Pelvic floor dysfunction (PFD) refers to a broad constellation of symptoms and anatomic changes related to abnormal function of the pelvic floor musculature. The disordered function corresponds to either increase activity (hypertonicity) or diminished activity (hypotonicity) or inappropriate coordination of the pelvic floor muscles. Alterations regarding the support of pelvic organs are included in the discussion of PFD and are known as Pelvic Organ Prolapse (POP). The clinical aspects of PFD can be urologic, gynecologic, or colorectal and are often interrelated. Another way to compartmentalize the concerns are anterior- urethra/bladder, middle- vagina/uterus and posterior- anus/rectum.
There are various procedures used to address prolapse. Cystoceles are treated with a surgical procedure known as a Burch colposuspension, with the goal of suspending the prolapsed urethra so that the urethrovesical junction and proximal urethra are replaced in the pelvic cavity. Uteroceles are treated with hysterectomy and uterosacral suspension. With enteroceles, the prolapsed small bowel is elevated into the pelvis cavity and the rectovaginal fascia is reapproximated. Rectoceles, in which the anterior wall of the rectum protrudes into the posterior wall of the vagina, require posterior colporrhaphy.[6][11]
The pelvic floor muscles support various pelvic organs, including the bladder, prostate, rectum, and female reproductive organs. The muscles themselves are also involved in the functioning of the urinary and anal sphincters. When they are functioning normally, you are able to control your bowel and bladder movements by contracting and relaxing these muscles.

Biofeedback: This is the most common treatment, done with the help of a physical therapist. Biofeedback is not painful, and helps over 75% of people with pelvic floor dysfunction. Your physical therapist might use biofeedback in different ways to retrain your muscles. For example, they may use special sensors and video to monitor the pelvic floor muscles as you try to relax or clench them. Your therapist then gives you feedback and works with you to improve your muscle coordination.


Pelvic floor dysfunction (PFD) refers to a broad constellation of symptoms and anatomic changes related to abnormal function of the pelvic floor musculature. The disordered function corresponds to either increase activity (hypertonicity) or diminished activity (hypotonicity) or inappropriate coordination of the pelvic floor muscles. Alterations regarding the support of pelvic organs are included in the discussion of PFD and are known as Pelvic Organ Prolapse (POP). The clinical aspects of PFD can be urologic, gynecologic, or colorectal and are often interrelated. Another way to compartmentalize the concerns are anterior- urethra/bladder, middle- vagina/uterus and posterior- anus/rectum.
Once patients with pelvic floor constipation have these basic tools, they can begin retraining the pelvic floor muscles with biofeedback. Based on the principle of operant conditioning, biofeedback provides auditory and visual feedback to help retrain the pelvic floor and relax the anal sphincter. Biofeedback training is the treatment of choice for medically refractory pelvic floor constipation, with some studies showing improvement in more than 70 percent of patients. Patients also learn to identify internal sensations associated with relaxation and long-term skills and exercises for use at home.
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.
You’ve likely already heard of kegels, the most common method for strengthening the pelvic floor. But there are plenty of additional exercises you can try to help train your pelvic floor. Watch this video to see yoga and fitness expert Kristin McGee (who recently gave birth to twins!) demonstrate three simple yet effective moves for strengthening your pelvic floor.
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