When it comes to treating pelvic floor disorders, we take a collaborative approach.

Our experts understand that pelvic floor disorders, such as pelvic muscle spasm, prolapse or urinary incontinence can dramatically affect your daily life. That’s why we educate you on the common causes and when necessary connect you to physical therapists, nurse practitioners and any necessary specialists to help treat your particular condition. Our physicians have skills that overlap multiple specialties; they act as pelvic condition “managers,” making sure you receive treatment from the right specialist or team of specialists when necessary. When you choose Northwell Health for pelvic floor disorder treatment, you’re choosing a team of compassionate, qualified professionals and Dr Lind has special interest and expertise in pelvic floor spasm.

Overview

The pelvic floor refers to a group of muscles in your pelvic area that support and act as a “hammock” for organs such as the bladder, uterus, vagina and rectum. When these muscles and tissues are injured or weakened, it is referred to as a pelvic floor disorder.

Causes and risk factors

Though some pelvic floor disorders have no typical risk factors, some common causes include:

• Childbirth
• Obesity
• Chronic constipation
• Heavy lifting
• Pelvic surgery or radiation treatment
• Connective tissue disorder

Pelvic floor disorders include:

• Fecal incontinence — Fecal incontinence refers to the inability to control bowel movements, which causes involuntary stool leakage from the rectum. The severity can range from a small amount of stool to a full loss of bowel control.
• Urinary incontinence — Urinary incontinence refers to the loss of bladder control. There are several types of urinary incontinence, including stress incontinence, which occurs when urine leaks due to exerted pressure (laughing, coughing or lifting heavy objects). An overactive bladder is another reason for urinary incontinence. This involves frequency and urgency of urine, along with the inability to suppress an urge to urinate.
• Pelvic organ prolapse — Pelvic prolapse refers to one of the pelvic organs, such as the vagina, urethra, rectum, uterus or small intestine dropping from its normal place of support due to weakened muscles or connective tissue.
• Difficulty Urinating or defecating
• Pelvic Muscle Spasm
• Vaginismus — Vaginismus is the involuntary contraction of vaginal muscles typically associated with any attempted vaginal penetration. This condition affects a woman’s ability to engage in sexual intercourse, use tampons and receive gynecological exams.

Common symptoms related to pelvic floor disorders include:

• Constipation
• Pain or pressure in rectum
• Muscle spasms in pelvis
• Vaginal or pelvic pain
• Painful sex
• Difficulty urinating
• Unexpected loss of urine
• Inability to urinate
• Abdominal bloating

Diagnosis and Testing

Your physician may be able to diagnose your condition through a pelvic exam. If your condition is still unclear, your doctor may suggest other testing procedures. Depending on your condition, examples of these diagnostic methods could include:

Urodynamic testing — These tests evaluate how well your bladder passes urine. During the test, your bladder is filled with water and then emptied. Pressure readings from tiny catheters allow your physician to establish an accurate diagnosis and plan appropriate care.

Treatments

If you suffer from a pelvic floor disorder, there are several treatment options:

• Biofeedback techniques — These techniques can help you learn to strengthen or relax your pelvic floor depending on your condition.
• Pelvic muscle strengthening or relaxation techniques — Pelvic floor exercises, such as Kegels, can reduce symptoms associated with urinary incontinence and reduce symptoms of pelvic prolapse.
• Colon and rectal surgery — Colorectal surgery is used to treat conditions of the rectum and colon. Our division coordinates with colorectal surgeons when conditions overlap in specialties. This means you won’t have to worry about having separate surgeries by different specialties when it isn’t necessary.
• Electrical stimulation of the pelvic floor — This is a low-energy, painless office treatment for urinary frequency.
• Transvaginal prolapse repair — This minimally invasive surgery can help restore function and structure to the pelvic floor. Vaginal surgery is the least invasive method for gynecologic surgery. The entire surgery is accomplished through the vagina, leaving the abdomen with absolutely no incision or scar formation.
• Laparoscopic or robotic surgery — This state-of-the-art method uses tiny incisions in the abdomen (rather than one large incision) to accomplish extremely detailed reconstructive surgery. The dexterity, enhanced vision and minimally invasive nature of this surgery allow for a rapid recovery.
• Pelvic relaxation physical Therapy
• Botox Injection of the pelvic floor
• Trigger point Injections
• Vaginal Dilation

PELVIC ORGAN PROLAPSE

Prolapse occurs when an organ falls or sinks out of its normal location. The pelvic organs normally have tissue (muscle, ligaments, etc.) holding them in place. Certain factors, however, may cause those tissues to weaken, leading to prolapse of the organs.

Northwell urogynecologists are experts in diagnosing and treating pelvic prolapse. They will recommend the right treatment option for each patient based on the individual specific type and severity of prolapse, age, overall health and future desire to have children. If surgery is required, the physicians have unique specialty training to handle pelvic surgeries.

Common causes of pelvic organ prolapse are:

• Childbirth
• Repeated heavy lifting
• Chronic coughing or constipation
• Previous surgeries in the pelvic area
• Hysterectomy
• Obesity
• Genetics

Common symptoms of prolapse include:

• A bulge or lump in the vagina
• Part of the vagina protruding from the body
• A pulling or stretching feeling in the groin
• Difficult or painful sexual intercourse
• Vaginal pain, pressure, irritation, bleeding or spotting
• Urinary and/or fecal incontinence
• Difficulty with bowel movements
• Delayed or slow urinary stream

There are several types of pelvic organ prolapse:

• Cystocele is defined as the protrusion or prolapse of the bladder into the vagina.
• Urethrocele is the prolapse of the urethra into the vagina. These are caused by a defect in the pubocervical fascia (fibrous tissue that separates the bladder and vagina).
• Rectocele occurs when the rectum prolapses into the vagina, caused by a defect in the fibrous tissue that separates the rectum and vagina.
• Enterocele occurs when a part of the small intestine prolapses into the vagina.
• Uterine prolapse occurs when the uterus protrudes downward into the vagina.
• Vaginal prolapse
• Combined prolapse: more than one of the above organs protrude at the same time