There are a variety of approaches to treating pelvic floor disorders, says Dr. Rodríguez. Choosing one depends on many things, such as the severity of the symptoms and other health problems an individual may have as well as their goals and how active they are. No matter what pelvic floor issues you’re experiencing, it’s best to speak with a pelvic floor specialist to determine which treatment may be right for you.
Pelvic Floor Physical Therapy
A specialized therapist uses exercises and other techniques, such as relaxation and biofeedback, that can help you control your pelvic floor muscles. These techniques can help people with urinary and fecal incontinence, mild prolapse, and painful intercourse.
Changing lifestyle habits can improve symptoms. For example, curbing coffee and alcohol intake can reduce incontinence, and eating more high-fiber foods can help bowel movements.
Medications can improve problems such as incontinence (and they pose few side effects). For example, some prescription medicines help the bladder relax and not spasm so people can hold urine longer.
Stimulating specific nerves can work to block abnormal signals to the bladder that lead to urinary incontinence. With nerve stimulation, electrodes are placed inside the vagina or other sites on the body to deliver mild electric impulses to treat muscle weakness, spasms, and pain. Nerve stimulation can also be used to help people regain control of bowel function.
Botulinum toxin (Botox), often used to treat wrinkles, can be quite effective for certain incontinence symptoms. The drug paralyzes muscles in the bladder so that patients don’t have spasms. It can also be used to relax tight vaginal muscles that cause pain during intercourse and to facilitate bowel movements in people with defecation difficulties.
To aid those who leak urine while, say, coughing or jumping, doctors may inject bulking agents into the walls of the urethra to help tighten it so leakage is less likely.
For some incontinence cases, sling surgery may be recommended, in which a “sling” made of mesh or human tissue is placed under the urethra to prevent leakage of urine. For prolapse, vaginal surgery or robotic or other minimally invasive procedures may be recommended to lift the pelvic organs back into place.