Pelvic Floor Disorder Treatment

Pelvic floor disorder, or pelvic floor dysfunction, is a condition in which the pelvic floor muscles contract during bowel movements instead of relaxing. This contraction makes normal defecation difficult or impossible, and may additionally result in bowel incontinence as residual stool leaks from the rectum. The causes of PFD may be physical and psychological in origin, and treatment options include physical therapy, dietary modification, medication and surgery.

Physical Therapy

• If you are diagnosed with PFD, treatment will center on retraining the muscles of the pelvic floor. This may involve one or more physical therapy techniques.

  In manual therapy, a trained physical therapist will directly massage your pelvic floor muscles through the rectum or vagina. This method focuses on revealing trigger points, or contraction points, in the muscles and deactivating them through direct pressure. External massage may also be used if you find the internal technique uncomfortable. Although manual therapy may actually make you feel worse in the short term, PFD improvement frequently occurs after a month or two of weekly treatments.

  Biofeedback is also used to treat PFD, with the goal of familiarizing your muscles with the sensations of a full bowel movement. This may involve a number of techniques. One technique involves placing a probe in the vagina or rectum that translates muscle movements into audio or visual feedback. In another version of this technique, electrodes are placed on the perineum and sacrum to provide the same audio and visual cues. You may then use this feedback to learn how to properly relax your pelvic muscles. Another technique involves learning to expel a small balloon from your rectum. Biofeedback is effective in roughly 75 percent of PFD cases.

  You may also benefit from direct electrical stimulation of your pelvic floor muscles. In this technique, a small probe is inserted in the rectum or vagina and then electrically charged in order to stimulate the muscles. A similar technique uses external electrodes to calm the spasms that sometimes accompany PFD.

  In order to quicken your progress, your physical therapist may also assign you home exercises for PFD. Potential techniques here include leg and back stretches, kegel exercises, general relaxation, visualization and posture training. Consult your physical therapist for a full explanation of PFD-related techniques.

Diet and Medication

• In some cases, the constipation associated with PFD may be eased by the introduction of a high-fiber diet. Your doctor may also recommend the use of stool softeners to achieve this same goal. Additionally, your doctor may prescribe low doses of muscle relaxants to augment physical therapy.

Surgery

• If your symptoms do not improve through other methods, your doctor may recommend surgery to address your PFD. This may be particularly indicated if you show abnormal signs such as a folded rectum (rectal prolapse) or rectal pouching (rectocele). Your doctor will inform you of the options available to address these conditions.