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Misconceptions about pelvic health

Less-invasive treatment options can improve a woman's quality of life


According to a study in the journal Obstetrics & Gynecology, it is estimated that by 2050, 43.8 million American women will experience at least one pelvic floor disorder.

The three main types of pelvic floor disorders are urinary incontinence, fecal incontinence and pelvic prolapse. Women with these disorders will often experience the urgent need to urinate, pelvic pain, constipation and muscle spasms in the pelvic area. Unfortunately, many women are embarrassed to talk about these symptoms and believe they are a part of the normal aging process. Therefore, many women go untreated.

Dr. Cary Fishburne, a urogynecologist at Novant Health Urogynecology in Charlotte, North Carolina, would like women to know there are options available to treat pelvic floor disorders, which can ultimately improve their overall quality of life.

“Many women believe that as they grow older they have to live with the symptoms of pelvic floor disorders, such as urinary incontinence and pelvic pain,” Fishburne said. “They have the misunderstanding that improving pelvic floor disorders requires invasive surgical treatments. Today, there are lots of treatment options available, including physical therapy. It’s about treating the whole person and customizing a treatment plan that meets each patient’s unique goals.”

According to Fishburne, pelvic floor disorders are caused by weakened pelvic muscles or tears in the connective tissue. While not a normal or an acceptable part of aging, pelvic floor disorders are more common as women get older. A woman’s risk tends to increase with the more times she has given birth and if she is overweight or obese. Smoking and diabetes can also contribute to an unhealthy pelvic floor.

So how does one improve the strength of the pelvic muscles? Open any women’s health magazine and “perform Kegel exercises” seems to be a frequent recommendation.

“Kegel exercises certainly have a role in strengthening pelvic muscles but there are additional exercises women should do and they must do them properly in order for them to be effective,” said Fishburne. “Unfortunately, most women aren’t performing Kegel exercises correctly or they are performing them when they shouldn’t be. Coached training with an experienced rehabilitation specialist is a great treatment option for women with weakened pelvic muscles.”

Other nonsurgical treatment options for pelvic floor disorder may include:

Biofeedback. A treatment technique that trains a woman to improve her symptoms by using signals from her own body. In the case of women with pelvic floor disorders, pelvic muscles are retrained to react appropriately while at rest.

Oral medications. Medications are best used to reduce pelvic pain or control the bladder for urinary urgency or incontinence.

Pessaries. These devices are inserted in the vagina to support pelvic organs and treat prolapse and stress urinary incontinence.

Women have options for treatment, said Fishburne, as long as they confide in their health care providers about symptoms they may be experiencing.

"My goal is always to optimize function while developing a therapeutic strategy for each patient to meet their individual goals and expectations," he said.





Published: 5/11/2016