Pelvic Floor Disorders in Women

In women, the pelvic floor is the system of muscles, ligaments and tissues that support the bladder, uterus, urethra, vagina, small bowel and rectum in the pelvic area. Pelvic floor disorders affect these organs and weaken the muscles and tissues that support them, causing such conditions as:

  • Urinary incontinence (lack of bladder control) 
  • Fecal incontinence (lack of bowel control) 
  • Pelvic organ prolapse (when one or more of a woman’s pelvic organs drops from its normal position and pushes against the walls of the vagina)

Pelvic floor disorders are surprisingly common, with as many as 1 in 3 women experiencing one of these conditions in her lifetime.

Urinary and fecal incontinence and pelvic organ prolapse may be caused by a variety of things that can damage a woman’s pelvic floor muscles, nerves or supporting tissues. This can include childbirth, repeated heavy lifting, smoking, obesity, aging, or certain chronic diseases. Genetics can also play a role.

Treatment for pelvic floor disorders depends on what’s causing the problem and how severe it is. Treatment can range from simple lifestyle changes to medications and surgery.

While incontinence and pelvic floor disorders may be embarrassing to discuss, women should not feel they have to simply “live with it” or that it’s an inevitable part of aging. It’s important to know that many pelvic floor disorders can be treated or cured—greatly improving a woman’s quality of life.

Notably, a subspecialty called urogynecology was established in the 1990s to address pelvic floor disorders in women. Today this subspecialty is called female pelvic medicine and reconstructive surgery. These highly trained doctors are skilled and compassionate in talking to women about these types of problems, and they offer an array of effective treatment options tailored to your individual situation.

Why Choose Cooper to Diagnose and Treat Pelvic Floor Disorders

Cooper University Health Care is home to a comprehensive urogynecology program that is on the forefront of care for pelvic floor disorders. Our team of fellowship-trained urogynecologists offers today’s most advanced diagnostic and treatment services, delivered in a caring, sensitive manner:

  • If you need surgery, we have the region’s only robotic surgery program for treating pelvic floor disorders—a minimally invasive approach that results in faster recovery, reduced pain and minimal scarring
  • We have the region’s only pelvic floor physical therapy (PT) program, a specialized form of rehabilitation that focuses on restoring optimal function to the pelvic floor
  • We are involved in teaching the next generation of urogynecologists through a respected fellowship program—testament to the high level of clinical expertise available here
  • Our urogynecologists are involved in leading-edge research, giving you access to the latest knowledge and advances in treating pelvic floor disorders 

Causes and Risk Factors for Pelvic Floor Disorders

Urinary incontinence, fecal incontinence and pelvic organ prolapse in women are primarily caused by damage to the pelvic floor muscles, nerves and/or supporting tissues due to pregnancy and childbirth. They may also be related to genetic or congenital (present at birth) conditions that cause weak connective tissues.

You may be at increased risk for developing pelvic floor disorders due to such factors as:

  • Aging (pelvic floor muscles can weaken and stretch with age)
  • Repeated heavy lifting
  • Repeated straining due to chronic constipation
  • Obesity
  • Smoking
  • Chronic cough or sneezing (due to asthma, smoking or allergies, for example)
  • Prior surgery or pelvic radiation
  • Menopause

Symptoms of Pelvic Floor Disorders

Common symptoms of a pelvic floor disorder include:

  • Involuntarily leaking urine when you cough, sneeze, laugh or exercise
  • Not making it to the toilet in time when you need to urinate
  • A constant urge to urinate
  • Difficulty emptying your bladder or bowel
  • Accidentally losing control of your bladder or bowel
  • Pain in the pelvic area
  • Painful sexual intercourse
  • Accidentally passing gas
  • Prolapse (a bulge or feeling of heaviness/pulling in the vagina)

Treating Pelvic Floor Disorders

Fortunately, most pelvic floor disorders can be reversed with treatment. Because these conditions vary in degree of severity from woman to woman, and have different causes, treatment can range from simple lifestyle changes to more complex surgery. Here’s an overview of some of today’s treatment options:

Nonsurgical treatments

  • Pelvic floor physical therapy: This involves biofeedback and exercises (including Kegel exercises) to encourage relaxation and strengthening of the muscles of the lower pelvis  
  • Injections for bladder control problems: Bulking agents can be injected near the bladder neck and urethra to thicken the tissues and narrow the bladder opening
  • Medication: Medication may be prescribed to treat certain bladder control problems or to prevent loose stools or frequent bowel movements
  • Vaginal pessary: This plastic device is inserted into the vagina to help support the pelvic organs; it is used to treat some types of prolapse and improve bladder control

Surgical treatments

Surgery may be appropriate for certain pelvic floor disorders that cannot be effectively treated conservatively (without surgery). Using minimally invasive techniques, some surgical treatments can be performed as outpatient procedures.

  • For prolapse: Surgery involves repairing the prolapse and rebuilding pelvic floor support. There are several ways to do this, depending on the type of prolapse and other factors. Learn more here [LINK to Pelvic Organ Prolapse page].
  • For urinary incontinence: Surgery involves returning the bladder to its correct position and holding it in place. 
  • For bowel incontinence: Surgery may be needed to repair a damaged anal sphincter muscle or repair certain types of prolapse. Learn more here [LINK to Bowel Incontinence page].

Some women may require a combination of both nonsurgical and surgical treatments if they are dealing with more than one type of pelvic floor disorder.

Make an Appointment With a Cooper Pelvic Floor Disorders Expert

To learn more about the resources available for diagnosing and treating pelvic floor disorders at Cooper or to request an appointment, please call 800.8.COOPER (800.826.6737).