Pelvic floor dysfunctions

Pelvic floor dysfunctions are more common than is often known, because they are associated with a great deal of shame and it can feel difficult to talk about the topic. It is estimated that up to 30–40 percent of women suffer from some degree of urinary incontinence. Pelvic floor problems are especially common in women who have given birth, but they also affect men, especially after prostate surgery, as well as older adults.

Pelvic floor dysfunctions include several conditions: stress urinary incontinence (urine leaks when coughing, laughing or jumping), urge urinary incontinence (a sudden, uncontrollable urge to urinate), prolapse disorders (the uterus, bladder or rectum descend from the pelvic floor), pelvic floor pain syndrome and fecal incontinence. The symptoms can significantly affect quality of life, social life and exercise activities.

The causes of pelvic floor dysfunctions include childbirth, especially instrumental delivery or having a large baby, hormonal changes during menopause, overweight, chronic constipation and repeated increases in abdominal pressure. In men, prostate surgery is the main risk factor. Heredity and connective tissue characteristics also play a role.

Diagnosis is based on an examination by a gynecologist or urologist, including an internal examination, provocation tests for urinary leakage and, if necessary, urodynamic testing, which measures bladder function. A pelvic floor physiotherapist performs a functional assessment of pelvic floor muscle function.

Conservative treatment is the first-line approach: pelvic floor muscle training is the scientifically most effective treatment for mild to moderate stress urinary incontinence. Properly guided pelvic floor physiotherapy is more effective than many drug treatments. Urge incontinence is treated with bladder training and medication. In prolapse disorders, surgical treatment is an option when conservative treatment is not enough.

You should not have to suffer from pelvic floor dysfunctions in silence. Treatment is effective and surgery is often not needed. It is worth seeking professional evaluation when symptoms begin to limit exercise, social life or sleep.