Physiotherapy is the basis for treating pelvic floor dysfunction. It can be improved relatively easily in many cases, but the improvement usually takes a few months to be noticed, so you have to be patient.
What Is The Pelvic Floor?
The pelvic floor is a group of muscles that forms the base of the pelvis and runs from the coccyx behind to the pubic bone in front.
The pelvic floor musculature supports and acts as a support for the pelvic organs (urinary bladder, prostate in men, rectum, vagina, and uterus in women).
The coordinated contraction and relaxation of the pelvic floor muscles facilitate urination, defecation, and participation in sexual function.
What Is Pelvic Floor Dysfunction?
In pelvic floor dysfunction, there may be excessive tension, weakness, or incoordination in the muscles. It can affect both men and women.
- In men, the most common causes of pelvic floor dysfunction are being overweight, aging, prostate surgery in men, trauma to the pelvic area, or repeated increased pressure in the abdominal and pelvic area from chronic coughing, exercise high impact, weight lifting, or chronic constipation.
- In women, pregnancy is added as the usual cause.
What Symptoms Does It Produce In Man?
The main symptoms of pelvic floor dysfunction are:
- Urinary problems or urinary incontinence.
- Problems in defecation such as constipation, pain, or fecal incontinence.
- Pelvic pain.
- Sexual alterations such as erection difficulties or pain during intercourse.
- In severe cases, there may be pelvic organ prolapse (uterine, bladder, or rectal prolapse).
Diagnosis And Treatment
For the diagnosis and treatment of pelvic floor dysfunction, it is necessary to see a specialist in this type of disorder. There are several medical specialties that touch the pelvic floor: gynecology, urology, neurology, and rehabilitation.
The specialist will do a complete medical history, and a physical examination of the area and may also need some additional complimentary tests. There are several possible tests: a urodynamic study, imaging tests (ultrasound or pelvic resonance), anorectal manometry, proctogram, or a specific neurophysiological study.
How Physical Therapy Helps
Physiotherapy is the basis for treating pelvic floor dysfunction. It can be improved relatively easily in many cases, but the improvement usually takes a few months to be noticed, so you have to be patient. It is very important that you start under the supervision of an experienced pelvic floor physiotherapist.
Physiotherapy consists of performing exercises (also called Kegel exercises) to learn to contract and relax the pelvic floor muscles well, to be aware of these muscles, and to exercise them. The contraction of the urethral sphincter and the anal sphincter (as if one wanted to close the stream of urine or hold a wind) is carried out gradually, and then it relaxes. It is recommended to do the exercise 10 times and repeat it three times a day. Usually, you start in a position lying on your back and when you have practice you can do it sitting or standing.
When performing these exercises it is advisable to continue breathing, not contract the buttocks and keep the thighs relaxed. It is not recommended to do the exercise when you are urinating, as it can trigger discomfort and voiding problems.
The exercises can be complemented with other types of physiotherapy:
- The biofeedback system helps the patient to learn to contract the muscles by monitoring them with special sensors.
- Electrostimulation serves as a neuromodulation exercise in some cases of urinary incontinence, or to accelerate muscle strengthening.
- Radiofrequency can relieve pelvic pain.
Relaxation techniques such as yoga or meditation can also help with pelvic floor dysfunction.
Surgery is not used for the treatment of pelvic floor dysfunction except when there is some type of pelvic organ prolapse.
What you should know…
- For the diagnosis and treatment of pelvic floor dysfunction, it is necessary to see a specialist in this type of disorder. There are several medical specialties that touch the pelvic floor: gynecology, urology, neurology, and rehabilitation.
- Physiotherapy is the basis for treating pelvic floor dysfunction. It can be improved relatively easily in many cases, but the improvement usually takes a few months to be noticed, so you have to be patient.
- Surgery is not used for the treatment of pelvic floor dysfunction except when there is some type of pelvic organ prolapse.
