What is Pelvic Floor Disfunction?

[crysann]

What does PFD feel like? Or, How do you know that you have it? What are the symptoms?

[Katrina]

PFD can be tested for either by your urologist or a physcal therapist. Symptoms can vary a lot possible symptoms include, pelvic pain, burning, stinging, enterance pain, constipation, diarhea, retention, urgency, frequency, and a lot of others I am sure. Talk to your doctor because physcial therapy helps many of us.

If things get bad enough you can end up with a prolapse.
http://www.piedmonthospital.org/piedmonthospital/womens_richardson.html


Symptoms associated with PFD in the female may include:

Urinary urgency and frequency
Pelvic pain
Pain associated with sexual intercourse
Sensation of incomplete urination
Lower back pain
Pain behind the vagina
Decreased urinary flow
Constipation
Symptoms associated with PFD in the male may include:
Urinary frequency and urgency
Sensation of incomplete urination
Lower back pain
Pain in the testicles and/or penis
Pain associated with ejaculation
Decreased urinary flow
Constipation

[July]

Thank you for the comprehensive information, Katrina!

[IcyAngel23]

Physical therapy hurts bad !!!!!!!!! I did three rounds of 16 weeks. No improvement.My PT told me that when my IC was under control my PFD would follow. She seems to think that my bladder was what was causing my PFD. I did TENS unit, EMG manual stimulation, ultrasound thearpy and biofeedback relaxation, yoga, breathing techniques. Nothing helped. Now I'm doing heparin injections into the abdomen and they help alot. I can't take elmiron or do instills do my senstive pissy bladder so Dr. Parsons (well known in the IC community, he was a speaker at the lectures in San diego he was hosting it at his hospital) went back to basics with the injections. I first few times I bruised but now I'm fine with the injections. Some people the PT works but for others it doesn't. Just like anyother treatment. Just wanted to let you know that PT isn't your only option.

Kristin

[csocain]

PFD physical therapy was a God-send to me. My PFD was so severe that it took 9 months to take care of the problems, but I was 95% better when I finished physical therapy. It was well worth my time and effort. I would highly recommend it to anyone with PFD. Yes, it is pretty uncomfortable in the beginning, but gets better over time. Praying that you get a confirmation if this would help you. Blessings of hope and peace to you and yours.

[DanaF]

Do you have to have pain in order to be diagnosed with PFD. I only have frequency and the feeling like I have to go a lot - along with burning at times - I'm fine with sex!

[July]

DanaF...I'm not sure if PFD always presents with pain. I assumed it did. Plus, I think pain with sex is common in PFD.

Csocain...what sort of things did you do in physical therapy that you found helpful?

[m123]

PFD doesn't come with pain. There are different types of it with ranges in severity just like IC. It may accompany IC.

This is what this website (http://www.bio-medical.com/news_display.cfm?mode=INC&newsid=47) had to say about Pelvic Floor Dysfunction:

"What is pelvic floor dysfunction (PFD)? This is non-neurogenic, uncoordinated behavior of the pelvic floor musculature. This is not like Parkinson’s or multiple sclerosis. This is a person who has no obvious neurological disease and the muscle function is uncoordinated. One example of being uncoordinated is shown here (slide): normally the bladder sits in a funnel of muscle. When one voids, the muscle of the bladder contracts, thereby forcing out urine. At the same time, the muscles of the pelvic floor, the levator muscles, and the muscles of the GU diaphragm have to relax. That is the normal process of voiding; it is a complex neurological mechanism. When this happens, there is a good stream of urine. In a patient with PFD, the bladder contracts and the muscles open up, but they are in spasm. They are not working properly. They open and urine does come out, but this can lead to disruptive symptoms.

The symptoms of PFD are similar to IC. A patient with IC typically has pelvic pain, the pain often worsens with bladder filling. They usually have day and nighttime urination, and their symptoms are affected by foods, in many instances. The patients who have PFD have similar complaints with a subtle difference (keep in mind that PFD can coexist with IC): IC should not normally result in a poor urinary flow rate. One exception is that if you are urinating tiny volumes each time, you will never be able to generate a good force of the urine stream. If you still have a poor urinary flow rate, that is suggestive of something else going on. In a male, you have to consider the presence of the prostate gland, which can also be causing problems. The first focus of attention in a male is typically on the prostate as a cause of blockage. "

[m123]

IcyAngel have you been properly diagosed with PFD? It can accompany IC, or your IC may be causing it. Maybe that's why no improvement.

[DanaF]

I don't really have the slow urination speed except when I'm in a flare and going a lot - Does that mean I prob don't have PFD. I gotta tell you, I feel like the kegels I learned from physical therapist recently have made me worse..days I don't do them I feel better- not to discourage people :)...I just find it strange....anyone understand that?

[msstrunk]

I found that after several weeks of physical thereapy which was a combination of internal massage, stretching, relaxation exrercises, kegals regular exercise, and yoga all significantly reduced my PFD pain. It took time, patience, and understanding that I was essentially retraining my muscles to work properly. In the beginning I had quite o bit of discomfort, but by being consistent and follwing my diet and therapy 100% I feel so much better. I had a WONDERFUL PT in California... the only one in a 200 mile area that knew how to treat PFD. I think, like IC, every person will have different levels of pain and tolerance. It's important to have excellent communication with your PT in order to get the most benefit from the therapy.

[July]

Msstrunk,
When you first started the kegals, did you develop some pressure pain in your lower abdomen/pelvic area? And, if so, did it go away and did you continue the Kegals? I've been doing kegals for about 4 weeks, and a painful pressure has developed. What were your instructions for doing Kegals?

[msstrunk]

Ok, sorry it's so long.. but I wanted to answer as best as possible...

When I first started therapy I would get what my PT called "She's mad a getting back at you" pain. I was in therapy for about six months, then moved to doing the work at home. In regards to the kegal exercises... those were the most difficult. I was so messed up "down there" that I had a lot of rebuilding and retraining to do. So yes.. I was uncomfortable for a while... but I did exactly what my PT did and it truly did help. I felt like I couldn't do half of the exercises.. I would kind of crap... get really fatigued etc. I wasn't able to "hold" for more than 4 seconds. However... I am SOOOOO much better now.

The first thing was that I had to completely stop doing crunch exercises as that mees up your pelvic tilt, etc. I was taught completely different tummy exercises to get back in allignment. MY PT ROCKED!!!!!

My PT also did an internal massage to relieve the pressure. Then we would move onto exercises. Here are some examples...

Then I did biofeedback exercises (when they hook you up to a machine - now there are ones you can take home)
1) 10x maximum contractions then release ("quick flicks")
2) Then I would have to watch the gauge and contract to my "mid" level and hold for 5-10 seconds then get myself to relax back down to zero
3) Then I had to squeeze to a number on the guage like #6 then release one notch at a time until I got to zero.

This is where the breathing and relaxation was key. I was unable to relax to zero for months becasue of the PFD. That's where yoga etc came into play.

[DanaF]

Why is it that I felt worse the weeks I did Kegels all the time, and then a week later I wouldn't do the kegels and I felt better? I had only been doing PT for a month but I really felt like the kegels worsened things- Now a week after not doing them I feel much better than how I did before starting PT- is that normal?

[July]

DanaF,
I'm having the exact same experience with the Kegels as you!! I hope someone can shed some light on why this happens. I did read that perhaps starting out with too many Kegels when your pelvic floor is messed up to begin with can be a problem. So, I've cut down the number I do and try to do them very gently. I guess that makes sense. If you do any kind of excercise too much at first, your bound to get some muscle strain. I'm going to ask my physical therapist about it. Let me know if you get an answer.