pelvic floor dysfunction
Pelvic floor dysfunction is related to the muscle imbalances of the pelvic floor muscles. They can be hypertonic (too much tension), or hypotonic (too little tension). Muscles imbalances of the pelvic floor lead to bowel and bladder issues in both men and women. The dysfunction most commonly studied is that of urinary incontinence.
symptoms
Pelvic floor dysfunction can lead to:
- Urinary hesitancy
- Painful urination
- Urinary incontinence
- Pain with bowel movements
- Pain with intercourse
- Bladder issues:
- Urinary hesitancy
- Painful urination
- Urinary incontinence
- Bowel issues:
- Pain with bowel movements
- Pain
- Pain with intercourse
diagnosis
- Extensive history of patient's history
- Defecting proctogram (from the physician), recording movements of the pelvic floor muscles
- Manual internal examination of pelvic floor muscles by physical therapists specialized in pelvic floor dysfunction
- Manual muscle test of the pelvic floor muscles and ligament testing
- Perineometer: a small, tampon-like sensing device placed into the vagina or rectum
treatment
For hypertonic pelvic floor muscles:
- Electrical stimulation
- Interferential therapy
- The goal is to relax pelvic floor muscles and avoid stressing them
- Modalities such as:
- Electrical stimulation
- Interferential therapy
- Self care: educate how to avoid pushing or straining the pelvic floor
- Warm baths
- Muscle relaxants (per physician)
- Physical therapy pelvic floor retraining program (manual therapy, home exercises, use of relaxation devices)
references
- Interstitial Cystitis Association: http://www.ichelp.org
- American Society of Colon and Rectal Surgeons: http://www.fascrs.org
- Mallet V, Bump R. The epidemiology of female pelvic floor dysfunction. Current Opinion in Obstetrics and Gynecology. 1994;6:308-312.