​​​​​Pelvic floor dysfunction: Effects on urination, bowel movements, and sexual intercourse

June 27, 2019
healthcaretoday, Pelvic floor dysfunction, urination, bowel movements, sexual intercourse, leakage of urine, stool, pain during intercourse, pregnancy, childbirth, aging, stress, anxiety, Tissue disorders, interstitial cystitis, irritable bowel syndrome, pelvic organ prolapse, erectile dysfunction, prostatitis, constipation, anorectal diagnosis,
   By Dr Patricia Lim Su Lyn ,​
   Obstetrician and Gynaecologist
   KPJ Tawakkal Specialist Hospital
​Pelvic floor dysfunction is a common condition that affects the coordination and relaxation of the muscles in the pelvic floor. This can lead to difficulties with urination, bowel movements, and even sexual intercourse. 

What is pelvic floor dysfunction?
The pelvic floor is a group of muscles that support the organs in the pelvis, including the bladder, uterus, prostate, and rectum. These muscles play a crucial role in controlling urination and bowel movements. In a healthy individual, the pelvic floor muscles tighten and relax as needed. However, in people with pelvic floor dysfunction, these muscles remain tense, causing a range of symptoms.

Symptoms and causes
The most common symptoms of pelvic floor dysfunction include frequent bathroom visits, difficulty emptying the bladder or bowels, leakage of urine or stool, and pain during intercourse. These symptoms can significantly impact a person's quality of life and may be caused by various factors, including:
  • Traumatic injuries to the pelvic area, such as a car accident or a fall from a high place.
  • Overuse of the pelvic muscles, such as straining during bowel movements.
  • Prior pelvic surgery, such as a hysterectomy or prostatectomy.
  • Pregnancy and childbirth, especially difficult deliveries.
  • Aging, which can weaken the pelvic floor muscles.
  • Stress and anxiety.
  • Connective tissue disorders.

Conditions that can be mistaken for pelvic floor dysfunction
Pelvic floor dysfunction can often be mistaken for other conditions, including interstitial cystitis, irritable bowel syndrome, pelvic organ prolapse, erectile dysfunction, prostatitis, constipation, and anorectal conditions. It is essential to consult a healthcare provider for an accurate diagnosis and appropriate treatment.

Diagnosis and tests
To diagnose pelvic floor dysfunction, a healthcare provider will typically ask about the symptoms and medical history. They may also perform a physical exam to check for muscle spasms, knots, or weakness in the pelvic floor muscles. Other tests that may be conducted include anorectal manometry, defecating proctogram, and urodynamic testing.

Management and treatment
Fortunately, pelvic floor dysfunction can be managed without surgery. Treatment options include:
  • Pelvic floor physical therapy: A physical therapist can help identify and stretch tense pelvic floor muscles and improve their coordination.
  • Biofeedback: This treatment involves using sensors and video to monitor pelvic floor muscle activity and providing guidance to improve muscle control.
  • Medications: Daily medications may be prescribed to regulate bowel movements.
  • Relaxation techniques: Meditation, warm baths, yoga, and acupuncture can help relieve tension in the pelvic floor muscles.
  • Trigger point injections: In severe cases, a pain injection specialist may inject numbing medications into specific muscles to relax them.

With proper treatment, most people with pelvic floor dysfunction can experience significant improvements in their symptoms. However, it may take a few months of physical therapy sessions to notice a difference. It is essential to seek treatment as pelvic floor dysfunction symptoms can worsen if left untreated.

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