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Help for Pelvic Floor Disorders

December 13, 2018
Pelvic floor disorders are more common than you may think and affect both women and men. And while most of these disorders are not a danger to your health, they can have a significant impact on your quality of life. Dr. Joan Blomquist, Chief of Urogynecology at GBMC, and Claudette Cole, a pelvic physical therapist at the Greater Baltimore Center for Rehabilitation Medicine, talked with Mary Beth Marsden about pelvic floor disorders and what treatments can help patients regain their quality of life and pelvic health.

“At least 25% of women in the U.S. have some type of pelvic floor disorder,” said Dr. Blomquist. “About 18% of American women undergo surgery to treat pelvic organ prolapse, so these conditions are more common than many think, in part because many women, and men, are embarrassed to talk about their condition with their doctors. But you should talk to your doctor if it’s impacting your quality of life. You don’t have to live with this.”

To understand pelvic floor disorders, it helps to know a bit about the anatomy of the pelvis. The pelvic floor is made up of muscles and connective tissue that support the bladder, intestines, and, in women, the uterus. It looks like a hammock cradling the organs. When that hammock sags, the bladder, uterus, and rectum can slip lower in the pelvis, causing discomfort, pressure, urinary incontinence, and bowel problems.

There are many different causes for pelvic floor disorders, including genetic factors that affect connective tissue, obesity, smoking (especially if you have a chronic cough from smoking), chronic constipation, and frequent heavy lifting.

Dr. Blomquist discussed the treatment options for pelvic floor disorders in women, which range from pessaries that sit in the vagina and provide support to physical therapy and surgical treatments. She also talked about the use of vaginal mesh in pelvic floor surgery, a topic that’s gotten a lot of attention in the media in the last few years.

Claudette Cole shared what physical therapy may include for women and men who have been diagnosed with a pelvic floor disorder. “Before we start, we do a head to toe assessment to identify any issues that may be contributing to the condition,” she explained. Claudette uses several different treatments for her patients, including biofeedback, massage, and exercises that strengthen the muscles of the pelvic floor.
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