Women often find it embarrassing to talk about pelvic floor disorders—a broad category of issues also called pelvic floor dysfunction. These issues often stem from weakening or injury of the muscles and connective tissues of the pelvis. But these conditions are common, and women should feel comfortable discussing them with their doctor.
A 2014 study found that 25 percent of U.S. women have at least one pelvic floor disorder. That’s only the number of women who have reported it; the actual number is likely quite a bit higher. By age 80, half of U.S. women will experience some type of pelvic floor disorder.
25% of U.S. women have at least 1 #pelvicfloor disorder. via @MedStarWHC
Women often believe that the symptoms of these disorders are just a part of getting older or a side effect of having children, and there’s nothing that can be done. But that’s not true. While aging and giving birth do increase the risk, there are techniques and treatments available to give women relief.
Types and causes of pelvic floor disorders
There are several forms of pelvic floor disorders, such as:
- Pelvic organ prolapse: Downward movement or dropping of the pelvic organs, including the uterus, vagina, bladder and rectum.
- Stress urinary incontinence: Leaks of urine that can happen when a woman coughs, exercises or sneezes.
- Urgency incontinence: Problems holding back the urge to urinate.
- Fecal incontinence: Leakage from the bowel, ranging from gas to stool.
Many factors can contribute to a woman developing a pelvic floor disorder, including:
- Pregnancy and delivery
- Injuries during a hysterectomy or some other surgical procedure in the pelvic region
- Strain in the abdomen, or belly, such as lifting heavy objects
Pelvic floor disorder treatments
Women may be able to improve mild symptoms through changes in their behavior. Decreasing the amount of fluid you drink per day means the bladder isn’t as full, which can make it easier to hold back urine. Scheduled bathroom breaks or Kegel exercises to strengthen the muscles of the pelvic floor also can help.
Another non-surgical option for urinary leakage and pelvic floor relaxation is a “pessary,” which is a device similar to a diaphragm used for birth control. The device is inserted into the vagina and provides support for the pelvic organs. Some women use pessaries all the time, while some only use them during the daytime. They need to be cleaned regularly to prevent infections.
Surgery for pelvic floor disorders
If behavioral changes or a pessary don’t work, or if a woman doesn’t want to try a pessary, minimally invasive surgery is an option to treat many pelvic floor disorders. The more surgeries a doctor or hospital does to treat these conditions, the better outcomes are for patients. Our pelvic floor disorder program is the largest such program in the country.
Surgery to correct pelvic floor disorders used to be very invasive, but nearly all of these procedures are minimally invasive today. We can perform these surgeries either through the vagina or laparoscopically, which involves tiny incisions in the abdomen. These surgeries are often performed as an outpatient, without the need for a hospital stay.
Minimally invasive surgical procedures have several advantages over traditional surgery, such as:
- Fewer complications
- Less pain and discomfort
- Shorter hospital stay, if a stay is needed at all
- Quicker return to work and normal activities
Some women may have been told in the past that they’re not good candidates for minimally invasive surgery to treat these issues. There are very few reasons nowadays for women to need open surgery for pelvic floor disorders. This might be more of a reflection of the surgeon’s expertise than anything else.
Our program is well known for our expertise in this area of surgery. When I came to MedStar Washington Hospital Center in 2005, I was the first surgeon in Washington to perform a minimally invasive sacralcolpopexy, which is a procedure to lift the vagina. And we were one of the first centers in the world to perform robot-assisted pelvic floor surgery. In fact, we are a recognized Center or Excellence in the treatment of pelvic floor disorders, and are one of the largest programs in the country training doctors in female pelvic medicine and reconstructive surgery.
Bathroom trouble and pelvic relaxation aren’t just normal symptoms of getting older. These are common conditions that we have the tools and expertise to treat. I urge all women who are suffering with these symptoms to ask their doctors for help. We can help you get your life back.
Request an appointment with one of our urogynecologists to explore your options for treating pelvic floor disorders.