Ultrasound uses high-frequency sound waves applied through a wand or probe on your skin to produce an internal image or to help treat pain. Real-time ultrasound can let you see your pelvic floor muscles functioning and help you learn to relax them. Therapeutic ultrasound uses sound waves to produce deep warmth that may help reduce spasm and increase blood flow or, on a nonthermal setting, may promote healing and reduce inflammation.
Biofeedback uses electrodes placed on your body (on the perineum and/or the area around the anus) or probes inserted in the vagina or rectum to sense the degree of tenseness in your pelvic floor muscles. Results displayed on a computer or other device provide cues to help you learn to relax those muscles. Usually, patients feel relief after six to eight weeks of therapy. You may be able to buy or rent a unit to use at home.
Medications: Daily medications that help to keep your bowel movements soft and regular are a very important part of treating pelvic floor dysfunction. Some of these medications are available over-the-counter at the drugstore and include stool softeners such as MiraLAX®, Colace®, Senna or generic stool softeners. Your primary care doctor or a gastroenterologist can help to advise you which medications are most helpful in keeping your stools soft.
By definition, postpartum pelvic floor dysfunction only affects women who have given birth, though pregnancy rather than birth or birth method is thought to be the cause. A study of 184 first-time mothers who delivered by Caesarean section and 100 who delivered vaginally found that there was no significant difference in the prevalence of symptoms 10 months following delivery, suggesting that pregnancy is the cause of incontinence for many women irrespective of their mode of delivery. The study also suggested that the changes which occur to the properties of collagen and other connective tissues during pregnancy may affect pelvic floor function.
Currently there is no surefire way to distinguish PFD from IC, and oftentimes patients have both conditions. Some healthcare providers examine pelvic floor muscles externally and internally to gauge their tightness (tightness indicates PFD). Other IC and PFD experts, like ICA Medical Advisory Board member, Robert Moldwin, MD, perform a lidocaine challenge. By instilling lidocaine into the bladder, Dr. Moldwin determines whether your pain is coming from your bladder, which would indicate IC.
A defecating proctogram is a test where you’re given an enema of a thick liquid that can be seen with an X-ray. Your provider will use a special video X-ray to record the movement of your muscles as you attempt to push the liquid out of the rectum. This will help to show how well you are able to pass a bowel movement or any other causes for pelvic floor dysfunction. This test is not painful.
^ Mateus-Vasconcelos, Elaine Cristine Lemes; Ribeiro, Aline Moreira; Antônio, Flávia Ignácio; Brito, Luiz Gustavo de Oliveira; Ferreira, Cristine Homsi Jorge (2018-06-03). "Physiotherapy methods to facilitate pelvic floor muscle contraction: A systematic review". Physiotherapy Theory and Practice. 34 (6): 420–432. doi:10.1080/09593985.2017.1419520. ISSN 0959-3985. PMID 29278967. S2CID 3885851.
Increases bladder and bowel control. The pelvic floor muscles are directly responsible for controlling urine and bowel movements. If these muscles are weak, you’re more likely to experience constipation, urinary incontinence, struggle to control flatulence, or experience urine leakage from forceful activities like when sneezing, coughing, or laughing (called “stress incontinence”). Strengthening your pelvic floor can improve your bowel and bladder control.