What is a pelvic floor dysfunction?

The pelvic floor consists of a group of muscles and connective tissue in your pelvic area that form a bowl-like network of support between the hip bones, pubic bone and tailbone. Contracting and relaxing these muscles is an important part of normal bowel and bladder function.

In women, pelvic floor disorders often arise as a result of pregnancy or delivery, though they can present for other reasons, such as nerve damage, chronic stress on the pelvic floor or prior pelvic surgery. For some, pelvic floor disorders occur as a result of aging or due to a genetic predisposition.

Nearly 1 in 4 women suffers from a pelvic floor disorder and, too often, they don’t seek treatment. It might be uncomfortable to talk about pelvic floor disorders, but there are many treatment options that can make you feel normal again. Regardless of the cause of your symptoms, a team of Ohio State University Wexner Medical Center specialists will work to ensure that treatment is complete and comprehensive. 

Expert pelvic floor treatment that changes lives

If you’re a woman, there’s a 1 in 4 chance you’ll experience a pelvic floor disorder in your lifetime. Often, it’s difficult to discuss your condition or know when and where to seek treatment. At the Ohio State Wexner Medical Center, our Female Pelvic Medicine and Reconstructive Surgery experts are specially trained in treating pelvic floor conditions specific to women. Our team performs a comprehensive evaluation and tailors treatment options to relieve your symptoms. 

Just because you’ve had children or are getting older doesn’t mean you have to suffer. Whether you’re struggling with urinary or bowel incontinence or are experiencing discomfort from pelvic organ prolapse, our team of specialists provides personalized, compassionate care and will help create a treatment plan that’s right for your unique concerns. Our goal is to provide the least invasive, most effective treatment possible. 

As a division of the Department of Obstetrics and Gynecology, we provide the latest surgical, nonsurgical and behavioral therapies. If surgery is necessary, we may be able to offer a variety of minimally invasive approaches such as a vaginal prolapse repair or robotic surgery using the da Vinci Surgical System. These contribute to a shorter hospital stay, easier recovery and minimal scarring.

We understand the impact a pelvic floor disorder can have on your daily life. That’s why our ultimate goal is to return the freedom and function you need to enjoy activities again without the worry of persistent symptoms. 

What causes pelvic floor dysfunction?

While there are many different causes of pelvic floor problems, one of the most common reasons for the weakening of pelvic muscles from pregnancy, particularly vaginal births. Pelvic floor disorders may also arise from previous surgeries or nerve damage, and are also more prevalent in people who are obese or have chronic strain on the pelvic floor such as from a chronic cough, heavy lifting, etc.

Pelvic floor disorder symptoms

• The feeling that you need to urinate frequently, or a sudden urge to urinate
• Leaking when you sneeze, cough or exercise 
• Feeling like you can’t fully empty your bladder even after you urinate
• Heaviness, fullness, pulling or aching in the vagina
• Mild leaking to uncontrollable wetting
• Strong urge to urinate with inability to make it to the bathroom in time
• Difficulty with bowel control 

Common pelvic floor issues

We regularly provide treatment for women experiencing: 

• Urinary incontinence
• Overactive bladder 
• Pelvic organ prolapse (including cystocele, rectocele, uterine and vaginal prolapse)
• Recurrent urinary tract infections
• Fecal incontinence
• Genitourinary and rectovaginal fistulas
• Microscopic hematuria (non-visible blood in urine)
• Dysuria (painful urination)
• Pelvic injuries
• Vaginal atrophy (menopausal changes in the vagina, like dryness and discomfort)
• Voiding dysfunction
• Vaginal pain, pain with intercourse
• Anatomic abnormalities of the vagina, vulva or urethra
• Interstitial cystitis/painful bladder syndrome
• Postpartum healing issues

Diagnosing pelvic floor dysfunction 

The Ohio State Wexner Medical Center clinical team will perform a physical exam and get a thorough understanding of your health history. You may also be asked to keep a diary of your fluid intake and urinary habits. 

Additional testing, such as a cystoscopy or an in-office bladder test might be performed to better understand an individual’s unique condition. 

Treatment for pelvic floor dysfunction

For many with pelvic floor dysfunction, there are several treatment options available. At Ohio State Wexner Medical Center, these options include: 

• Pelvic floor muscle exercises 
• Physical therapy 
• Prescription medication to prevent or minimize bladder overactivity 
• In-office Botox® 
• Pessary (a device that can be inserted into and removed from the vagina to provide support for prolapse and/or incontinence) 
• Minimally invasive or vaginal surgery, including non-mesh and uterine-preserving surgical options
• Sacral neuromodulation
• Bladder neck bulking
• Posterior tibial nerve stimulation

Some pelvic floor exercises, including Kegel exercises, can easily be performed at home.

Pelvic floor/Kegel exercises for women  Pelvic floor/Kegel exercises for men

Specialized care for pelvic floor dysfunction associated with pregnancy and childbirth

Ohio State offers unique, personalized care for women experiencing pelvic floor issues during their pregnancy and in the postpartum period. This specialized evaluation takes into account your health history, obstetric history, details of your delivery, and breastfeeding goals. A personalized treatment plan is developed that focuses on education, rehabilitation and healthy healing, while ensuring that your obstetric provider remains informed of your care.