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Understanding Pelvic Disorders

James Wright, M.D.

Imagine if you had the frequent urge to go to the bathroom at unexpected times. Or if you couldn’t exercise due to pelvic discomfort. Or if you weren’t able to play with your children for fear of urinary leakage.

Life can be challenging for women who are coping with these issues—all symptoms of pelvic floor disorders. By age 55, nearly half of all women will have some type of pelvic floor condition—and many will suffer in silence with the uncomfortable, embarrassing and sometimes disabling symptoms.

An Overview of Common Conditions

The “pelvic floor” is the group of muscles that form a sling across the opening of the pelvis. These muscles keep all of the pelvic organs in place and help them function. Pelvic floor organs include the bladder and urethra, the vagina, and the anus and rectum. Female pelvic floor disorders can affect the pelvic floor muscles or any of these organs. Urinary incontinence and pelvic organ prolapse are the most common pelvic floor disorders.

Urinary Incontinence

This is a loss of bladder control leading to urinary accidents. Urinary incontinence affects one in three women. Two common types of urinary incontinence are urge incontinence (urinary leakage with the sudden need to urinate) and stress incontinence (urinary leakage that occurs with physical effort, such as coughing, sneezing or exercising). Click here for a Webinar presentation, given by Dr. Wright, on when to get treatment for urinary incontinence.

Pelvic Organ Prolapse

These pelvic support problems occur when one or more of the organs in a woman’s pelvis—the uterus, vagina, urethra, bladder or rectum—shifts down and bulges out of the vaginal canal, making everyday activities extremely uncomfortable. Women with pelvic organ prolapse may see or feel a bulge coming out of their vaginal opening. Types of pelvic organ prolapse are commonly called cystocele, enterocele, rectocele and uterine prolapse.

Pelvic Organ Prolapse

Pelvic organ prolapse is a common condition. About one in every ten women will undergo surgery for the prolapse of their uterus or vagina.

Sacral Colpopexy

If the uterus or vagina have prolapsed out of the body, doctors may recommend a surgery called a sacral colpopexy. A sacral colpopexy can be performed through an abdominal incision or a minimally invasive, laproscopic technique. During a sacral colpopexy, a strap is created using a surgical mesh material. This strap is used to reposition and suspend the vagina back into its original position.

Uterosacral Suspension

If the uterus or vagina have prolapsed out of the body, doctors may recommend a surgery called a uterosacral suspension. A uterosacral suspension is performed through through the vaginal opening, leaving no visible scars on the outside of the body. During a uterosacral suspension, the vagina is attached to the woman's own uterosacral ligaments using stiches or sutures. This procedure suspends the vagina back into its original position.

Fecal Incontinence

This is a loss of bowel control leading to accidental passing of stool. This problem can be caused by muscle damage during childbirth, constipation, anal injury, nerve injury or rectal prolapse.

Defecatory Dysfunction

This condition refers to problems emptying the bowels. Symptoms may include the frequent and uncomfortable urge to have a bowel movement, constipation, and leakage of gas, diarrhea or solid stool.

Voiding Dysfunction

This term refers to a variety of conditions that lead to the inability to empty the bladder normally. Examples include weakness of the bladder muscle and mechanical obstruction.

When to Seek Help

Sometimes the start of symptoms is so gradual that women get used to these problems, or don’t really notice them until something major occurs. But one thing is certain—pelvic floor conditions do not get better over time. While these disorders are more common as women age, they are not normal. You should seek medical consultation if you experience any symptoms that affect your daily activities, such as heaviness or pressure in the area of the vagina or pelvis, a bulge of tissue coming through the vaginal opening, accidental loss of urine, frequent or unexpected urges to urinate, or difficulty urinating. Early diagnosis will help ensure that you receive the quickest and most effective treatment.

For more information about pelvic floor disorders, visit our Links & Resources page.

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