The pelvic floor is the sling-shaped group of muscles and ligaments that supports the pelvic organs. In women, the pelvic floor supports the bladder, uterus, vagina and rectum.

Pelvic floor issues can occur when that group of muscles becomes weakened or damaged. These disorders include:

• Pelvic organ prolapse: The uterus, bladder or bowel fall or press against the vagina.
• Incontinence: This includes both urinary (lack of bladder control) and bowel (lack of control of the bowels) incontinence.
• Overactive bladder: This involves the sudden need to urinate, sometimes paired with loss of bladder control.
• Bladder pain syndrome (interstitial cystitis or IC): This syndrome causes pain or pressure in the bladder and pelvic region.

Symptoms vary depending on the condition, but common signs include:

• Leaking urine when you sneeze, cough or laugh
• A sudden, strong urge to urinate
• Leaking stool or difficulty controlling bowel movements
• Pressure or a heavy feeling in the pelvis
• A bulge in the vagina or rectum
• Pain during sex
• Lower back or pelvic pain
• Muscle spasms in the pelvis

Pelvic floor disorders happen when the pelvic floor muscles are weakened or damaged. Common causes include childbirth, aging, obesity, heavy lifting, genetics and previous pelvic surgery or radiation treatment.

Our pelvic floor specialists diagnose and treat pelvic floor disorders. Your specialist might:

• Review your medical history and discuss your symptoms
• Perform a physical exam, including a pelvic exam
• Perform a test to evaluate bladder or bowel function
• Order imaging studies

Your pelvic floor specialist will create a treatment plan that fits your symptoms and lifestyle. Treatments may include:

• Physical therapy and biofeedback: Kegel exercises, or similar exercises that involve contracting your muscles, may not be enough to treat your condition. Your specialist may also suggest biofeedback therapy. Biofeedback allows your therapist to use sensors to evaluate how you relax and contract your pelvic muscles. After evaluating your muscle activity, your therapist can help you learn how to relax and coordinate the movement of your pelvic floor muscles.
• Lifestyle changes: Your specialist may suggest a variety of relaxation techniques, such as yoga, stretching and warm baths, to help relax your pelvic floor muscles. They might also suggest techniques to avoid pushing too hard or straining when you use the bathroom as well as diet and fluid intake changes.
• Medication: Your specialist may prescribe medications to help with urinary urgency or overactive bladder.
• Bladder muscle Botox injections: These can be performed in your doctor's office and can provide relief of bothersome bladder symptoms without the need for daily medications.
• Vaginal pessary: A vaginal pessary is a soft, removable silicone device that you or your doctor place in your vagina to support areas affected by pelvic organ prolapse. A pessary can also help ease symptoms of urinary incontinence, even during pregnancy.
• Sacral neuromodulation: Sacral neuromodulation is a procedure in which a small battery and wire are placed to stimulate the nerve known to control the bowel and bladder. The battery can be set up to provide long-term symptom relief.
• Surgery: If your symptoms don’t improve with nonsurgical treatments, surgery may be an option. We perform most surgeries using minimally invasive techniques, which means less time in the hospital and a faster recovery. The procedures most often recommended for pelvic floor disorders are the sling procedure and pelvic floor repair.

There are 2 types of incontinence in women: urinary incontinence (urine leaking from the bladder) and fecal incontinence (stool leaking from the bowels). They’re both common and usually caused by treatable medical conditions, including weakened pelvic floor muscles.

Stress incontinence can happen when you sneeze, cough or laugh, because these functions put pressure on the bladder and push urine out. It’s the most common type of urinary incontinence in women.

Urge incontinence is sometimes called overactive bladder. It causes a strong sudden and strong urge to urinate. If the urge is too strong, you may not be able to hold it, and your bladder can leak urine before you get to the bathroom.