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Pelvic Floor Dysfunction Treatment

Pelvic floor dysfunction refers to a group of disorders causing abnormal functioning of the pelvic floor muscles. These muscles support the pelvic organs, including the bladder, rectum, and uterus or prostate.

Dysfunction can lead to a range of symptoms, impacting daily life and overall well-being.

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Causes and Risk Factors

Age-related factors

  • The natural ageing process can lead to a decline in muscle tone and elasticity. As the pelvic floor muscles weaken over time, they may become less effective in supporting the pelvic organs.
  • Hormonal changes, especially during menopause in women, can affect the strength and function of the pelvic floor muscles. Reduced oestrogen levels can lead to thinning and weakening of these muscles.

Pregnancy and childbirth

  • Pregnancy places increased weight and pressure on the pelvic floor muscles for an extended period.
  • Vaginal childbirth can stretch and strain the pelvic muscles, especially during prolonged labour or when forceps or vacuum extraction is used.
  • Multiple pregnancies and deliveries can compound the strain on the pelvic floor.

Systemic diseases

  • Diabetes: Neuropathy, a common complication of diabetes, can affect the nerves controlling the pelvic muscles.
  • Chronic cough: Conditions that lead to chronic coughing, such as asthma, chronic bronchitis, or smoking, can exert repeated pressure on the pelvic floor, leading to its weakening over time.
  • Obesity: Excess body weight increases intra-abdominal pressure, which can strain the pelvic muscles.

Trauma and injuries

  • Surgical procedures in the pelvic region, such as hysterectomies or prostate surgeries, can damage the muscles or nerves.
  • Accidents or injuries that impact the pelvic region can lead to immediate trauma or long-term complications affecting the pelvic floor.

Other contributing factors

  • Chronic constipation: Regular straining during bowel movements can weaken the pelvic muscles over time.
  • Repetitive heavy lifting: Regularly lifting heavy objects without proper technique can increase intra-abdominal pressure, straining the pelvic floor.
  • Genetic factors: Some individuals may have a genetic predisposition that makes their connective tissues less supportive, increasing the risk of pelvic floor dysfunction.

Treatment Options

Dietary changes

  • Fibre intake: Increasing dietary fibre can help regulate bowel movements, reducing strain on the pelvic floor. Foods rich in fibre include whole grains, fruits, vegetables, and legumes.
  • Fluid consumption: Drinking adequate water supports healthy bowel function, preventing constipation and reducing strain during bowel movements.

Laxatives

There are various types of laxatives, including bulk-forming, osmotic, stimulant, and stool softeners. The choice depends on the specific bowel issue and its severity. A healthcare professional can recommend the most suitable type.

Pain relief methods

  • Medications: Over-the-counter pain relievers or prescribed medications can alleviate pain and discomfort associated with the condition.
  • Topical treatments: Gels or ointments containing anaesthetics or anti-inflammatory agents can provide relief when applied to the affected area.

Pelvic floor rehabilitation

  • Kegel exercises: These exercises involve contracting and relaxing the pelvic floor muscles, helping to strengthen them.
  • Physical therapy: A trained physiotherapist can guide patients through exercises and techniques tailored to their specific needs.

Biofeedback

This technique uses electronic monitoring to display bodily functions in real-time. It helps patients gain awareness and control over their pelvic muscles, teaching them to contract and relax them correctly.

Pessary

A pessary is a silicone or rubber device inserted into the vagina to support sagging pelvic organs. It can be particularly useful for women with pelvic organ prolapse.

Surgery

  • Surgical interventions can be considered when other treatments are ineffective. Procedures can include repairing damaged muscles, ligaments, or supporting structures.
  • In cases of pelvic organ prolapse, surgery may involve lifting and securing the prolapsed organ.

Stem cell therapies

An emerging area of research, stem cell therapies aim to use the body’s own cells to repair and regenerate damaged tissues in the pelvic region. While promising, more studies are needed to establish their efficacy and safety.

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Conclusion

Pelvic floor dysfunction, while common, can significantly impact an individual’s quality of life. Understanding the causes and available treatment options helps for effective management. Early diagnosis and intervention can lead to better outcomes and improved well-being.

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Dr Lee Fang Jann image

Dr Lee is a urologist and kidney transplant surgeon with a broad-based expertise of all urological disorders

He has subspecialty focus on men’s health and male infertility, and special interest in minimally invasive prostate enlargement therapy and kidney stone treatment. Dr Lee has received numerous awards for service excellence such as the Service With A Heart Award (2006-2008, 2011) and the Singapore Health Quality Service Award (2016).

  • Bachelor of Medicine and Bachelor of Surgery (Singapore)
  • Membership of The Royal College of Surgeons (Edin)
  • Master of Medicine (Surgery) (Singapore)
  • Fellowship of the Academy of Medicine (Urology)
  • Clinical fellowship at Oxford Transplant Centre in the UK

Prior to entering private practice, Dr Lee served in the public sector for 16 years at SGH, where he initiated dedicated clinics evaluating and treating patients with complex men’s health and fertility issues. He also led the Renal Transplant Program and laparoscopic donor nephrectomy service as Surgical Director.

Apart from clinical work, Dr Lee is active in academia and believes in the importance of grooming the next generation of doctor. He was Senior Clinical Lecturer at NUS’ Yong Loo Lin School of Medicine and currently, Adjunct Assistant Professor at the Duke-NUS Medical School. Dr Lee is also regularly invited to share his experiences locally and regionally through lectures, workshops and surgical demonstrations.

Our Clinic Locations

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Farrer Park Medical Centre, #08-05
1 Farrer Park Station Rd, Singapore 217562
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Mon – Fri: 8:30am to 5:30pm
Sat: 8:30am to 12:30pm

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3 Mount Elizabeth, #11-16 Medical Centre, Singapore 228510
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Mon – Fri: 8:30am to 5:30pm
Sat: 8:30am to 12:30pm

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    Frequently Asked Questions

    What is the pelvic floor and why is it important?
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    The pelvic floor is a set of muscles that support the pelvic organs. It plays an important role in urinary and faecal continence, sexual function, and overall pelvic health.

    How is pelvic floor dysfunction diagnosed?
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    Diagnosis typically involves a physical examination, patient history, and, in some cases, diagnostic tests like ultrasound or MRI.

    Are there exercises that can help strengthen the pelvic floor?
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    Yes, pelvic floor exercises, often referred to as Kegel exercises, can help strengthen these muscles.

    How is pelvic floor dysfunction related to childbirth?
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    Childbirth can strain or damage the pelvic floor muscles, leading to dysfunction.

    What is the difference between pelvic floor dysfunction and other pelvic disorders?
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    While pelvic floor dysfunction refers to abnormal functioning of the pelvic muscles, other disorders might involve organ prolapse, infections, or anatomical abnormalities.

    Can pelvic floor dysfunction be cured?
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    With appropriate treatment, many individuals experience significant improvement or complete resolution of symptoms.

    How common is pelvic floor dysfunction?
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    It is a prevalent condition, especially among older adults and women who have given birth.