Pelvic floor dysfunction and its treatment

The pelvic floor is a group of muscles attached to the sides, front and back of the pelvic bones, which function as a sling. It is through the contraction and relaxation of these muscles that bowel and bladder functions are controlled, along with sexual intercourse in women. Pelvic floor dysfunction is a condition where there is too much tension in the pelvic muscles. Symptoms of PFD are constipation with straining and pain during bowel movements, pain during or after sexual intercourse and orgasms, urinary urgency, pain and incomplete emptying and uncoordinated muscle contractions and spasms. DiagnosisrnPelvic floor dysfunction is diagnosed through a physical examination using internal or external manual techniques to assess the body’s ability in contracting and relaxing pelvic floor muscles. If a patient is not comfortable with internal examinations, the physician may externally place electrodes on the perineum and/or sacrum to determine how effectively the pelvic floor muscles contract and relax. A perineometer may also be used to measure pelvic floor contractions. This is a tampon-like device that is placed in the vagina or rectum to measure the contractions.rnTreatmentrnThe best and most important treatment for pelvic floor dysfunction lies in relaxing pelvic floor muscles. This is achieved through a combination of self care, physical therapy, home exercise and medication.rn1. With self care, the patient avoids pushing and straining while urinating. Any constipation problems should be treated by increasing fiber intake, and use of laxatives, if required. Warm baths twice a day help relax pelvic floor muscles.rn2. The physician may also prescribe a mild muscle relaxant, such as diazepam, three times a day.rn3. Maintaining good posture reduces pressure on bladder and pelvic organs.rn4. Stretching and other techniques such as yoga help in avoiding spasms of the pelvic floor.rn5. A physical therapist may conduct an internal and external evaluation of the pelvis to determine the correct external and internal manual therapy in treating individual pelvic floor dysfunction problems. Various devices, exercises and therapy are used to relax the pelvic floor muscles in conjunction with this evaluation.