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Pelvic Floor Dysfunction
Aka: Pelvic Floor Dysfunction, Pelvic Floor Muscle Dysfunction, Pelvic Floor Disorder, Pelvic Floor Muscle Weakness, Pelvic Floor Insufficiency, Pelvic Floor Dyssynergia
- Definitions
- Pelvic Floor Disorder
- Injury, weakness or prolapse of the pelvic Muscles and surrounding ligaments and connective tissue
- Pelvic Floor Dyssynergia
- Pelvic Muscles paradoxically contract and rectal sphincter tightens during Defecation (instead of normal relaxation)
- Results in pain and Constipation
- Complications
- Dyspareunia
- Chronic Pelvic Pain
- Urinary Incontinence
- Defecatory Dysfunction (Constipation)
- Exam
- See Chronic Pelvic Pain Exam
- Patient contracts pelvic floor Muscles which should raise the perineum
- Assess for tenderness while palpating pelvic floor Muscles via the vaginal introitus
- Management
- See Pelvic Floor Exercise
- Consider physical therapy (Pelvic Floor specific programs)
- Other interventions
- Gabapentin (Neurontin)
- Trigger Point Injection (local Anesthetic or Botulinum Toxin A)
- Neuromodulation with nerve stimulator (posterior tibial, pudendal, sacral nerve)
- References
- Hill (2021) Am Fam Physician 103(10):597-604 [PubMed]