Expert Pelvic Floor Dysfunction Treatment – Orange, Bathurst And Parkes

Pelvic floor dysfunction is generally treatable and there are many different treatment options available. The type of treatment will depend on the underlying cause of the condition and the severity of the symptoms.

Non-surgical treatments

Doctors may initially treat these conditions with the following non-surgical treatment options first.

Bladder training 

This involves using the bathroom on a set schedule to regain bladder control and applying techniques to overcome inappropriate urges to urinate. The end goal is to urinate only every 2.5 to 3 hours. You may be referred to an incontinence nurse to help you achieve this.

Pelvic floor muscle training

Often referred to as Kegel exercises, Pelvic Floor Muscle Training (PFMT) involves contracting and releasing the pelvic floor muscles. When performed correctly and on a regular basis, it may help reduce the symptoms of urinary incontinence and prolapse. However, PFMT cannot repair the prolapse. You may be referred to/may have already seen a physiotherapist with a special interest in the pelvic floor.

Medications

Medications may also be prescribed to treat certain bladder or bowel control issues like incontinence, constipation, etc.

Vaginal pessary

This device, made of plastic/silicone, is designed to treat prolapse. It can also be beneficial in improving bladder control. A healthcare provider will insert the pessary into the vagina of a female patient to provide support to the pelvic organs.

To ensure the most comfortable shape and size, a physician will fit the pessary to the woman and teach her how to use and take care of it.

Pessaries need to be changed at least every 3-6 months by your practitioner. If they are too loose, they may be expelled or if they are too tight they may cause discomfort-hence correct sizing of the pessary may be required in the beginning. Pessaries can also cause vaginal discharge and ulceration due to friction and hence require vaginal care.

Surgical treatments

If doctors have recommended non-surgical treatments, and they have not been successful, or if surgical treatment is recommended the following options are available.

For prolapse

Surgery involves repairing the prolapse and restoring a well-supported pelvic floor.

The general principle of surgery is to repair the deficit in the pelvic floor – also called Site-specific repair. This may involve the repair of one or more compartments as per the involvement and severity of pelvic organ prolapse.

This is usually done using the patient’s native tissue. At the time of writing Dr Kotasthane does not use synthetic or external mesh products for prolapse repair(although research is on to find the “ideal” scaffold to support the pelvic floor tissues in case of weakened tissues).

Women with uterine prolapse may also, sometimes need to have a hysterectomy. Additionally, some women may also need surgery to address or prevent bladder control issues/incontinence-this may either be done as a separate procedure or concomitantly with the prolapse surgery.

Bladder control problems

Surgery is a highly effective treatment for stress incontinence, a type of urinary leakage caused by an activity such as coughing, sneezing, or exercising. This occurs when the exertion squeezes the bladder, and the weakened support around the urethra causes urine to leak out.

The most common type of surgery used is a mid-urethral sling, in which the surgeon places material under the urethra to support it and prevent leakage.

Bowel control problems

Surgery may sometimes be necessary to repair a damaged anal sphincter muscle. Medications can also be injected into the sphincter, and a stimulator for the nerves that control the bowel can be implanted.