Pelvic Floor Disorders

The pelvic floor is a group of muscles, ligaments and tissues that resembles a hammock and supports the organs in your pelvic area. These muscles are responsible for controlling bladder and bowel movements as well as other functions. Pelvic floor dysfunction is when the pelvic floor muscles become weak or damaged, affecting the surrounding organs.

At The University of Kansas Health System, our team coordinates care across multiple specialties to offer the latest treatments for both men and women who are living with the challenging symptoms of pelvic floor disorders. Together, we’ll work with you to determine an accurate diagnosis as well as the best course of treatment.

Our pelvic health therapists have advanced training through the Herman & Wallace Pelvic Rehabilitation Institute to treat men, women and children suffering from pelvic health disorders. Our expertise and experience allow us to design a program specific to meet your needs.

Both men and women have a pelvic floor, which are the muscles, ligaments, nerves and connective tissues that support the bladder and rectum, as well as other pelvic organs. In women, the pelvic floor also supports the uterus and vagina, while in men, the pelvic floor supports the prostate.

When this support structure stops working properly, you can lose muscle control over the pelvic organs, causing incontinence and other issues. In some cases, the organs can shift in placement, dropping down. This is called prolapse. If symptoms are left untreated, pelvic floor dysfunction can not only be uncomfortable and painful but can also cause long-term damage.

There are 3 main types of pelvic floor dysfunction:

• Bowel incontinence or rectal prolapse
• In women, pelvic organ prolapse (dropping of the uterus, vaginal walls or the vagina itself)
• Male urinary incontinence or urinary incontinence in women

There are several symptoms that could indicate pelvic floor dysfunction, depending on the specific type of disorder you have:

• A feeling of heaviness in the pelvis
• Back pain/sacroiliac joint dysfunction
• Bathroom frequency or urgency, both urinary and bowel movements
• Coccydynia (tailbone pain)
• Constipation or diarrhea
• Diastasis Recti (separation of the rectus abdominis muscles)
• Dyspareunia (painful intercourse)
• Hemorrhoids
• In men, erectile dysfunction
• Osteoporosis
• Pain or pressure in the vagina or rectum
• Painful urination or bowel movements
• Pelvic pain
• Pudendal neuralgia
• Postpartum musculoskeletal pain
• Seeing or feeling a bulge in the vagina or rectum
• Straining to pass a bowel movement
• Urinary incontinence
• Vulvodynia (including vaginismus) persistent pain or discomfort in the vulva 

Doctors aren’t sure exactly what causes the pelvic floor to fail, but there are several known risk factors:

• Age (although pelvic floor dysfunction is not a typical effect of aging)
• Being overweight
• Injury or trauma to the pelvic area, including radiation treatment for cancer, surgery, scar tissue
• Interstitial cystitis
• Pregnancy and childbirth

Diagnosing pelvic floor dysfunction begins with a complete medical history and physical exam, often including a pelvic and/or rectal exam. Your doctor may also have you do stress tests to check for urine leakage or prolapse when you strain or cough.

Additional tests your doctor may suggest can check for pelvic muscle control function, sphincter control and function, or effectiveness of urination or bowel movements.

The best treatment for pelvic floor dysfunction symptoms will depend on the specifics of your diagnosis. Different treatment options can include: