What Are Pelvic Floor Disorders (PFD’s)?
Pelvic floor disorders are a set of disorders related to the woman’s pelvis and the pelvic floor, and to the different organs and support systems in that area, (muscles, ligaments, fasciae, etc.). Weakness of or injury to the various support systems or pelvic organs, may affect the normal function of surrounding organs, such as the bladder, urethra, vagina, uterus, vulva and rectum. Women with PFDs may experience various symptoms:
- Urinary problems, such as urinary incontinence, mainly following a stressful event (stress urinary Incontinence, SUI) but also an urgent need to urinate, urge incontinence, painful urination, incomplete emptying of their bladder, etc.
- Pelvic organ prolapse – where weakness of the pelvic support system causes various surrounding organs to prolapse into the vaginal cavity with various resultant complaints
- Rectal problems such as fecal incontinence, constipation, straining or pain during bowel movements.
- Sexual dysfunction
- Pain or pressure in the vagina or rectum.
- Other less frequent complaints
The most prevalent PFDs are urinary incontinence and pelvic organ prolapse which affect around 50% of the female population, worldwide, and are associated with huge financial burden on both patients and medical systems.
Stress Urinary Incontinence
Stress Urinary Incontinence (SUI) is the most common type of urinary incontinence in women. It involves the involuntary leakage of urine due to damage and loss of support to the urethra, leading to urethral hypermobility and inadequate intra-urethral pressure. SUI is characterized by loss of urine from increased abdominal pressure caused by activities such as coughing, laughing, sneezing, running, lifting, and walking. This condition may be caused by direct damage to the urethra; however, it is more commonly caused by damage to structures that support the urethra and hold the bladder neck in position along the back of the pubic bone, resulting in hypermobility of the bladder neck and the urethra. Such damage is usually the result of events such as childbirth, constipation with straining, and pelvic surgery. Urinary incontinence is a very prevalent condition in women, reaching as high as 53.2%. The risk of incontinence increases with age.
Pelvic Organ Prolapse
Pelvic organ prolapse (POP) is a condition in which vaginal wall support is lost, and various pelvic organs prolapse into the vagina. Symptoms of POP may vary from being completely absent to a combination of various complaints which may be very bothering and influence everyday life. including:
- Feeling of pelvic heaviness
- Bulging out of the vagina
- Vaginal discomfort / pains
- Pelvic and/or lower back pain
- Recurrent bladder infections
- Voiding difficulties up to retention
- Difficulty emptying the bowels
- Difficulty inserting or keeping a tampon in place
- Vaginal-cervical mucosa hypertrophy, excoriation, ulceration, and bleeding