Pelvic floor dysfunction is a common medical disorder that can cause difficulties urinating, defecating, and engaging in sexual intercourse. The condition is related to abnormal spasms or control issues in the muscles that support the pelvic organs. A person with pelvic floor dysfunction might have chronic constipation or problems emptying his or her bladder because the muscles do not work together properly. Many patients who are diagnosed with the condition can find relief by taking medications and working with therapists to learn how to strengthen and better control muscles. Surgery may be needed if organs prolapse through the weak floor or a cyst develops.
Many different factors can contribute to pelvic floor dysfunction, and in many cases an underlying cause cannot be discovered. Unlike most other muscle control problems, pelvic floor dysfunction does not seem to be related to neurological disorders. The muscles in the pelvis are just uncoordinated; a patient can control their movement, but he or she cannot make them contract in unison to pass stools and urine. Possible causes include weakening of the muscles and nerves after giving birth, an obtrusive prostate gland, and trauma to the pelvic region. In addition, straining too hard during a bowel movement can cause damage the pelvic floor muscles.
The symptoms of pelvic floor dysfunction can vary depending on the degree of coordination issues and the specific muscles involved. Many people have trouble emptying their bowels and bladders, resulting in chronic constipation and frequent but nonproductive urges to urinate. When muscles are unusually weak, incontinence can be the major issue. Females also may experience significant pain during intercourse because the muscles supporting the vagina cannot relax properly.
A doctor can usually diagnose pelvic floor dysfunction based on a patient's symptoms and a thorough physical exam. X-rays and other imaging scans may be performed to look for signs of a swollen prostate, organ prolapse, or defects in the muscles. The doctor might press on the lower abdomen to see if it gives way to pressure and if the area is tender. A camera probe is used in some cases to view muscle movement from within the bowels or vagina.
Pelvic floor problems can be treated in a few different ways. Patients who have chronic constipation are often given muscle relaxers and encouraged to exercise, drink plenty of water, and eat fiber-rich foods. Another treatment called biofeedback is a physical therapy technique in which a specialist helps a patient see what it feels like to control different muscles. With practice, many people are able to gain better coordination. If problems persist, a surgeon may need to manually fix muscles and organs into place or confront other underlying issues, such as an enlarged prostate.