McLaren Health Care
Urogynecology - Urinary Incontinence and Pelvic Floor Therapy

Causes of Urinary Incontinence Disorders:

Pelvic floor disorders can be caused by a combination of different factors. For example, pregnancy with a vaginal delivery may weaken or stretch some of the pelvic muscles or damage nerves. The more vaginal deliveries you have, the more at risk you may become for a pelvic floor disorder, according to the American Urological Association (AUA). Age is another factor that determines the likelihood of developing one of these disorders; the older you are, the greater the chances. Other causes of pelvic floor disorders may include the following:

• heavy lifting
• chronic coughing
• constipation
• obesity
• menopause
• pelvic surgery
• radiation treatments
• genetics

Symptoms of Urinary Incontinence Disorders

Sometimes a woman can have more than one type of pelvic floor disorder. Many of the symptoms are easy to see and feel. Discomfort in the vaginal area, problems with urination, and painful intercourse are all indications that you could be suffering from a pelvic floor disorder. According to NIH, other symptoms include:

• a feeling of heaviness or fullness in the vaginal area
• aching or bulging in the pelvic area
• difficulty emptying the bladder or accidental loss of urine
• frequent urination
• painful urination
• frequent urinary tract infections
• pain in the lower abdomen, groin or lower back
• tissue protruding from the vagina
• constipation
• difficulty controlling the bowels
• vaginal bleeding and/or discharge

According to the American Urological Association, if severe symptoms are ignored, kidney damage or infection could occur. In some mild cases, there may be no symptoms whatsoever. If you are experiencing one or more of these symptoms, see your healthcare provider.

Types of Pelvic Floor Disorders

The different types of pelvic floor disorders are named for the organ that is affected. Many disorders involve a bulging of tissue, similar to a hernia, but some can cause an individual to lose control of bodily functions. According to the Pelvic Floor Disorder Network (PFDN), they include:

• Rectocele - the rectum pushes through the middle of the vaginal muscles and protrudes into the back wall of the vagina
• Enterocele - the small intestine bulges into the vagina
• Cystocele - the bladder drops down and protrudes into the vagina. This is also referred to as a prolapsed bladder.
• Cystourethrocele - similar to a cystocele but develops when the upper part of the urethra drops down with the bladder
• Prolapse of the uterus - the uterus drops down into the vagina. In such cases, the cervix can be lower than normal and can be felt easily with the finger tip or even come out through the vagina
• Prolapse of the vagina - the upper part of the vagina drops into the lower part so that the vagina turns inside out
• Urinary incontinence - urine leakage
• Fecal incontinence - bowel leakage

Diagnosis of Pelvic Floor Disorders

Your healthcare provider will be able to diagnose a pelvic floor disorder. This is usually done by taking a history of symptoms as well as performing a pelvic examination. Finding out how well the bladder and rectum are functioning may involve some simple tests. If necessary, your doctor may order one or more of the following procedures:

• Cystoscopy - viewing the inside of the bladder
• Urethroscopy - viewing the inside of the urethra
• Voiding Cystourethrogram - an X-ray taken during urination
• Fluoroscopy - another form of X-ray that allows physicians to obtain real-time, moving images of internal structures
• Urodynamics - bladder testing

Factors determining the treatment of Pelvic Floor Disorders

Factors determining the treatment of Pelvic Floor Disorders:

There are many different treatment choices for people with pelvic floor disorders, but those choices depend upon a number of factors including:

• how weak the pelvic ligaments have become
• your health
• your age
• whether you want to become pregnant