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PELVIC HEALTH

Pelvic floor dysfunction refers to a wide range of problems (incontinence, constipation, pain) that occur when the muscles of the pelvic floor are weak, tight, or there is an impairment of the sacroiliac joint, low back, coccyx and/or hip joint. The tissues surrounding the pelvic organs may have increased or decreased sensitivity and/or irritation resulting in pelvic pain.

HOW CAN A PHYSICAL THERAPIST HELP THE PELVIC FLOOR?

BLADDER DISORDERS

  • Urinary frequency- more than 12 voids in a 24 hour period

  • Urinary urgency, hesitancy, retention and/or incomplete emptying

  • Nocturia (urinary frequency at night) more than 1 void during sleeping hours

  • Pain in the urethra, bladder, and/or pelvis

  • Difficulty initiating urination

  • Weak urine stream and/or a stream that stops and starts

  • Interstitial Cystitis (IC): Also known as painful bladder syndrome (PBS). Recurring pain or discomfort in the bladder and the surrounding pelvic region. Signs and symptoms may include urinary urgency, frequency, nocturia (nighttime frequency) and retention; dyspareunia (painful intercourse); pain in the low back, suprapubic area, and/or abdomen; and pain before, during, or after urination.

  • Urinary Incontinence: Any involuntary loss of urine. This can be due to muscle weakness or muscle spasm/tightness.

    • Urge incontinence: Urine loss due to a strong desire to urinate (urgency), with only a quick warning.

    • Stress incontinence: Urine loss due to an increase in abdominal pressure, such as coughing, sneezing, lifting, laughing and running.

    • Mixed incontinence: Combination of urge and stress incontinence.

  • Urinary retention: Difficulty or inability to urinate. This could be caused by various medical conditions of the prostate, kidneys or urethra. Additionally, some medications may cause urinary retention. Retention may be a symptom of pelvic floor dysfunction when pelvic floor muscles are in spasm or guarding and a patient is unable to relax the muscles, which is necessary for emptying of the bladder.

BOWEL DISORDERS

  • Constipation

  • Fecal Incontinence

  • Bowel frequency, urgency, retention, and/or incomplete emptying

  • Hemorrhoid pain

  • Rectal prolapse (Rectocele)

  • Difficulty controlling flatulence/gas

  • Diarrhea Bloating

  • Rectal and/or abdominal pain, pressure, or spasm

  • Pelvic pain

  • Levator Ani Syndrome

PELVIC ORGAN PROLAPSE

  • Cystocele: Herniation or protrusion of the bladder into the vagina most often due to pelvic floor muscle weakness. May result in incomplete emptying of the bladder and consequently urinary leakage.

  • Enterocele: Herniation or protrusion of the small intestine between rectum and vagina

  • Uterine Prolapse: Herniation or protrusion of the uterus into the vagina

  • Rectocele: Rectal prolapse

PELVIC PAIN

  • Prostatitis

  • Proctalgia Fugax

  • Coccydynia

  • Anismus

  • Endometriosis

  • Pelvic Congestion

  • Pelvic Inflammatory disease (PID)

  • Dyspareunia

  • Vaginismus

  • Vulvar vestibulitis

  • Vulvodynia

  • Lichen Planus

  • Lichen Schlerosus

POST SURGICAL CARE

  • Hysterectomy

  • Hernia repair

  • Laparoscopy/laparotomy

  • Cesarean section

  • Appendectomy

  • Prostatectomy

  • Episiotomy

SERVICES FOR CHILDREN

Is your child over 5 years of age and still wearing pull-ups? Is your child on medication to regulate his/her bowel/bladder? If any of the problems listed below sound familiar, then we can help! We meet with each child and their parent/s or guardian initially to get a thorough knowledge of history and current problems. We then do a physical examination, looking at the muscles of the abdomen, legs, back and others we feel applicable to the specific problem. Finally, we consult with the parent and child to develop an individualized treatment plan. Treatment is one-on-one, hands on, in a comfortable and private treatment room with the parent or guardian present.

  • Urinary incontinence (Loss of urine)

  • Urinary urgency (Constant/strong need to urinate)

  • Urinary frequency (Urinating over 8 times in a 24-hour period)

  • Urinary retention (not fully emptying the bladder)

  • Fecal urgency, frequency, and/or retention

  • Bowel incontinence, pain with defecation, inability to empty bowels

  • Excessive gas, abdominal bloating

  • Constipation, diarrhea with/without soiling or staining