Pelvic floor disorders

Our approach

When it comes to treating pelvic floor disorders, we take a collaborative approach. Our experts understand that pelvic floor disorders, such as pelvic muscle spasm, prolapse or urinary incontinence can dramatically affect your daily life. That’s why we educate you on the common causes and connect you to physical therapists, nurse practitioners and any necessary specialists to help treat your particular condition. Our physicians have skills that overlap multiple specialties; they act as pelvic condition “managers,” making sure you receive treatment from the right specialist or team of specialists when necessary. When you choose Northwell Health for pelvic floor disorder treatment, you’re choosing a team of compassionate, qualified professionals. 

Overview

The pelvic floor refers to a group of muscles in your pelvic area that support and act as a “hammock” for organs such as the bladder, uterus, vagina and rectum. When these muscles and tissues are injured or weakened, it is referred to as a pelvic floor disorder. 

Causes and risk factors

Though some pelvic floor disorders have no typical risk factors, some common causes include:

  • Childbirth
  • Obesity
  • Chronic constipation
  • Heavy lifting
  • Pelvic surgery or radiation treatment
  • Connective tissue disorder

Types

Pelvic floor disorders include:

  • Fecal incontinence — Fecal incontinence refers to the inability to control bowel movements, which causes involuntary stool leakage from the rectum. The severity can range from a small amount of stool to a full loss of bowel control.
  • Urinary incontinence — Urinary incontinence refers to the loss of bladder control. There are several types of urinary incontinence, including stress incontinence, which occurs when urine leaks due to exerted pressure (laughing, coughing or lifting heavy objects). An overactive bladder is another reason for urinary incontinence. This involves frequency and urgency of urine, along with the inability to suppress an urge to urinate.
  • Pelvic organ prolapse — Pelvic prolapse refers to one of the pelvic organs, such as the vagina, urethra, rectum, uterus or small intestine dropping from its normal place of support due to weakened muscles or connective tissue.
  • Vaginismus — Vaginismus is the involuntary contraction of vaginal muscles typically associated with any attempted vaginal penetration. This condition affects a woman’s ability to engage in sexual intercourse, use tampons and receive gynecological exams.

Symptoms

Common symptoms related to pelvic floor disorders include:

  • Constipation
  • Pain or pressure in rectum
  • Muscle spasms in pelvis
  • Painful sex
  • Difficulty urinating
  • Unexpected loss of urine
  • Inability to urinate
  • Abdominal bloating

Diagnosis and testing

: Your physician may be able to diagnose your condition through a pelvic exam. If your condition is still unclear, your doctor may suggest other testing procedures. Depending on your condition, examples of these diagnostic methods could include:

  • Urodynamic testing — These tests evaluate how well your bladder passes urine. During the test, your bladder is filled with water and then emptied. Pressure readings from tiny catheters allow your physician to establish an accurate diagnosis and plan appropriate care.
  • Cystoscopy — During this procedure, a small tube is inserted through the urethra, the organ that carries urine out of the body, into the bladder. This test helps to visualize the inside of your bladder with a tiny camera.

Treatments

If you suffer from a pelvic floor disorder, there are several treatment options:

  • Biofeedback techniques — These techniques can help you learn to strengthen or relax your pelvic floor depending on your condition. 
  • Pelvic muscle strengthening — Pelvic floor exercises, such as Kegels, can reduce symptoms associated with urinary incontinence and reduce symptoms of pelvic prolapse.
  • Colon and rectal surgery — Colorectal surgery is used to treat conditions of the rectum and colon. Our division coordinates with colorectal surgeons when conditions overlap in specialties. This means you won’t have to worry about having separate surgeries by different specialties when it isn’t necessary.
  • Electrical stimulation of the pelvic floor — This is a low-energy, painless office treatment for urinary frequency. 
  • Transvaginal prolapse repair — This minimally invasive surgery can help restore function and structure to the pelvic floor. Vaginal surgery is the least invasive method for gynecologic surgery. The entire surgery is accomplished through the vagina, leaving the abdomen with absolutely no incision or scar formation.
  • Laparoscopic or robotic surgery — This state-of-the-art method uses tiny incisions in the abdomen (rather than one large incision) to accomplish extremely detailed reconstructive surgery. The dexterity, enhanced vision and minimally invasive nature of this surgery allow for a rapid recovery.

Find the doctor who is right for you.