Common pelvic floor issues from diastasis recti to sexual dysfunction

Pelvic floor dysfunction refers to a range of issues that can affect the muscles, ligaments and nerves that support the pelvic organs.

“There really is no reason for patients to suffer with sexual dysfunction, constipation or other pelvic floor issues,” says Dr. Punam Parikh-Amin, a colorectal surgeon at Baylor College of Medicine. “These issues definitely impact quality of life, and we have a number of resources – from physical therapy to surgery – to help improve a patient’s symptoms and overall well-being.”

Some common patient concerns, conditions and treatments related to pelvic floor dysfunction include:

1. Urinary incontinence: This is a common condition where the patient experiences unintentional leakage of urine. It can be caused by weakened pelvic floor muscles, nerve damage or other underlying health conditions. Treatment options include pelvic floor exercises, bladder training, medication and surgery.
2. Constipation: This happens when patients have weak pelvic floor muscles, poor dietary habits, dehydration, lack of physical activity, take certain medications or have medical conditions such as irritable bowel syndrome or hypothyroidism. In some patients, there is a mechanical or anatomic problem with the colon, rectum or anus, which all contribute to forming and expelling stool. This may require surgical treatment. Otherwise, more common treatments options include pelvic floor exercises, fiber-rich diet, drinking plenty of fluids, regular physical activity, medication, biofeedback or bowel retraining.
3. Pelvic organ prolapse: This is a condition where the pelvic organs (such as the uterus, bladder or rectum) drop down into the vagina due to weakened pelvic floor muscles. Treatment options include pelvic floor exercises, pessary use and surgery.
4. Urinary, vaginal or rectal fistula: Symptoms include incontinence, pain or discomfort, recurring infections or discharge. Possible causes include trauma to the pelvic area, surgery, radiation or infection. Treatments: Surgery to repair the fistula, medication to manage symptoms and pelvic floor physical therapy to improve muscle function.
5. Sexual dysfunction: Pelvic floor dysfunction can lead to sexual dysfunction in both men and women. In women, it can cause pain during intercourse, while in men it can lead to erectile dysfunction. Treatment options include pelvic floor exercises, medication and counseling.
6. Diastasis recti: This is a condition where the abdominal muscles separate during pregnancy or childbirth, causing a gap between the muscles. Treatment options include physical therapy, wearing a support garment and surgery in severe cases.

Treatment for pelvic floor dysfunction typically involves a combination of lifestyle changes, medication and pelvic floor physical therapy. Pelvic floor exercises, also known as Kegels, can be effective in strengthening the pelvic floor muscles and improving symptoms. In some cases, surgery may be necessary to correct the underlying issue.

If you are concerned about any of these pelvic floor issues, call to schedule an appointment with a pelvic floor specialist at (713) 798-4321.

Learn more about Baylor Medicine colorectal surgery services. 

By Tiffany Harston, communications associate with the Michael E. DeBakey Department of Surgery.