Kelly Scott, M.D. Answers Questions On: Pelvic Floor Dysfunction

A number of factors can lead to pelvic floor dysfunction.

While pregnancy and childbirth are common causes in women, both men and women can experience pelvic floor muscle tension, spasm, or weakness as a result of trauma, scar tissue, surgical complications, poor body posture, straining to defecate, and many other factors that can contribute to pelvic floor disorders.

Stress- and anxiety-related tension also are major causes of pelvic floor dysfunction. Just as stored tension can cause conditions such as migraines, chronic neck pain, and temporomandibular joint (TMJ) problems, tension can be stored in the pelvic muscles and lead to issues such as chronic constipation and pain.

While some types of pelvic floor dysfunction are specific to women, men and women can experience many of the same issues. These include pelvic pain, urinary and fecal incontinence, constipation, pain with intercourse, and tailbone pain.

Interestingly, research indicates that more than 90 percent of men diagnosed with prostatitis actually suffer from overactive pelvic floor muscles. The men – and frequently their urologists, as well – incorrectly assume that because they feel pain in the prostate area, the problem is related to the prostate gland.

Men also can experience urinary leakage after undergoing a prostatectomy.

Women who are pregnant or have recently given birth can suffer from a number of musculoskeletal issues related to the pelvic nerves and muscles

Back pain in pregnancy is a big one – and while that condition may be common, it’s not normal, and there are things we can do to manage it. Because women with severe back pain in pregnancy often go on to become chronic back-pain patients, it’s important to evaluate and treat pain when it begins.

Pregnancy and delivery also can result in issues such as sacroiliac joint dysfunction, pelvic floor dysfunction, pubic symphysis pain, and intrapartum nerve injury – all of which we’re able to treat.

UT  Southwestern is home to one of the world’s experts in magnetic resonance (MR) neurography, a highly advanced type of radiographic imaging we use extensively to help diagnose pelvic pain. Very few U.S. centers offer this technique.

We also offer MR defecography, another very specialized radiographic imaging technology, as well as nerve-conduction and electromyography studies.

MR neurography and defecography help us understand the anatomy and people’s problems much better, particularly problems of the deep pelvic nerve. Before these technologies were available, there weren’t any great ways to diagnose and treat those issues, and many people simply lived in pain.