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Your pelvic floor is a group of muscles and ligaments that support and hold your pelvic organs in place by forming a kind of 'sling' around them. They help stabilise your core and allow you to perform normal bodily functions like peeing, pooping and having sex.
Pelvic floor disorders, also known as pelvic floor dysfunction, include several conditions where your pelvic floor muscles become weakened, leading to problems controlling your bladder or bowel. The condition is more common in older women.
Pelvic floor disorders include:
- Pelvic organ prolapse: This occurs when one or more of your pelvic organs drop from their usual place in your lower abdomen and push against the walls of your vagina
- Urinary incontinence: Involuntary leakage of urine from your bladder
- Faecal incontinence: Involuntary leakage of faeces from your bowel
- Sexual dysfunction: May include pain during sex, problems with arousal or other sexual problems
At Circle Health Group, our expert gynaecologists and urogynaecologists can diagnose and offer a range of treatments for pelvic floor disorders.
Call or book online today to arrange a consultation to discuss private pelvic floor disorder treatment with a consultant of your choice at Circle Health Group.
This page explains what pelvic floor disorders are, looks at the causes and symptoms of pelvic floor disorders, and explains how they are treated.
The symptoms of pelvic floor disorders vary from person to person and depend on the type of pelvic floor disorder you have. Symptoms range from mild to severe, and may be worse when you stand, jump, laugh, cough or lift heavy objects.
Symptoms of pelvic floor disorders may include:
- Needing to pass stools (poop) frequently
- Difficulty passing stools, constipation or straining during bowel movements
- Needing to pass urine (pee) frequently or urgently
- Leaking urine, especially when coughing, sneezing, laughing or running
- Leaking stool
- Difficulty passing urine
- Pain when passing urine
- Feeling a bulge at your vaginal opening, or a sensation of heaviness in your vagina
- Recurrent urinary tract infections (UTIs), or thrush
- Lower back, genital, or pelvic pain
- Pain during sex
Pelvic floor disorders occur when there is weakness or damage to the muscles and tissues that support your pelvic organs.
This may be caused by:
- Pregnancy and childbirth
- Previous pelvic surgery or injury
- Obesity
- Persistent or long-term coughing
- Spinal cord conditions
- Connective tissue disorders
You may have a higher risk of developing a pelvic floor disorder if you:
- Are female
- Are over 50 (the risk increases with age)
- Have a family history of pelvic floor disorders
- Have been through menopause
- Have given birth more than once, especially if you had a prolonged or difficult delivery
- Are overweight or obese
- Smoke
- Have chronic constipation
- Have a lung condition that leads to chronic coughing, such as COPD
- Have had previous pelvic surgery or an injury to your pelvis
There are several treatment options available for pelvic floor disorders. Your consultant will recommend the best treatment for you depending on your diagnosis, how severe your symptoms are, your age, your general health and whether you plan to have children in the future.
Physiotherapy
Physiotherapy is often one of the first treatments for pelvic floor disorders and involves muscle training and pelvic floor exercises to strengthen or relax your pelvic floor muscles and improve muscle coordination and function.
Physiotherapy for pelvic floor disorders may also include:
Manual therapy
This uses techniques, such as massage and manual manipulation, to help release tension in your muscles and improve muscle coordination.
Biofeedback
This uses a machine with sensors that provides real-time feedback and allows you to visualise and learn to control your pelvic floor muscles. During the treatment, your physiotherapist will guide you to contract and relax your muscles in specific ways, helping you retrain your muscles.
Breathing exercises
This involves deep diaphragmatic breathing to relax and lengthen your pelvic floor, helping your pelvic floor muscles coordinate and move correctly.
Lifestyle advice
Your physiotherapist can advise you on lifestyle changes you can make to improve your bladder and bowel function.
Medication
Depending on your symptoms, your consultant may prescribe medications such as vaginal hormone treatment (oestrogen), in the form of tablets or cream, painkillers, stool softeners or medicines to help with urinary incontinence.
Pessary
A pessary is a plastic device that is inserted into your vagina to help support your pelvic organs and hold them in place. It can be used to treat conditions such as pelvic organ prolapse or urinary incontinence. A pessary is a good alternative to surgery if you are thinking about having children in the future or are not a suitable candidate for surgery. The device can be used long or short term.
Surgery
If your pelvic floor disorder is severe or not improving with other treatments, your consultant may recommend surgery to repair your pelvic floor.
There are several surgical procedures for pelvic floor disorders, including surgery to tighten your pelvic floor muscles or using surgical mesh to support your organs and prevent them from prolapsing again.
In some cases, your consultant may remove your womb with surgery called a hysterectomy to treat a prolapsed womb, strengthen the vaginal muscles and reduce the risk of the prolapse happening again.
Depending on the procedure, pelvic floor repair surgery may be performed vaginally, laparoscopically (keyhole surgery), or as robotic surgery.
Recovery depends on the type of procedure you had and other factors such as your age and general health, but in general takes around four to six weeks.
Before you start your treatment, you’ll have a consultation with a consultant gynaecologist, a doctor specialising in female pelvic floor disorders.
At this appointment, your consultant will ask you about your symptoms, medical and family history and general health. They will perform a physical examination, including a rectal or pelvic exam to check for muscle spasms, knots, weakness, or prolapse. They may ask you to cough or strain during the examination to see how your organs move.
Your consultant may arrange some tests to check how well the muscles in your pelvic floor are working.
These may include:
- Anorectal manometry: This is a test to measure the pressure in your rectal and anal muscles to check how well they are working to control bowel movements
- Electromyography (EMG): This is often performed with anal manometry to test the coordination of your pelvic floor muscles
- Defecating proctogram: This is a test that uses X-rays to see how well your pelvic floor muscles work when you empty your bowels
- Urodynamic testing: This test measures how well you empty your bladder and checks for any issues with bladder and urethral function
- Cystoscopy: This test uses a thin, flexible tube to examine your bladder and check for any problems that could be causing your symptoms
- Urine analysis: A urine test to check for infections that could be causing your symptoms
During your appointment, your consultant will spend time getting to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. At Circle Health Group, we want you to be as well-informed and comfortable as possible during your time with us, so please discuss any questions or concerns with your consultant during your appointment.
What questions should I ask my consultant about my pelvic floor disorder?
It may help to write down any questions you have before your appointment, so you don’t forget them. You may want to ask about:
- The type of pelvic floor disorder you have
- The possible cause, such as pregnancy, childbirth, menopause, surgery, or ageing
- The available treatment options
- Any lifestyle changes you can make to improve your symptoms or prevent them from worsening
- Any activities you should limit or avoid, such as heavy lifting, strenuous exercise, or sexual activity
- If you are planning to get pregnant in the future, how your condition or treatment may impact this
- How effective the treatment is, and when you can expect to see an improvement in your symptoms
- If surgery is recommended, the type of surgery, the anaesthetic that will be used, any potential risks and complications and the estimated recovery time
At the end of your appointment, your consultant will make a diagnosis based on your symptoms, physical examination and the results of any tests. They will explain your diagnosis to you in detail and create an individualised treatment plan that is tailored to your needs.
When you choose to go private with Circle Health Group, you can expect:
- Flexible appointment times and locations to fit your routine
- The freedom to choose which hospital and consultant suits your needs
- Personalised, consultant-led treatment plans tailored to your individual needs
- Comfortable and safe private facilities maintained by expert multidisciplinary teams
- Affordable, fixed-price packages with aftercare included
- Flexible payment options to help you spread the cost of your care
If you would like to learn more about treatment for pelvic floor disorders, book your appointment online today or call a member of our team directly.
- Pelvic Floor Dysfunction, NHS Forth Valley
- Pelvic Floor Disorders, Johns Hopkins Medicine
- About Pelvic Floor Disorders (PFDs), NIH
