Pelvic health is an emerging field of medicine that focuses on the diagnosis and treatment of pelvic floor disorders. A multidisciplinary team of doctors, nurses, and physical therapists, specialize in problems related to the muscles, ligaments, and connective tissues that support the pelvic floor, the bladder, vagina, uterus, and rectum. Treatment of these complex problems requires recognition of the interconnected nature and importance of pelvic structures, and a wide set of specialized knowledge provided at our center by a team of urogynecologists, urologists, colon and rectal surgeons, physical therapists, psychologists and others.
Injuries to the pelvic support structures occur during childbirth, heavy lifting, straining such as constipation, menopause, which leads to a weakening of the pelvic floor and a variety of pelvic floor disorders. Symptoms can include sexual dysfunction and pain, pressure, abdominal pain, anemia, and depression.
Pelvic health disorders may be extremely uncomfortable, embarrassing, activity limiting, and painful. Avoidance of treatment can negatively impact the quality of life not just for the patient, but their family, as well. Fortunately, recent national recognition of these underreported and treated problems by the National Institute of Health (NIH) has prompted new interest in the ongoing development our understanding of the disorders of this field. Both medical and surgical treatments are available that can successfully improve and restore pelvic health and continence
The term “pelvic floor” refers to the group of muscles that form a sling or hammock across the opening of a woman’s pelvis. These muscles, together with their surrounding tissues, keep all of the pelvic organs in place so that the organs can function correctly.
A pelvic floor disorder occurs when the pelvic muscles and connective tissue in the pelvis weaken or are injured. An estimated one-third of all U.S. women are affected by one type of pelvic floor disorder in her lifetime. Disorders may result from pelvic surgery, radiation treatments, and, in some cases, pregnancy or vaginal delivery of a child.
There are a variety of problems related to the pelvic floor. The most common include:
Pelvic organ prolapse – A “prolapse” occurs when the pelvic muscles and tissue become weak and can no longer hold the organs in place correctly. In uterine prolapse, the uterus can press down on the vagina, causing it to invert, or even to come out through the vaginal opening. In vaginal prolapse, the top of the vagina loses support and can drop through the vaginal opening.
Some symptoms of pelvic organ prolapse may include:
- A feeling of heaviness or fullness or as if something falling out of the vagina.
- Some women also feel a pulling or aching or a “bulge” in the lower abdomen or pelvis.
- Prolapse may also cause a kinking in the urethra, making it harder for a woman to empty her bladder completely, or causing frequent urinary tract infections.
Urinary Incontinence – This can occur when the bladder drops down into the vagina. Because the bladder is not in its proper place symptoms may include uncontrolled leaking of urine, urgency to urinate, frequent urination, and painful urination.
Fecal Incontinence – This can occur when the rectum bulges into or out of the vagina, making it difficult to control the bowels. It can also occur when there is damage to the anal sphincter, the ring of muscles that keep the anus closed.
Some women don’t need treatment for their pelvic floor disorder. In other cases, treatment for symptoms includes changes in diet, weight control, and other lifestyle changes. Treatment may also include surgery, medication, and use of a device placed in the vagina called a pessary that helps support the pelvic organs.
Recent NICHD research has found that combining repair surgery with a second surgical procedure can help prevent urinary incontinence later.
Exercises for the pelvic floor muscles (known as Kegel exercises) can often help strengthen the muscles around the openings of the urethra, vagina, and rectum. Treatments for incontinence can also include medication and bladder or bowel control training.
The team at the UTMB Pelvic Health and Continence Center can evaluate you, advise and assist with all these conditions and treatments. Contact us...
Endometrium - the lining of the uterus.
Uterus - also called the womb, the uterus is a hollow, pear-shaped organ located in a woman's lower abdomen, between the bladder and the rectum.
Ovaries - two female reproductive organs located in the pelvis.
Cervix - the lower, narrow part of the uterus (womb) located between the bladder and the rectum. It forms a canal that opens into the vagina, which leads to the outside of the body.
Vagina - the passageway through which fluid passes out of the body during menstrual periods. It is also called the "birth canal." The vagina connects the cervix (the opening of the womb, or uterus) and the vulva (the external genitalia).
Vulva - the external portion of the female genital organs.
Source, and additional information on pelvic floor disorders, are available from the National Institutes of Health.
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