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Tuesday, May 4, 2010
Women no longer have to suffer silently
Sometimes the start of symptoms is so gradual that women get used to them, or don’t even notice them until something major occurs. But for many women, pelvic floor disorders worsen with time.
Whether it’s a frequent urge to urinate, or an inability to control bowel movements, pelvic disorders are uncomfortable and embarrassing. As a result, they are also underreported and underdiagnosed. Many people also believe that they can’t be corrected.
“In the past, incontinence was something women just suffered through silently. But today more and more women are learning that there are many options, both surgical and non-surgical to address a variety of pelvic floor disorders,” explains May Wakamatsu, MD, director of Pelvic Reconstructive Surgery and Urogynecology at the Pelvic Floor Disorders Service at Mass General.
The pelvic floor is a network of muscles, ligaments and tissues in the lower abdominal area. It acts like a hammock to support the uterus, vagina and rectum. Pelvic floor disorders are caused by tears, weakness or poor function of the muscles and nerves in the pelvic floor.
Urinary incontinence: This is a loss of bladder control leading to urinary accidents. Two common types of urinary incontinence are urge incontinence (urinary leakage with the sudden need to urinate) and stress incontinence (urinary leakage that occurs with physical effort, such as coughing, sneezing or exercising).
Pelvic organ prolapse: Pelvic support problems occur when one or more of the organs in a woman’s pelvis—the uterus, vagina, bladder or rectum—shifts down and bulges out of the vaginal canal, making everyday activities extremely uncomfortable. Women with pelvic organ prolapse may see or feel a bulge coming out of their vaginal opening.
Fecal incontinence: This is a loss of bowel control leading to accidental passing of stool. This problem can be caused by muscle damage during childbirth, constipation, anal injury, nerve injury or rectal prolapse.
Defecatory dysfunction: This condition refers to problems emptying the bowels. Symptoms may include the frequent and uncomfortable urge to have a bowel movement, constipation, and leakage of gas, diarrhea or solid stool.
Voiding dysfunction: This term refers to a variety of conditions that lead to the inability to empty the bladder normally. Examples include weakness of the bladder muscle and mechanical obstruction.
Fortunately, many of these things can be managed with self-help measures.
If you experience any symptoms that affect your daily activities, such as heaviness or pressure in the area of the vagina or pelvis, a bulge of tissue coming through the vaginal opening, accidental loss of urine or stool, frequent or unexpected urges to urinate, or difficulty urinating you should see a specialist. At the Pelvic Floor Disorders Service at Mass General a multidisciplinary team of gastroenterologists, gynecologists, colorectal surgeons and a nurse practitioner tests and evaluates patients to determine the best course of therapy. The center offers a range of non-surgical options, including bladder training, biofeedback, electrical stimulation, physical therapy, medication, vaginal support rings and weighted cones that address pelvic floor disorders. When non-surgical options fail or the patient prefers surgery, the most advanced, minimally invasive procedures are offered.
For information on physicians and making an appointment, visit Mass General's Pelvic Floor Disorders Service.
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