What is all this talk about the pelvic floor?

Pilates exercise

At WAFFL we thought it important to address a particular area: The pelvic floor. So yes this article is primarily for the ladies who want to find more about urology and the pelvic floor.

If you were not aware, urology is the study of problems affecting both the male and female urinary system. The term pelvic floor has been whispered about for years to women. Some may have only heard about it from a Sex and the City episode (Kegel exercises) or during or after child birth. However, it is generally neglected and unfortunately can lead to uncomfortable and at times embarrassing conditions.

The pelvic floor are a group of muscles and ligaments that support the organs in the pelvis: the uterus, bladder and bowel. Normally these muscles and ligaments are tight to aid functional support but as age occurs, they start to become lax. This laxity can also be affected by childbirth. Women usually describe a dragging sensation being felt in the vaginal region. The most common symptom that occurs as a result, is urinary incontinence. However, as time goes by it could lead to the other extreme called a pelvic organ prolapse.

There are two main types of urinary incontinence which can give clues to the origin of the problem.

  • Urge incontinence: refers to an urgent desire to pass urine and occasionally urine leaks before you can even reach the toilet.
  • Stress incontinence: is more common and refers to leaking urine when you increase the pressure in your bladder. Examples would be when you cough or sneeze.

It’s possible to have a combination of both and it’s really from an assessment by your GP and an examination that a differentiation maybe made. Depending on the type and severity, further tests like an abdominal or trans-vaginal ultrasound may be ordered. These will be valuable for further diagnosis when a referral is arranged.

Pelvic Exercises

Treatment can consist of particular exercises to strengthen your pelvic floor. There are different variations however all are based on the same core principles to work the pelvic floor.

Instructions:

  1. Sit comfortably in a chair with legs slightly apart.
  2. Squeeze the muscles surround your anus. You should aim to hold that squeeze for a count of five then relax.
  3. Generally repeat it five times. You may have to build yourself up slowly so don’t push it too much on the first attempt.
  4. Gradually you should aim to do it for five minutes three times a day.

Results generally are seen from 8-20 weeks as your pelvic floor muscles are strengthened. The good point about this exercise is it can be done at any time and in any place. Prompts or reminders on your phone or other devices can help to get a good rhythm going. Further information on pelvic floor exercises are readily available however a good resource is patient.co.uk or YouTube.

In  some instances, exercise will not be enough and these circumstances will require a referral to a urologist/gynaecologist. Surgery or other medications may be offered based on the degree of pelvic floor compromise.

It is important to realise that occasional embarrassing “one off ” accidents can happen regarding urinary incontinence. A common scenario is laughing too hard. This would not immediately ring alarm bells however frequent occurrences would and that requires further evaluation.

I also need to clarify urinary incontinence can also be seen in a much more common condition which is a urinary tract infection (UTI). This is sometimes referred to as cystitis but essentially is an infection of the urinary system. This can cause a range of symptoms not usually present in a pelvic floor prolapse which are, pain on passing urine, changes in the colour or odour of the urine, abdominal pain and fever. A UTI is normally treated effectively by an antibiotic from a doctor. Over the counter treatment from the chemist may also help but in my experience is not reliable. Therefore please seek assistance from your local doctor if not effective or symptoms become worse. In men, urinary incontinence or symptoms of a UTI should always be looked at by a doctor.

At WAFFL we have taken time to construct exercises and regimens as part of lifestyle. A good exercise routine would inadvertently make use of the pelvic floor muscles. But if a routine does not then it indeed should be a worthwhile activity to include in your daily life.

Therefore ladies – take care of your pelvic floor and look after it. Medically and physically it has significant benefits both short term but more importantly long term. Why be at risk of embarrassing urinary symptoms when action can be easily taken now to address them.

Dr A Egboh, WAFFL Doctor
MBBS, BSc, AICSM MRCGP

Photo by HelisusaOwn work, CC BY-SA 4.0, Link