Restoring Quality of Life
Through Effective Treatment
Chronic pelvic pain and its associated symptoms can be truly disabling.
Urinary incontinence, chronic constipation, tailbone pain, pain with
intercourse, and other types of pelvic dysfunction can severely limit people’s
ability to live life the way they want.
It’s possible to significantly minimize symptoms and
restore quality of life with proper treatment of pelvic musculoskeletal
dysfunction, even if pelvic problems are caused by a disease like endometriosis
or nonbacterial prostatitis.
We take a multidisciplinary approach to
diagnosing and treating pelvic floor disorders, using a team of specialists who
work closely together to facilitate care and provide the best possible
outcomes. Among our specialists are nationally recognized experts in the fields
of:
Our collaboration with
subspecialists from other fields ensures that patients have some of the best
medical minds working for them, from the point of diagnosis all the way through
treatment.
Conditions
Several factors can contribute to pelvic floor disorders,
including aging, pregnancy, hormonal changes, and injuries.
We treat a broad range of pelvic floor conditions, such as:
- Urinary
and fecal incontinence or urgency
- Pelvic
organ prolapse and mesh complications
- Pelvic
pain
- Overactive
bladder
- Constipation
- Sexual
dysfunction
- Coccydynia
(tailbone pain)
- Dyspareunia
(pain with intercourse)
- Dysuria
(pain with urination)
- Interstitial
cystitis (bladder pain)
- Nocturia
(nighttime urination)
- Chronic
low back, hip, abdominal, rectal, groin, buttock, vaginal, or testicular
pain
- Piriformis
syndrome
- Sacroiliac
joint pain or dysfunction
- Chronic
nonbacterial prostatitis
Diagnosing
Pelvic Floor Disorders
Patient care for pelvic floor disorders begins with a comprehensive
diagnostic evaluation that includes a history, a physical examination, and a thorough
discussion of symptoms.
Our physicians might do a postural and structural assessment, a
neurological evaluation, and musculoskeletal and neuromuscular examinations. We
also offer electrodiagnostic and radiologic evaluations, if necessary, to confirm
the diagnosis.
Treatments for Pelvic Floor Disorders
We offer nonsurgical, surgical, and robotic treatment
options, so patients have access to a broad range of leading-edge care. Among
the pelvic floor treatments we offer are:
Nonsurgical Options
- Biofeedback
- Botox injections
- Counseling
- Electrical stimulation
- Medications
- Percutaneous tibial nerve stimulation (PTNS)
- Physical therapy
- Pessary therapy (vaginal support device)
Surgical Options
- Vaginal, abdominal, laparoscopic, and robotic repair of
pelvic structures
- Sling procedures
- Periurethral and injectable agents
- Sacral neuromodulation (a nerve-stimulating device that helps
control overactive bladder, fecal incontinence, and urinary retention)
- Latest robotic technology (dual-console da Vinci robot)
Pelvic Floor Rehabilitation
Pelvic rehabilitation is an effective method
for treating pelvic pain, pelvic muscle dysfunction, and back or pelvic pain
and associated disorders resulting from pregnancy and the postpartum period. Our goal is to reduce pain,
increase function, and restore quality of life.
Treatments are administered by an experienced and skilled team of physical medicine and rehabilitation physicians who
specialize in treating disorders of the muscle, bone, and nerves. They’re
joined by a staff of certified, specially trained therapists who are experts at
working with patients who are suffering from pelvic pain and dysfunction.
Pelvic floor rehabilitation treatments we offer include:
- Biofeedback
- Bladder retraining
- Bowel retraining
- Connective tissue manipulation
- Electrical stimulation
- Home exercise program
- Interventional pain procedures
- Manual therapy
- Medication management
- Myofascial release
- Neural mobilization
- Neuromuscular re-education
- Patient education
- Physical therapy (both general and specialized for
pelvic floor muscle problems)
- Psychology referral
- Strengthening/alignment/stabilization exercises
- Support devices and orthotics
Pregnancy and Postpartum
Pelvic Issues
Pregnant women who suffer severe low back or pelvic pain can have
trouble working, sleeping, and taking care of their families. Also, after
giving birth there can be a host of new physical problems, such as urinary
incontinence, pain with sexual intercourse, pelvic muscle injuries, and nerve
injuries.
Proper treatment can alleviate these
conditions and help patients enjoy their pregnancy and life with their new
babies.
Pregnancy and postpartum conditions we treat include:
- Back
or pelvic pain during pregnancy or following delivery
- Sacroiliac
joint dysfunction in pregnancy or postpartum
- Pubic
symphysis pain or dysfunction
- Urinary
incontinence or other urinary problems during pregnancy or following
delivery
- Fecal/bowel
incontinence following delivery
- Constipation
- Painful
sexual intercourse following delivery
- Pelvic
muscle injuries during delivery
- Nerve
injuries during pregnancy or delivery
- Neck
or back pain with childcare/breastfeeding activities
- Abdominal
and scar pain after cesarean section
- Hip,
leg, or groin pain or weakness during pregnancy or following delivery
Clinical Trials
Research being performed at UT Southwestern shows promising treatments might reduce the recurrence of pelvic floor dysfunction symptoms. An ongoing clinical trial, led by UT Southwestern’s David Rahn, M.D., is examining the effectiveness of vaginal estrogen – a supplemental, nonsurgical therapy – to reduce symptom recurrence and spare more women the risks and financial implications of revisional surgeries. We’re also studying how vaginal estrogen may impact other pelvic floor disorders such as overactive bladder, urinary incontinence, sexual dysfunction and painful intercourse, and postoperative bladder infections.