For some patients, pelvic floor disorders can be difficult to talk about--they may find the subject sensitive or embarrassing. However, pelvic floor disorders affect 1 in 5 women, and recognizing the signs is important. If you’re experiencing symptoms of a pelvic floor disorder, our urogynecologists can help you identify the problem and rule out bladder stones, tumors, or other possible conditions.
Diagnosing Pelvic Floor Disorders
DiagnosisIf you feel pain while urinating or in the pelvic area, talking with your doctor is the first course of action. Your doctor will begin by asking about your symptoms and medical history. They may ask you the following questions:
- Do you experience frequent urinary tract infections?
- Have you given birth, and how many times?
- Do you have interstitial cystitis (long-term inflammation of the bladder wall)?
- Do you experience painful sexual intercourse?
- Do you strain to have a bowel movement?
- Do you live with irritable bowel syndrome (IBS)?
Tests and exams
Clinicians can often detect pelvic floor disorders during a physical exam. Depending on the exam results, additional tests may be ordered to help with diagnosis or treatment planning.
Doctors may conduct tests to identify bladder control problems associated with pelvic floor disorders, including:
- Cystoscopy - Examines the insides of the bladder to look for problems, such as bladder stones, tumors, or inflammation
- Urinalysis - Detect bladder infection, kidney problems, or diabetes
- Urodynamics testing - Evaluates the function of the bladder and urethra
Your healthcare provider will want to perform an internal exam to determine the strength of the muscles in your pelvic area. They may need to give you an intrarectal (inside the rectum) or vaginal exam, checking for spasms, knots, or muscle weakness. Other tests used to diagnose pelvic floor disorders include:
- Surface electrodes - An option if you do not opt for an internal exam. This includes self-adhesive pads attached to your skin which can test your pelvic muscle control. These electrodes are placed between the or on the sacrum.
- Anorectal manometry - A test of how well the sphincter muscles are working
- A defecating proctogram - This test includes an enema of a thick liquid that can be seen on an X-ray. It records the movement of the muscles as you push the liquid out of the rectum.
- A uroflow test – Shows how well you can empty your bladder when you urinate, determining how weak the muscles may be if you must stop and start the flow of your urine. This could be an indicator of pelvic floor dysfunction. Again, this test is not painful.
Treatments for Pelvic Floor Disorders
TreatmentsTreatment options for pelvic floor disorders are most often nonsurgical procedures or therapies. Some of the therapies are:
- Pelvic floor muscle exercises
- Abdominal and core strengthening exercises
- Improved body posture
- Bladder and bowel training to avoid straining when having "to go"
- Dietary modifications to avoid foods more likely to cause constipation
- External and/or internal manual stretching
- Biofeedback is effective in helping over 75% of people living with pelvic floor dysfunction. Special sensors and a video are used to monitor the pelvic floor muscles as you try to relax and contract them. Your therapist will give you feedback to help you improve your muscle coordination.
NewYork-Presbyterian's Urogynecology Department offers our patients the latest treatments and procedures related to pelvic floor dysfunction. Our clinicians provide a full range of nonsurgical and surgical treatments for pelvic floor conditions.
- Nonsurgical treatments
- Minimally invasive surgery
- Long-term management
Get Care for Pelvic Floor Disorders at NewYork-Presbyterian
We realize that some patients may be hesitant to discuss pelvic floor disorder symptoms. Some may put it aside as being just an ordinary course of getting older. Our expert Columbia and Weill Cornell physicians are here to provide comprehensive, compassionate care in a nonjudgmental environment.
Most pelvic floor disorders can be treated nonsurgical and with positive results. Our goal is to approach your care with the least invasive therapies to reduce complications and speed recovery.