The bladder, rectum, genital organs and a major part of the urethra reside within a cavity, which is termed as ‘pelvic cavity’ or simply the pelvis. There are several muscles present within the walls of the Pelvic cavity, which hold the organs in place and work with the surrounding tissues to ensure proper movement, support and function. Across the floor of the pelvis on the inferior lining of the cavity, these muscles form a hammock or sling like structure called the pelvic diaphragm. This is integral because it forms the foundation of the entire organ system, weak pelvic floor muscles mean a weak pelvis.
The Pelvic Organs and Muscles:
The cavity is home to several organs, which include:
- Bladder: A bag or pouch that stores and collects urine.
- Intestines: These organs are an integral part of the digestive tract. After passing through the stomach, the food is broken down here by the action of enzymes and the nutrients are absorbed.
- Rectum: A tube at the end of the larger intestine where solid waste material is stored in the form of faeces.
- The uterus and vagina: Female genital organs.
- The prostate and scrotum: Male genital organs.
The organs work together hand-in-hand to perform a number of functions. The body’s weight is transferred to the lower limbs through the pelvic girdle assisting in locomotion. They cavity is home to abdominal and digestive organs, which are protected, guarded and kept in place by the pelvic muscles. The birth canal in the female body is present within the pelvic girdle. It plays a crucial role in childbirth as the surrounding muscles help move the baby along during delivery.
Just like any other muscle of the body, the muscles at the pelvic floor contract and relax periodically. They guard the opening of the ureter and rectum by wrapping around these structures. Their sphincter-like function provides urinary and fecal continence, allowing us to go to the bathroom according to our convenience.
These muscles are also integral for healthy sexual function amongst both males and females. These muscles help to attain and sustain and erection as well as assist in the process of ejaculation within males. In females, they contribute towards sexual arousal, feelings of pleasure and sensation.
Pelvic Floor Disorders and Their Causes:
The muscles that stretch like a trampoline across the tail bone and pubic are normally firm and thick. When due to any circumstance the muscles at the pelvic floor undergo strain and stress, they become weakened or injured. Several reasons like heavy lifting, chronic constipation, obesity and childbirth affect the elasticity and strength of these muscles obstructing the normal function of the pelvis. Although they may seem insignificant, these disorders largely affect the quality of an individual’s life.
- Faecal and Urinary Incontinence:
Extremely common amongst aging individuals, the condition is characterized by loss of control over normal bowel movement. People with this issue struggle with keeping control of their bladder and rectum which can lead to an involuntary passage of urine and stool. Under normal conditions, it is the contracting and relaxing of the pelvic floor muscles that allows an individual to empty their bowels as per their convenience. When the nerves that control these muscles are damaged, they can’t properly transfer messages to the muscles informing them when they should tense up or relax. There are two common types of incontinence:
- Stress incontinence: Involuntary flow of urine or stool caused by activities like coughing, sneezing, laughing and running that tend to exert pressure on a full bladder.
- Urge incontinence: The strong urge or feeling to constantly go to the bathroom. Frequent need to urinate can be the result of numerous underlying health conditions and also a side effect of certain surgeries.
There are numerous factors that contribute to incontinence by damaging the nerves in the sphincter muscles. Diarrhea, chronic constipation and holding urine for long periods of time (urine retention) are the most common reasons people struggle with the issue. In females, child-birth is the leading cause of pelvic floor disorders. However, incontinence can often be a sign of an underlying medical condition like Multiple sclerosis, Alzheimer’s disease, Diabetes, Hemorrhoids, Infections within the brain and spinal cord as well Crohn’s disease and ulcerative colitis.
- Pelvic Organ Prolapse:
Mostly observed amongst females, its condition in which the weakening of the pelvic muscles cause the organs within the cavity to drop lower and press against the organs below. In a uterine prolapse. The cervical muscles can no longer support cervix and uterus causing them to descend on the vagina and sometimes even come out through the vaginal opening. Similarly, a bowel prolapse causes the bowel to slip downwards from its position and bulge through the anus. Although the condition isn’t life threatening, it can cause immense pain and discomfort.
Initially, you may start feeling a certain load and heaviness within your lower tummy region which progresses to the feeling of a heavy weight pressing against your genitalia. It may feel like you’re sitting on top a small ball. A lump or bulge is soon observed near the vagina or prostate leading to numbness during sexual intercourse.
Pregnancy and childbirth are the leading causes of pelvic organ prolapse. The risk is doubled in an individual who has had a long difficult labor and given birth to multiple babies at the same time. Being obese and performing jobs on daily basis that require heavy lifting contribute to the problem as well. Other common reasons include increasing age, menopause and medical issues that strain the pelvis.
There are instances when the prolapse gives of no symptoms at all and is in fact observed later when a medical examination like a cervical screening is carried out for other reasons. When checking for a prolapse, your healthcare provider is likely to ask you to undress from the waist down and lie straight on your back. An instrument called the speculum is used to keep the vaginal walls open while they inspect the region for any bumps and bulges. If the results aren’t conclusive, they can also recommend urine tests.
They are likely to then suggest a treatment plan according to the severity and intensity of your condition. In most cases, basic lifestyle changes like reducing weight, avoiding intense exercises and treating constipation tend to solve the problem.
- Obstructive defecation:
A highly uncomfortable situation that prevents an individual from being able to pass stool through the digestive tract and out the anus. The inability to evacuate bowels properly and the sensation of a blockage puts added strain on the muscles of bowel and rectum. It is accompanied with the feeling of having more stool left behind even after the attempt at defecation.
Amongst all the causes for this condition, structural deformities like a rectocele or a prolapse caused by genetics, age, injuries and neurological disorders are the most common. Childbirths that damage the fascia; a tissue separating the vagina from the anus also increase the risk. These conditions disrupt the ability of the pelvic floor muscles to coordinate properly, preventing them from relaxing or contracting.
To diagnose this condition your doctor will conduct a series of invasive tests like a colonoscopy and anal manometry to get a deeper look into the functioning of your colon and test the muscles that wrap around the anus and rectum for abnormalities. If need be, they may also [perform an Electromyography and Dynamic Defecography to assess your bowel function. A treatment plan is then worked on depending on the underlying cause of the issue. Often surgery and biofeedback therapy are required for optimal outcomes.
What are the available options for treating Pelvic Floor Disorders?
People often find it embarrassing to discuss these issues with their doctors, but as healthcare providers it is their job to help struggling individuals. Open communication will allow your doctor to not only assess the situation better but also help them develop a treatment plan that is catered and suited to your needs.
Biofeedback Therapy: A technique that helps train patients to better control functions of the body that otherwise take place involuntarily. The process is entirely pain-free and has proven to help over 75% of the individuals who struggle with Pelvic Floor Disorders. Specialized sensors and electrodes are used to monitor the functioning of your muscles while you perform everyday tasks. Physiological responses to stress, tension, relaxing, headaches, etc., are observed and then the information is fed-back to the patients via auditory and visual cues either continuous beeping sounds or flashing lights.
Based on your results your physical therapist will then guide you towards relaxation techniques, with regular practice and effort, these will allow you to gain conscious control will help you conquer your issue.
The training and treatment are mostly outpatient and is done at therapy centers, clinics and hospitals. Frequency and duration of each session depends upon the severity of your conditions but normally patients require 10-15 sessions with each session varying between 30 minutes to an hour.
Physical Therapy: Coupled with biofeedback therapy, physical therapy has proven to give effective results in the long term. There are several exercises that allow patients to gain gradual and conscious control over their body muscles. Kegels and deep belly breathing are most commonly recommended. The patient is made to lie down or sit comfortably and then try to contract their pelvic muscles as if they are stopping the flow of urine. Practicing this movement twice a day for up to 25 seconds will strengthen the pelvic muscles in the long run.
Lifestyle Changes: Small changes in your daily routine can also give drastic benefits if done consistently. Abundant water intake, eating a diet rich in fibers and avoiding alcohol can help manage diarrhea and constipation. Warm baths, yoga and making sure that you don’t excessively push or apply unnecessary strain while peeing and defecting all contribute to good pelvic muscle health
Medications: Although there are several over the counter drugs available for constipation, diarrhea and other common pelvic floor disorders, it is recommended that you do not opt for any medication unless recommended by a professional. If need be, your doctor will recommend a fixed dose of daily medication to keep your stool soft, your bowel movements regular and assist in overall gastral help.
Acoustic Sound-wave Therapy: The use of low intensity sound waves or shock waves is a relatively new but a revolutionary treatment to deal with dysfunctions of the pelvic floor. It is a non-invasive, pain-free, drug-free and surgery free treatment that has no adverse effects on your body. It increases and amplifies blood flow to repair damaged nerve endings and promote the growth of new nerves and blood vessels that can strengthen the coordination amongst pelvic muscles.
True Freedom Therapy has professionals who have years’ worth of experience in this procedure. With just 4-6 sessions of 15 minutes each and no additional pills, pumps or injections patients have reported observing drastic changes in their pelvic health. Our healthcare providers here at True Freedom are available for your assistance at all time. Book a free consultation to get their expert opinion on you issue and the then select a treatment plan accordingly.
Surgery: If your condition is a result of a long-term structural deformity within the pelvis you are likely to be recommended surgery. Although these surgeries are a permanent fix, they are typically invasive procedures that have several risks involved. The recovery period after a pelvic surgery is also relatively long and it takes several months for the pain and discomfort to entirely go away.
Both males and females struggle with pelvic disorders and these issues are more common than you think. The good news is that most of these issues are reversible and can be treated without any permanent damages.
Regardless, it’s necessary that before you decide on a treatment plan, you consult a professional to get a deeper insight into the underlying causes of your condition. Choosing an appropriate treatment option according to your condition is crucial towards effective and efficient recovery. Our team here at True Freedom Therapy works day and night to ensure 100% satisfaction of all our patients. Our goal is to help them recover and regain their confidence in the fastest, easiest way possible.
If you are suffering from impotence or erectile dysfunction related symptoms, schedule a free consultation with us now to discuss treatment options!