Building and maintaining a strong pelvic floor is crucial for women of all ages. The pelvic floor is a group of muscles at the bottom of your pelvis that supports the womb, bladder, and bowels. So if these muscles become weak—whether it's due to childbirth, pregnancy, aging, or weight gain—it may be challenging to control your bladder and bowel activity. This is referred to as incontinence, a condition that affects nearly 25 million Americans, 75% to 80% of which are women.
Mechanistically, the causes of pelvic floor dysfunction are two-fold: widening of the pelvic floor hiatus and descent of pelvic floor below the pubococcygeal line, with specific organ prolapse graded relative to the hiatus. Associations include obesity, menopause, pregnancy and childbirth. Some women may be more likely to developing pelvic floor dysfunction because of an inherited deficiency in their collagen type. Some women may have congenitally weak connective tissue and fascia and are therefore at risk of stress urinary incontinence and pelvic organ prolapse.
Although many centers are familiar with retraining techniques to improve pelvic floor dysfunction, few have the multidisciplinary expertise to teach patients with constipation how to appropriately coordinate abdominal and pelvic floor muscles during defecation, and how to use bowel management techniques, along with behavior modification, to relieve symptoms. Because pelvic floor dysfunction can be associated with psychological, sexual or physical abuse and other life stressors, psychological counseling is often included in the evaluation process. 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.
Reduces the chances of pelvic organ prolapse. Pelvic organ prolapse is a health condition in which the pelvic floor muscles are so weak that they can’t support the pelvic organs (bladder, cervix, uterus, and rectum). During a pelvic organ prolapse, one or more of the pelvic organs falls down into the vagina, creating a bulge. Since pelvic floor exercises strengthen the pelvic muscles, they can help prevent the muscles from becoming too weak and allowing prolapse.