Treatment for Pelvic Floor Disorders and Urinary Incontinence

Urinary incontinence is more common in women than in men. It affects 10-25% of women under age 65. Incontinence does not always mean that a woman leaks often. Bladder leakage for an active woman or one who loses a large amount of urine each time, even one time a week or less may be too much.

Women often do not tell their doctor about their symptoms of urinary incontinence. Less than one half of women seek treatment. Instead, they rely on pads or changes in lifestyle to deal with this condition. They may feel ashamed and even avoid social or work events. Some women have a false belief that incontinence is a normal part of aging and that nothing can be done to correct it. Urinary incontinence often can be treated. A variety of options for treatment are available. Treatments may include behavioral changes, special devices, medication, or surgery.

1 out of 3 women experience bladder leakage. If bladder leakage is not treated, it will likely worsen as a woman ages. Symptoms can range from leakage when coughing, laughing or exercising (stress incontinence) to urgency and urinary frequency (urge incontinence).

Pelvic Floor Dysfunction

The pelvic floor refers to a small group of muscles that support the pelvic organs, including the bladder and rectum, the uterus in women and prostate in men.

When this group of muscles is not working properly it is referred to as pelvic floor dysfunction. This is a common condition where you’re unable to correctly relax and coordinate the muscles in your pelvic floor to urinate or have a bowel movement. If you’re a woman you may experience pain during sex and men can have trouble getting and maintaining an erection.

Other symptoms can include pelvic pain, rectal pain, pain with urination, urinary urgency and frequency, difficulty evacuating urine or stool, or bladder and bowel incontinence.

Causes of pelvic floor dysfunction can include traumatic injuries to the pelvis such as a car accident, pregnancy, overuse of the muscles, pelvic surgery, weight gain and advanced age.

To diagnose pelvic floor dysfunction your provider will obtain a thorough history. The physical exam can include a pelvic or rectal exam to assess the pelvic floor muscles for areas of tightness or weakness.

Treatment of pelvic floor dysfunction can include pelvic floor physical therapy, medication, relaxation techniques and pelvic floor biofeedback.

Pelvic floor biofeedback is a common treatment for men, women, and children with symptoms of pelvic floor dysfunction. It is not painful and is effective in over 80% of patients. With use of special sensors and a video monitor the provider can monitor the muscles during contraction and relaxation, assisting with muscle coordination and retraining.

A common treatment for patients with pelvic floor muscle weakness or tension is the use of pelvic floor EGS therapy. Also known as electro galvanic stimulation. This is performed with use of the vaginal sensor in women and the rectal sensor in men. The sensor rests on the pelvic floor muscles and can be programmed to emit a specific frequency to help strengthen or relax the pelvic floor, depending on their symptoms and biofeedback test results.

A research study was conducted in 2013 which looked at over 700 women who completed 5-8 sessions of pelvic floor biofeedback therapy. These patients reported 80-85% improvement in their symptoms of pelvic floor dysfunction after 5 treatments. A follow up study performed in 2016 revealed similar outcomes with reported ongoing improvement for over a year after treatment. This study also revealed significant improvement in nighttime urinary frequency and early-stage pelvic organ prolapse symptoms.

Pelvic floor dysfunction is a common disorder. Discussing these symptoms with your health care provider can often be embarrassing, especially talking about bowel movements. The good news is that pelvic floor symptoms can be easy to treat. If you think you have pelvic floor dysfunction, please contact our office and we will be happy to schedule you for a thorough evaluation of your pelvic floor with our expert, Julie Starr, FNP, PhD. The sooner treatment is started, the less likely it will become a chronic problem.

For more information, you can go to The American Urogynecologic Society website by clicking on this link

Types of Incontinence

  • Urge

Leakage of urine caused by overactive bladder muscles that contract too often.

  • Stress

Loss of urine during coughing, laughing, sneezing, or physical activity.

  • Overflow

The bladder does not empty all the way during voiding.

If you have symptoms of urinary incontinence, or feel as if it is affecting your daily life, tell your doctor. A thorough exam is needed to find the cause of the problem. In most cases, urinary incontinence treatment is successful.