Pelvic Floor Dysfunction

A sad lonely 70 years old senior in is apartment
Drawing to show the pelvic floor

When you can’t appropriately tighten or relax your pelvic floor muscles, or they no longer support your pelvic organs, you experience pelvic floor dysfunction. Any weakness or tear in the pelvic floor can displace your pelvic organs, including the bladder, rectum or vagina.

Conditions that commonly occur with pelvic floor dysfunction can include:

  • Constipation
  • Fecal incontinence (inability to control stool)
  • Obstructive defecation (inability to have a bowel movement)
  • Rectal prolapse (tissue slips out of the anus)
  • Rectocele (weakened tissue between the rectum and vagina, complicating bowel movements in women)
Causes of pelvic floor dysfunction

A variety of events and conditions can weaken or tear the muscles of the pelvic floor, including:

  • Age-related muscle weakness
  • Chronic (long-term) constipation or diarrhea
  • Obesity
  • Pregnancy
  • Prior pelvic surgery
  • Trauma to the pelvic area
Symptoms of pelvic floor dysfunction

The signs and symptoms of pelvic floor dysfunction can vary depending on the location of the weakness and the organs affected. Common symptoms include:

  • Constipation
  • Frequent urge to have a bowel movement
  • Having to strain to have a bowel movement
  • Incontinence (inability to control the flow of urine or stool)
  • Pain in your lower back, pelvic area, genitals or rectum
  • Pain while urinating
Diagnosing pelvic floor dysfunction

Your UNC REX specialist may use one or more of the following tests to diagnose pelvic floor dysfunction:

  • Colonoscopy and physical exam. Your gastroenterologist will often initially perform a colonoscopy and physical exam to rule out any other conditions that can cause similar symptoms, such as colorectal cancer, prior to your Colorectal Specialist referral.
  • Anorectal manometry. This test measures the strength of your internal and external pelvic floor muscles and the reflexes of the anal canal. Results help your surgeon and Pelvic Floor Physical Therapists confirm your ability to recognize the need to have a bowel movement. They also determine if your body can have a bowel movement without difficulty.
  • Defecography. This test uses fluoroscopy (a specialized x-ray with contrast dye) to evaluate how the bowels empty and if your pelvic floor muscles can relax and contract appropriately.
  • EndoAnal ultrasound or magnetic resonance imaging (MRI). These imaging tests can identify damaged sphincters (tightening muscles) or other areas that may be causing your symptoms.
Treatments for pelvic floor dysfunction

Treatment for pelvic floor dysfunction focuses on increasing your ability to control your pelvic floor muscles. It usually includes a combination of medical management and working with a physical therapist specially trained in the pelvic floor muscles, such as:

  • Learning to recognize the feeling when you need to have a bowel movement using biofeedback techniques
  • Practicing techniques to relax your pelvic floor muscles
  • Taking over-the-counter stool-softening medications
  • Using pelvic floor physical therapy to increase control of your pelvic muscles (such as Kegel exercises)

Learn more about the procedures and surgeries that our team offers.