Common Pelvic Floor Disorders and Treatments
UF Health Jacksonville urogynecology offers a variety of treatment options for women with pelvic floor disorders
Pelvic floor disorders, or PFDs, are conditions affecting the muscles, ligaments and connective tissue in the lowest part of the pelvis. For women, the organs supported in this area are the bladder, rectum, uterus and vagina. PFDs are common and can affect 1 in four women over the age of 20.
Some of the contributing factors for PFDs include aging, childbirth, diet, heavy lifting, menopause, obesity and smoking. PFDs can include bowel incontinence and fistulas, but the two most common PFDs are urinary incontinence and pelvic organ prolapse.
Ruchira Singh, MD, MS, FACOG, is a urogynecologist at UF Health Jacksonville and chief of female pelvic medicine and reconstructive surgery for the University of Florida College of Medicine – Jacksonville. Singh is committed to providing compassionate and personalized care to women with PFDs using a spectrum of therapeutic options. These include dietary modifications, pelvic floor therapy, medications and nonsurgical treatment options, as well as minimally invasive robotic-assisted surgical procedures.
“Women don’t have to suffer from pelvic floor disorders,” Singh said. “There are treatment options available, and you can have a better quality of life. I encourage women to talk to their doctor and seek consultation from a urogynecologist.”
The two common types of urinary incontinence are stress urinary incontinence and urge incontinence. Stress urinary incontinence is urine leakage due to coughing, laughing, exercising or sneezing. Urge incontinence is a sudden urge to urinate that leads to involuntary loss of urine.
“Urinary incontinence can affect quality of life and there are multiple treatment options available for women,” Singh said.
Treatment options for stress urinary incontinence may range from lifestyle modifications and pelvic floor physical therapy to nonsurgical devices, such as a pessary, and surgery. A pessary is a silicone device inserted into the vagina, and designed to support the urethra and improve urinary leakage.
Singh specializes in midurethral sling procedures, which is a common minimally invasive procedure performed for stress urinary incontinence. It can result in improvement of symptoms in 85% of women and has a quick recovery time and high cure rate.
Urge incontinence, or overactive bladder, is a condition whereby patients may experience a strong urge to urinate, frequent urination and urinary leakage with the urge to void.
As an initial management option for overactive bladder, Singh recommends a conservative treatment that includes dietary modification, limiting bladder irritants, such as caffeinated and carbonated products, lifestyle modifications and pelvic floor physical therapy.
Other treatment options that can help improve overactive bladder symptoms include medications, bladder Botox injections and nerve stimulations.
“Educating women about PFDs and the available options is the key to empower them to achieve treatment goals,” Singh said.
Pelvic organ prolapse
Pelvic organ prolapse occurs when the muscles around the pelvic floor are weakened and cause the pelvic organs to drop. Symptoms of pelvic organ prolapse may include constipation, low back pain, pressure in the pelvic area, painful intercourse or spotting from the vagina.
Nonsurgical treatment methods for pelvic organ prolapse include lifestyle changes, pelvic floor physical therapy and a pessary device.
Surgery for pelvic organ prolapse is recommended based on the severity of prolapse and symptoms, general health and patient preference. Singh specializes in different types of prolapse surgery, including robotic-assisted sacrocolpopexy.
Sacrocolpopexy is a procedure for treatment of uterine or vaginal prolapse. This minimally invasive procedure can be performed with a few small incisions, rather than one large incision, which can usually expedite recovery after surgery.
“I see a trend in women who are embarrassed to talk about their condition and end up not getting treatment,” Singh said. “My goal is to provide comprehensive patient-centered care and transform the lives of women suffering from pelvic floor disorders.”
Singh, along with her care team of advanced-level nurse practitioners and physical therapists, offers comprehensive care for surgical and medical management of PFDs. Patients with PFDs undergo detailed evaluation, after which an individualized treatment plan is developed.
Visit UFHealthJax.org/female-pelvic-medicine for more information or call 904.427.8898 to schedule an appointment.