Pelvic floor disorders are treatable and controllable. However, successful therapy requires active patient participation both for diagnosis and therapy. Treatment typically depends on the severity of the condition and many times, the best success comes from using several treatment options together.

Nonsurgical Options

  • Kegel muscle-building exercises can be extremely helpful for pelvic floor conditions of a mild degree. Biofeedback can help train and strengthen the pelvic muscles.
  • A pessary can be inserted in the vagina. This ring-shaped device and can stay in the body all day to help give support to the pelvic floor organs. This custom device helps slow the deterioration of the pelvic muscles for several years and is a good option for women who still want to have children or those who are not good candidates for surgical repair.
  • Electral impulses can be sent through the rectum or vagina to help control and stimulate the pelvic floor muscles. This treatment must be done several times over a few months.
  • A bowel management program and stimulated defecation (enemas, suppositories, medications). 

Surgical Options

Transvaginal Pelvic Floor Repair

These procedures treat pelvic prolapse through incisions in and around the vagina to restore the normal anatomy of the pelvic floor.

Laparoscopic Pelvic Floor Repair

In this procedure, surgeons insert a tiny telescope (laparoscope) through a small incision. The laparoscope is attached to a camera-television setup, giving the surgeons a magnified view of the pelvic floor. After making several "keyhole" incisions in the abdomen, the surgeons use specially designed instruments to lift and attach the prolapsed organs back in their normal positions with permanent sutures. There are numerous benefits to having pelvic floor defects treated laparoscopically, such as:

  • Providing an accurate identification of the pelvic floor defects because of the laparoscope's excellent view of the pelvic floor from above
  • Minimizing the need and extent of vaginal repair, thus reducing the risk of painful internal scars
  • Avoiding or deferring hysterectomy for uterine prolapse
  • Allowing the patient to enjoy a shorter recovery time and to experience less postoperative discomfort

Urinary Incontinence

Nonsurgical Options

Depending on the reason for a person's incontinence, behavioral changes may help with some of the urinary symptoms. Bladder training and scheduled urination can help to rid the bladder continuously instead of waiting for the feeling of having to go. Llessening alcohol and caffeine intake, as well as acidic foods and liquids, can also help. Finally, medications can be prescribed to help control the bladder: antimuscarinicsc (for overactive bladders); imipramine-an antidepressant to relax the bladder muscle; antibiotics-when your condition is related to a urinary tract infection; Alpha blockers and other medicines to relax your urinary sphincter muscle or shrink the prostate.

Surgical Options

  • Overactive bladder or retention of urine can be treated by the placement of electrodes in the spinal region that sends electrical stimulation to the nerves of the bladder.
  • A "sling" can be inserted during a minimally invasive procedure in the urethra to support it into its natural position. This can be performed in patients with urinary incontinence or sphincter dysfunction.
  • The tissue surrounding the urethra can be surgically enhanced or "bulked" around the urinary sphincter to help tighten the sphincter.
  • Bladder neck suspension surgery can be performed by making an incision into the abdomen and securing the bladder to a ligament near the pubic bone.
  • An artificial urinary sphincter muscle may be inserted to help control the pelvic floor muscles. This doughnut-shaped ring is inserted around the urethra. It stops the flow of urine, and when pressed manually, will release it.
  • Sacral nerve stimulation: electrodes placed to stimulate spinal nerves.

Fecal Incontinence

Surgical Options

Most people with fecal incontinence will not be candidates for surgical correction, but some individuals may benefit. A variety of surgical procedures and techniques exists for the treatment of fecal incontinence:

  • Sphincteroplasty: direct repair of a muscle defect.
  • Artificial bowel sphincter: an implanted inflatable donut placed around the anal muscles.
  • Sacral nerve stimulation: electrodes placed to stimulate spinal nerves.
  • Colostomy or ileostomy.