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What Is the Pelvic Floor?

"Pelvic Floor" is the name used by doctors to describe the interconnected organs (muscles, ligaments and tissues) located within the pelvis or lower abdomen. The pelvic floor can be thought of like a sling or hammock which supports the uterus, bladder, vagina and rectum in women (and the bladder and bowel in men). The muscles of the pelvic floor help control the flow of urine.

Pelvic floor disorders occur when any of these structures, as well as their related nerves, become damaged or weakened. 

It is generally accepted that pelvic floor disorders are more common in women than in men. Some estimates say that pelvic floor conditions will be experienced by one out of every three women. In addition, the chance of experiencing a pelvic floor disorder increases with age.

Why Are Pelvic Floor Disorders a Problem?

For good bladder control, all parts of your system must work together. The pelvic floor must hold up the organs, the sphincter muscles must control the flow of urine and the nerves must activate these muscles to function. Bladder and bowel control problems can occur when the muscles in the sphincter become weak. Sexual dysfunction (including different types of pain, avoidance of sex, and subsequent relationship difficulties) can also result. 

What Are Some Common Causes of Pelvic Floor Dysfunction?

  • Pregnancy
  • Childbirth
  • Episiotomy (grade 1-4)
  • Hysterectomy
  • Abdominal surgery
  • Hormonal imbalance, such as during menopause or post-menopause
  • History of chronic infection
  • Chronic cough or constipation
  • Obesity
  • Muscle weakness
  • Stretch weakness (faulty posture)
  • Pelvic injuries, including pelvic fractures or dislocations
  • Increased abdominal pressure with lifting and jumping
  • Improper lifting of infant or inappropriate nursing postures

What Are the Symptoms of Pelvic Floor Disorders?

  • Loss of urine with lifting, laughing, sneezing, running, and/or jumping
  • Increased frequency of urination, such as urinating more than eight times a day
  • Sudden urgency to urinate, such as when you hear water
  • Need to urinate often during the night
  • Leaking urine during normal activities of daily living causing a need to wear protective liner/pad in clothing
  • Inability to void urine and bowels/constipation
  • Lower back pain
  • Pelvic pain during sexual intercourse, exercise or other activities
  • Diastasis recti, or separation of the abdominal muscles
  • Pubic symphysis separation which occur often after childbirth
  • Pelvic organ prolapse

Are Pelvic Floor Disorders Treatable?

Yes. Inova's dedicated team of physicians, nurses and physical therapists will help determine the most successful diagnosis and treatment options for you – so you can return to a full and active life.

What Are the Various Treatments? Non-Surgical? Surgical?

Your course of treatment will depend on the nature and severity of your condition. A primary care doctor or gynecologist may recommend physical therapy for minor pelvic floor discomfort or bladder leakage. If your condition is more severe you may be referred, or self-refer, to have a consultation with a urogynecologist. Urogynecology combines principles from multiple disciplines including obstetrics and gynecology, urology, colorectal surgery, neurology and physical medicine and rehabilitation in order to address female pelvic floor disorders in a comprehensive fashion.