. Dr. Scolieri, a board certified urologist, provides the most comprehensive science based therapy to his patients. Algorithms or care paths have been developed using the most current research from the urologic, gynecological and gastroenterologic communities. Patients are provided with clear pathways of management, specific to their complaints, allowing their participation in treatment and a clear understanding of goals and expectations.

Pelvic Floor Dysfunction treatment can include one or more of the following:

Behavioral & Diet Modification

Medications

Massage Therapy

Pelvic Floor Rehabilitation and Biofeedback

This treatment is administered in the physician’s office, usually weekly for 4-12 weeks. It is not painful. Each session takes 15-60 minutes. It consists of sensors to detect the tension in the patient’s pelvic muscles, and those are displayed to the patient. Additionally, small electrical stimulation is applied to pelvic floor muscles to relieve pain, to teach the patient to regain control of these muscles, and to calm spasm. Patients are taught exercises and methods to continue training at home. Learn More

Posterior Tibial Nerve Stimulation

Posterior Tibial Nerve Stimulation (PTNS) was FDA approved in 2005 for the treatment of symptoms of overactive bladder. Those symptoms include urinary frequency and urgency with or without urge incontinence.

Botox

Botox (onabotulinumtoxinA) is a prescription medication that was FDA approved for treatment of overactive bladder in 2013. The medication can be used to treat symptoms of frequency and urgency with or without incontinence.

InterStim Therapy

InterStim Therapy is a minimally invasive surgical procedure which is performed as an outpatient. The procedure takes less than 30 minutes under “twilight anesthesia”. This therapy is highly effective in treating pelvic floor dysfunction.

Surgical Treatments

Surgical options also exist to treat some of the conditions of PFD.

Couple discussing Pelvic Floor Dysfunction

Dr. Michael Scolieri is a board certified urologist specializing in female urology, female pelvic medicine and reconstructive surgery at the Comprehensive Urology Institute with offices conveniently located in Salem, Canfield, and Alliance, OH.