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Pelvic Floor Dysfunction

In women, the pelvic floor consists of the muscles, ligaments, connective tissues and nerves that act as a “hammock” to support the bladder, uterus, vagina and rectum and help these pelvic organs function. You rely on these muscles to control your bladder and bowel movements.

Pelvic floor disorders occur when that support becomes weakened or damaged. The symptoms of pelvic floor disorders depend on the type of the disorder and the muscles or nerves affected. The three main areas of pelvic floor disorders are:

  • Urinary incontinence
  • Fecal incontinence
  • Pelvic organ prolapse

According to a National Institutes of Health study, almost 25 percent of women are faced with pelvic floor disorders. That number jumps to 37 percent of women 60 to 79 years old, and nearly half of women 80 or older. While pelvic floor disorders become more common as women age, they are not a normal or acceptable part of aging. These problems can have a significant negative impact on a woman’s well-being and quality of life. But while many women are reluctant to discuss this problem, continuing advancements in treatments can benefit your health, wellness and peace of mind.

Causes of Pelvic Floor Disorders

Pelvic floor disorders result from damage to the muscles and nerves of the pelvic floor. Natural childbirth is one of the main causes of pelvic floor disorders, and even pregnancy can be a factor. Having pelvic surgery or radiation treatments can cause these disorders, since these procedures could damage nerves and other tissues in the pelvic floor. Women who are overweight or obese are also at greater risk. Aging and genetics are other possible causes. In some cases, the exact source of the disorder remains unknown.

Treating Pelvic Floor Disorders

Urogynecology is a specialty of gynecologic medicine that involves the diagnosis and treatment of female pelvic floor disorders. Orlando Health offers comprehensive urogynecologic care that includes a full spectrum of diagnostic tests and treatment methods, including evaluations, biofeedback, electrostimulation, specialized physical therapy, prescription medication and minimally invasive surgical intervention.

Orlando Health’s commitment is to provide women with comprehensive care that only the most capable and highly trained physicians can offer in one of the most technologically advanced environments. If surgical intervention is needed, the vast majority of gynecological conditions can now be treated much more effectively through minimally invasive surgery, which reduces complications and allows for a faster recovery and quicker return to your normal daily life.

Orlando Health Winnie Palmer Hospital for Women & Babies is recognized as a Center of Excellence in Minimally Invasive Gynecology, a designation that recognizes our commitment and ability to consistently deliver safe, effective, evidence-based care in a compassionate, healing environment.

We routinely perform the following surgeries for pelvic floor disorders, using minimally invasive, laparoscopic and robotic-assisted techniques:

  • Uterine resuspension
  • Vaginal prolapse repair
  • Cystocele repair
  • Rectocele repair

Types of Pelvic Floor Disorders

Urinary Incontinence

Urinary incontinence, or lack of bladder control, is the most common pelvic floor disorder. It can be caused by a number of conditions, including a weakening of the muscles that control the bladder valve. A major symptom is the frequent urge to urinate; other symptoms include pressure on the bladder and a feeling that the bladder has not completely emptied. There are several different types of urinary incontinence and the severity can vary from person to person.

  • Stress incontinence is the leakage of urine when you cough, laugh or sneeze, or when exercising, lifting or performing other activities that put pressure on the bladder. Stress incontinence is caused by a weakness in the muscles and ligaments that support the bladder and urethra.
  • Overactive bladder and urge incontinence refers to having to urinate frequently, feeling a strong urge to urinate, and even involuntarily losing urine when you have a strong need to urinate. These sudden, uncontrollable bladder contractions are caused by damaged nerves along the pathway from the bladder to the brain.
  • Mixed incontinence is very common and refers to experiencing symptoms of both stress and urge incontinence, such as having urine leakage during exercise as well as when you feel a strong urge. 
  • Voiding dysfunction refer to the inability to empty the bladder completely.

Fecal Incontinence

Fecal incontinence is characterized by a loss of bowel control, which leads to the involuntary passing of stools. It is the second most common pelvic floor disorder, affecting men and women of all ages, although more commonly found in older adults. However, fecal incontinence is not normal at any age and can be successfully treated, leading to a significant improvement in quality of life. There are two main classifications of fecal incontinence.

  • Passive incontinence refers to the passing of stools without being aware of it.
  • Urge fecal incontinence is being aware of the need to pass stools but being unable to control their passage.

Pelvic Organ Prolapse

Pelvic organ prolapse is the third most common pelvic floor disorder and occurs when the pelvic muscles and other supporting tissues become weak, causing the pelvic organs to fall out of place. The uterus, bladder or bowel may “fall” onto the vagina and cause a bulge in the vaginal canal. While these conditions are usually not associated with serious health risks, they can cause major discomfort with symptoms that include a heavy feeling or like something is “falling out” of the vagina, a pulling or pressure in the lower abdomen or pelvis, pain during intercourse, and frequent urinary infections due to a reduced ability to release urine from the urethra. There are several types of pelvic organ prolapse, depending on the organ involved.

  • Uterine prolapse occurs when the muscles and ligaments supporting the uterus weaken, and the uterus descends into the vaginal canal.
  • A cystocele is the result of a bulge formed from a defect in the wall between the bladder and vagina, and part of the bladder wall bulges into the vagina.
  • A rectocele is when part of the wall of the rectum bulges into the vagina because of a defect in the wall between the rectum and vagina.