A health clinic designed to focus on pelvic floor muscles for females, including expectant women and new moms

The pelvic floor is a group of muscles and connective tissue in your pelvic area that forms a bowl-like network between the hip bones, pubic bone and tailbone. This area can be seriously impacted by pregnancy or childbirth.

Damage to the pelvic floor can result in lasting complex vaginal, urinary, bowel, intercourse and pain problems.

At The Ohio State University Wexner Medical Center, our specialists are experts in the pelvic floor and understand the dramatic impact this can have on your overall quality of life. We are here to help.

Our goal is to prevent pelvic floor injuries in the first place, but when they occur, our focus is on your recovery and improving your symptoms.

Conditions We Treat

Advanced or complex vaginal lacerations
Episiotomy issues
Urinary leakage
Bowel leakage, including gas and/or stool
Other bowel and bladder control issues
Constipation
Infection and abnormal healing
Painful intercourse
Vaginal or vulvar pain
Fistulas

Pelvic floor dysfunction symptoms

Urinary leakage, frequency, and/or urgency (the feeling that you need to get to the restroom very quickly)
Difficulty with bladder emptying
Bowel issues including constipation and accidental leakage, including gas and/or stool, and fecal urgency
Pelvic organ prolapse (weakening of the pelvic support of the bladder, vagina, uterus/cervix, and rectum resulting in a pressure, fullness or bulge women can see or feel in the vagina)
Fistulas (abnormal connections between the pelvic organs resulting in leakage of urine, gas and/or feces into the vagina)
Pain in the vagina or vulva during intercourse
Infection and abnormal healing

Pelvic floor dysfunction diagnosis

To help us develop an individualized treatment plan, we’ll conduct a physical exam and review your medical, surgical and obstetric history, with particular focus on your current or most recent pregnancy issues and recent delivery.

To address all aspects of your postpartum care, we’ll also screen for and discuss concerns related to breastfeeding problems and postpartum depression.

We’ll evaluate for bowel or bladder problems, assess overall pain levels and answer questions about pelvic floor anatomy or tears you suffered during delivery.

Specialized diagnostic testing, including 3D ultrasound equipment, may be used to evaluate the anal sphincter and pelvic floor muscles.

Pelvic floor dysfunction education

Pelvic floor disorders can be confusing.

Our goal is for women to understand how their pregnancy and delivery may have impacted their current issues. And while treatment may be necessary for some patients, we’ll also discuss diet and lifestyle changes that can prevent incontinence later. Many women have questions about the impact of their pregnancy and delivery on future deliveries as well, which will be addressed in your visit, if applicable.

Pelvic floor dysfunction treatment

After recommendations and discussion of treatment options, you’ll partner with your physician to map out the best course of prevention or recovery from your particular pelvic floor issue.

We offer a range of innovative outpatient and inpatient procedures, including:

Physical therapy for pelvic muscle strengthening
Peripheral nerve electrode placement and Botox injections for the bladder to treat severe urinary urge and incontinence
Trigger point injections and Botox injections for vaginal pain
Fitted vaginal devices (pessary), mesh sling procedure, and transurethral bulking agent injections for stress incontinence
Revision procedures for abnormal healing and scarring to restore anatomy and alleviate pain
Vaginal laser therapy for vaginal thinning
Vaginal, laparoscopic and robot-assisted surgery for reconstruction and repair of pelvic organ prolapse
Peripheral nerve electrode placement and sphincteroplasty for bowel control issues
Repair of obstetric fistulas

We’ll always consider nonsurgical treatments first, but we work with each patient to provide the most effective, lasting treatment possible that also meets her personal goals.

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Clinic Director

Lisa Hickman, MD

The clinic is led by Lisa Hickman, MD, a physician and reconstructive surgeon who specializes in the care of women with pelvic floor disorders. She developed the first Special Interest Group on Childbirth and Pelvic Floor Disorders through the American Urogynecologic Society and currently serves as the organization’s vice chair. She has also published several articles and lectured at numerous local and national meetings about pelvic floor disorders, and was recipient of the Women’s Health Service and Leadership Award from the Cleveland Society of Obstetricians & Gynecologists in 2020.

Clinical profile

More about childbirth pelvic floor dysfunction

What is pelvic floor physical therapy?
If you have weakness or injury in your pelvic floor muscles, you may benefit from specialized physical therapy exercises designed for this area.

Pelvic floor physical therapy is useful for preventing muscle injury altogether, reversing minor damage before it advances to a more serious level or supporting recovery in conjunction with other recommended treatments.

At The Ohio State University Wexner Medical Center, you’ll learn techniques for recovering these muscles based on your individual condition from specially trained physical therapists. This may include:
- How to contract and relax pelvic floor muscles in relation to other muscles
- Breathing and timing techniques
- Manual therapy methods
- Exercises to stretch tight muscles, strengthen weak ones or improve flexibility
Schedule pelvic floor physical therapy: 614-293-4643
How to perform a sitz bath
A sitz bath is a warm, shallow bath that cleanses the perineum. It’s helpful following delivery or surgery.

If you’ve been advised to take a sitz bath by your physician, this is easy to do at home. All that’s required is a small amount of warm (not hot) water in a bathtub or shallow basin that has been freshly cleaned (you can find plastic kits that fit over your toilet bowl at many stores or pharmacies).

The warm water increases blood flow to promote faster healing and provide relief from itching, irritation or minor pain. Sometimes women prefer cool water and as no research has supported a specific water temperature, this is a fine option for those who find the cooler temperature more soothing. Women sometimes think they need to put additives in the sitz bath, such as Epsom salt, vinegar or baking soda. Typically these agents don’t provide additional benefits to the patient and aren’t necessary. If Epsom salt is preferred, ½ cup of salt to every 1 gallon of water is the typical regimen.
- Soak for 5 – 10 minutes.
- Gently pat yourself dry. Do not rub or scrub to avoid pain or irritation of the perineum.
- Stop using sitz baths and contact your doctor if your pain or itching worsens or you have any swelling of the perineum.
- You can take 3 – 4 sitz baths a day until you are fully healed.
How to care for your bottom after delivery
It’s common to have soreness following delivery, particularly if you had a vaginal tear or your doctor performed an episiotomy.

Keep the area clean and try to reduce swelling, infection risk and inflammation.
- Applying ice packs to the perineum, wrapped in a soft cloth can be soothing. These should be applied for no more than 20 minutes at a time and are most beneficial during the initial days after your delivery.
- Take short sitz baths 3 – 4 times per day.
- Utilizing a squirt bottle with warm water while urinating or for cleaning the area after toileting can help minimize irritation and keep the area clean.
- Take over-the-counter pain medications, such as acetaminophen or ibuprofen, as recommended by your doctor, and avoid narcotic pain medicines if possible, as they can cause constipation.
- Place cotton pads soaked in witch hazel in the refrigerator and use them to cool the perineum and perianal area several times per day, always disposing of the used pads.
- Avoid straining during a bowel movement.
- Adhere to a bowel regimen, including a stool softener and/or laxative as directed by your doctor.
How to perform a Kegel exercise
Kegel exercises contract and then relax the pelvic floor muscles to help strengthen and improve the support provided to your uterus, bladder, small intestine and rectum.

These exercises are especially helpful for preventing or improving urinary incontinence and can be effective even years after delivery or as your muscles weaken with age.
- To understand what muscles you’ll be strengthening:
  - Insert a finger in the vagina and squeeze the vaginal muscles around your finger
  - Imagine you are sitting on a marble and have to pick it up with the vaginal muscles
- Squeeze the muscles you would use to stop the flow of urine or hold back flatulence. (Note: do not do Kegels during urination, as this can lead to incomplete emptying of your bladder and cause a urinary tract infection.) You should feel the same sensation when doing a Kegel.
- No one will know you are doing a Kegel, so you can do it anywhere and anytime it’s convenient, although at first, many women find it easiest to do lying down.
- The goal is to perform sets of 10 squeezes, 2 – 3 times per day.
  - Squeeze: engage the pelvic floor muscles as described above; avoid performing Kegels while voiding
  - Hold: 2 – 10 seconds, increasing duration to 10 seconds as able
  - Relax: completely relax muscles before initiating the next squeeze
Don’t hold your breath; stay relaxed, trying to tighten only the pelvic floor muscles, not the muscles in your stomach, legs or buttocks.

Why choose Ohio State for childbirth pelvic floor dysfunction care

Our team of experts is trained in postpartum care and dedicated to your full recovery. Your treatment will be managed by a urogynecologist who specializes in pelvic muscle, bowel and bladder issues during pregnancy and after delivery.

And because our clinic is part of one of the nation’s largest academic health care centers, we can access a full range of medical and university experts as needed. Even if you have physical or mental health concerns unrelated to the pelvic floor conditions we’re treating, we’ll ensure that every aspect of your health is addressed.

Lastly, we understand the challenges presented by pelvic floor conditions and the unique stresses faced by pregnant women and new moms, so we’ll provide the empathy, respect and careful evaluation you deserve.

Childbirth Pelvic Floor Disorders Clinic

Specialized care to protect, repair and strengthen the pelvic floor during pregnancy and after delivery.

A health clinic designed to focus on pelvic floor muscles for females, including expectant women and new moms

Conditions We Treat

Pelvic floor dysfunction symptoms

Pelvic floor dysfunction diagnosis

Pelvic floor dysfunction education

Pelvic floor dysfunction treatment

Clinic Director

Lisa Hickman, MD

More about childbirth pelvic floor dysfunction

What is pelvic floor physical therapy?

How to perform a sitz bath

How to care for your bottom after delivery

How to perform a Kegel exercise

Why choose Ohio State for childbirth pelvic floor dysfunction care

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