Nonsurgical and Surgical Options

Pelvic floor disorders are treatable and controllable. However, successful therapy requires active patient participation both for diagnosis and therapy.

The specialists at the Pelvic Floor Center at the George Washington University Hospital can offer several nonsurgical and surgical treatment options for pelvic floor disorders. 

Nonsurgical Options 

  • Kegel muscle-building exercises can help with some pelvic floor conditions. Biofeedback can help train and strengthen the pelvic muscles.
  • A pessary can be inserted in the vagina. It is similar to a ring and can stay in the body all day to help give support to the pelvic floor organs. This custom device can help slow the deterioration of the muscles for several years, and it is especially good for women who still want to have children in the future 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. However, this treatment must be done several times over a few months.
  • A bowel management program and stimulated defecation (enemas, suppositories, medications) are other nonsurgical options.
  • Bladder training and scheduled urination can help to rid the bladder continuously instead of waiting for the feeling of having to go.
  • Medication can be prescribed to help control the bladder: antidepressants can relax the bladder muscle; antibiotics can treat urinary tract infections; alpha blockers can relax the urinary sphincter muscle or shrink the prostate.

Surgical Options 

For Urinary Incontinence 

  • 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 in the urethra during a minimally invasive procedure 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" to help tighten the area around the urinary 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.

For Fecal Incontinence 

  • Sphincteroplasty is the direct repair of the muscle defect.
  • Artificial bowel sphincter is an implanted inflatable donut placed around the anal muscles.
  • in sacral nerve stimulation, electrodes are used to stimulate spinal nerves.
  • Colostomy (a piece of the colon is directed to an opening in the abdomen to bypass a damaged part of the colon) or ileostomy (a piece of the small intestine is directed to an artificial opening in the abdomen).