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29 June 2005
Pelvic Floor Problems Left Untreated 
A survey presented at the American Urological Association meeting has prompted the researchers to recommend that pelvic floor disorders be part of routine physical examinations for all women. The researchers, from Temple University, were surprised to learn that while nearly three-quarters of all women reported suffering from one or more pelvic floor disorders, 70 percent of those had not sought medical help. And by the time they did see the doctor - usually triggered by the onset of incontinence - they were suffering from multiple uro-gynecological problems. Minor incontinence and other pelvic floor disorders usually begin after a woman gives birth. Then, as women age, the bladder stretches and pelvic muscles weaken, especially if they don't exercise. Uterine or rectal prolapse and incontinence can often ensue. Significant risks for pelvic floor disorders were older age, high body mass index, number of vaginal births, and the use of forceps. Researcher Jack Mydlo, at Temple University School of Medicine, said that of all pelvic floor disorders, it was incontinence that brought most women to the doctor. "They cannot tolerate leaking urine and the disruption to their daily lives. But incontinence is usually just the tip of the iceberg. Many are also suffering from such pelvic floor disorders as uterine or rectal prolapse."
The first course of action in treating incontinence is usually Kegel exercises to strengthen the muscles around the bladder and sphincter. Sometimes, the use of medications such as inipramine, an anti-depressant that stimulates the closure of the bladder neck, is warranted. "When medications don't help, we first try a conservative measure; the injection of a bulking agent into the bladder neck. This is usually pretty effective. And lastly, when all else has failed, a sling is surgically inserted to hold up the bladder neck," said Mydlo.
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