Pelvic Floor Dysfunction
Pelvic floor dysfunction refers to an abnormal response of the pelvic floor muscles during defecation. This condition can cause pelvic pain and other problems as well as difficulty with defecation. Pelvic floor dysfunction, though sometimes of unknown origin, may be caused by traumatic injury to the pelvic area or may result from complications after surgery or vaginal childbirth.
Since one of the muscles involved in the defecation process is known as the puborectalis, another name for this condition is paradoxical puborectalis contraction. "Paradoxical contraction" refers to the fact that the affected muscles contract when they should be relaxing in order for a normal bowel movement to occur. Another muscle in the area that may be affected is the external anal sphincter, so the condition is also known as anismus.
Symptoms of Pelvic Floor Dysfunction
Pelvic floor dysfunction affects both men and women and can occur in children as well. Symptoms of this disorder include:
- Constipation
- Straining to initiate or complete defecation
- Sensation of an incomplete evacuation of the stool
- Frequent urge to urinate or pain during urination
- Discomfort during sexual activity
In some cases, patients with pelvic floor dysfunction also experience back or pelvic pain.
Diagnosis of Pelvic Floor Dysfunction
Once a complete medical history is taken, a number of tests may be used to diagnose the disorder, including:
- Digital exam for muscle knots, spasms or weakness
- Perinometry to measure pelvic muscle control
- Defecography
- Electromyography (EMG)
For patients with urinary symptoms of pelvic floor dysfunction, a uroflow may also be administered.
Treatment of Pelvic Floor Dysfunction
There are several noninvasive treatments for pelvic floor dysfunction. These may include:
- Relaxation techniques, such as yoga and warm baths
- Muscle relaxant medication
- Biofeedback
- Physical therapy exercises
Biofeedback provides relief for about 75 percent of patients troubled by pelvic floor dysfunction, enabling them to function without discomfort or disability.