Pelvic Floor
Disorders

Treating Pelvic Floor Disorders

A pelvic floor disorder can make life extremely challenging. The only way to regain more control over your life is to have the disorder treated by qualified medical professionals.

At Huntington Colorectal Surgeons, we are a highly-trained and board-certified team of colorectal specialists with extensive experience treating pelvic floor disorders. Our customized treatments will address the damage to your pelvic floor and help to restore it to better function. We also work in a multidisciplinary fashion with other pelvic floor specialists to address all problems in one trip to the operating room.

Feel free to speak to us for more information.

What is the
pelvic floor?

The pelvic floor is composed of muscles and connective tissues that act as a foundation to support the pelvic organs, including the bladder, the rectum and anus, the vagina, the uterus, and the cervix (or prostate and urethra in a man). It is shaped like a hammock.

The pelvic floor contains openings – two in men (for the anus & urethra) and a third in women (for the vagina). These openings open and close as needed with specialized tissues and muscles with sphincters that allow flow from the bladder and rectum.

Some of the muscles in the pelvic floor are just like those in the arms and legs – they can be controlled consciously by the individual. However, others are under involuntary control and help to keep us continent during the day and night. These muscles can cause problems when they weaken or go into spasm.

Traditional pelvic floor disorder management

The pelvic floor has traditionally been divided into “compartments” – anterior for the bladder and urethra, posterior for the rectum and anus, and middle for the female reproductive organs. Traditional medical and surgical training had led to patients seeking specialists in each of these areas that didn’t address the pelvic floor as a functional unit.

At Huntington Colorectal Surgeons, Dr. Howard Kaufman, Dr. Gabriel Akopian, and Dr. Juliane Golan have been working with other pelvic floor specialists in multidisciplinary groups for decades. This more global and functional approach to pelvic floor disorders reduces the need for multiple trips to the operating room and addresses most issues in a single operation.

Types of pelvic floor disorders

Sometimes, the pelvic floor becomes weak or damaged and cannot support the pelvic organs or anorectal processes. When this happens, you have an onset of conditions that are called pelvic floor disorders.

There are three main types of pelvic floor disorders:

Bowel Control Problems

The pelvic floor supports a portion of the bowel. If there is something wrong with the pelvic floor, you’ll notice problems in the bowel as well, such as:

  • Fecal incontinence – Inability to control gas or stool.
  • Obstructed defecation – Inability to pass stool for extended periods due to a bowel obstruction.

Bladder Control Problems

The bladder is supported by the pelvic floor. If the tissues are weak, you’ll experience:

  • Urgency incontinence – when the bladder is overactive and uncontrollable.
  • Stress incontinence – when any pressure (from sneezing or coughing) causes uncontrolled bladder movement.

Pelvic Organ Prolapse

This is a condition where the pelvic floor is so weak that it is unable to hold the organs in place. As a result, the organs slip and move downward towards the vagina, sometimes even out of the vagina or anus. Common examples are bladder prolapse (cystocele), upper vaginal vault prolapse (enterocele), or posterior vaginal wall weakness (rectocele). Rectal prolapse another example where the rectum may protrude through the anus.

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Why does the pelvic floor become weak?

The pelvic floor weakens due to several reasons:

  • Genetics
  • Age
  • Muscle atrophy
  • Obesity
  • Pregnancy & childbirth
  • Pelvic surgery
  • Radiation & chemotherapy
  • Extensive lifting of weights

Our experts at Huntington Colorectal Surgeons will conduct an evaluation of your medical health and identify the cause and nature of the pelvic floor disorder. We may also refer you to some of our collaborating surgeons if your issue is more related to the bladder or reproductive organs. Contact us to schedule a consultation.

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Diagnostic tests for pelvic floor disorders

To diagnose your condition, our specialists will conduct a manual examination to identify the presence of any muscle knots, muscle spasms, and any bulging near the vagina. We may also suggest one or more of the following tests to better pinpoint the problem:

  • Anoscopy in the office to look for low cancers or large hemorrhoids.
  • 3-D High-Resolution Anorectal Manometry and tests of rectal sensation.
  • 3-D anal ultrasound to look for disruptions in the pelvic floor muscles supporting the anus and rectum.
  • MR defecography – specialized MRI to look for internal rectal prolapse and other associated prolapsing pelvic organs, internal hernias.
  • Consideration of colonoscopy or flexible sigmoidoscopy to look for a mass lesion.

We may also refer you to a urologist or urogynecologist if your conditions extend more globally in the pelvic floor. Once the pelvic floor disorder has been diagnosed, we will recommend one or more of the following treatments:

  • Pelvic floor physical therapy
  • Consideration of Botox to relax spastic muscles
  • Advanced therapy for fecal or urinary incontinence with Axonics Sacral Nerve Stimulation
  • Injection therapies to bulk tissues
  • Robotic surgery to suspend prolapsing tissue
  • Repair of weakened tissue through a vaginal approach

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