VAGINAL WEIGHTS

vaginal weights and pelvic floor dysfunction

The bladder, rectum, cervix and prostate are supported in the pelvis by a complex set of muscles. Proper functioning of these "pelvic floor muscles" is necessary in the process of urination and defecation.

The muscles of the pelvic floor normally relax during urination while the bladder contracts. In some patients, these muscles may become "irritated", often contracting abnormally. The general term given to this problem is "pelvic floor dysfunction (pelvic floor dysfunction)".

Symptoms associated with pelvic floor dysfunction 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 pelvic floor dysfunction 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
Diagnosis of pelvic floor dysfunction

The diagnosis of pelvic floor dysfunction is often difficult to make since no specific test exists to identify this problem. The final diagnosis is made on the basis of:

Typical symptoms

Objective findings on physical examination such as point tenderness on rectal/pelvic examination and abnormalities in the urine flow

Absence of other abnormalities such as prostatitis, endometriosis, urinary tract infection, bladder cancer, neurologic disease

What is the cause of pelvic floor dysfunction?

The cause of pelvic floor dysfunction is unknown; however, approximately 30 percent of patients identify a urinary tract infection as the cause of their symptoms. In these patients, urinary frequency and urgency persist long after their urinary tract infection has been successfully treated.

What is the cause of the decrease in urinary flow?

The normal process of urination involves coordination between the bladder and pelvic floor muscles; the pelvic floor muscles relax while the bladder contracts. In most patients, the bladder contracts normally but the urine flow is poor due to continued tightening of the pelvic floor.

What accounts for different symptoms in different patients?

This is unknown at the present time, however, the differences in symptoms most likely represent abnormal function in different regions of the pelvic floor muscles.

What is the cause of urgency frequency and urgency?

The sensation of urinary frequency and urgency appears, in many cases, to be linked to pelvic floor dysfunction. The natural tendency for many patients is to strain and push the last drop of urine out so they can prolong the intervals between bathroom sessions. Unfortunately, pushing and straining appear to further aggravate the pelvic floor muscles and worsen the symptoms. Hence, a vicious cycle develops.

What forms of therapy exist for the treatment of pelvic floor dysfunction?

Treatment for pelvic floor dysfunction is rather nonspecific and is primarily aimed at relaxation of the muscles which are affected. General treatment measures include:

Pelvic floor relaxation technique
Warm sitz baths two to three times daily
Avoidance of constipation with stool softeners
Anti-inflammatory agents
Stress reduction: stressful situations at home or at work, although not the cause of pelvic floor dysfunction, appear to worsen the symptoms of many patients.
Avoidance of sitting for long periods of time: patients should sit on chairs with very firm supportive seat cushions
Approximately 80 percent of patients who undergo conservative management of pelvic floor dysfunction will achieve relief of their symptoms. Unfortunately, symptoms may take up to three months to improve. Patients who undergo conservative therapy are expected to have "good" and "bad" days but should have an overall trend of improvement. The final outcome of treatment is extremely dependent upon the individual patient's motivation. Patients who achieve the best results are those who make these treatment measures a part of their daily lives.

What happens if conservative therapy fails?

Other forms of therapy which address specific symptoms may be employed, such as:

Analgesics
Muscle relaxants
TENS (transcutaneous electrical nerve stimulation)
Acupuncture
Biofeedback
Technique of Pelvic Floor Relaxation

Identification of the pelvic floor muscles is central to the technique of pelvic floor relaxation.

To identify the muscles of the pelvic floor, begin to urinate. When your stream is at its maximum flow rate, attempt to stop the flow suddenly.

Make a "mental note" of the group of muscles which you have tightened. Dysfunction of these muscles is usually responsible for your symptoms. This maneuver is meant only for identification of your "problem" muscles. It should only be performed once or twice. Repeated tightening of these muscles may aggravate your symptoms.

Once your pelvic floor muscles have been identified, it is extremely important to monitor them carefully throughout the day, particularly during urination.

When urinating, these muscles must be in a relaxed state. There should be no straining, even if your bladder doesn't feel completely empty. It is better to come back to urinate five minutes later than to strain.

Make sure that you do not become constipated since straining of the bowels may also aggravate your symptoms. Use a stool softener, if necessary.

Pelvic floor relaxation is a fairly easy technique to learn. However, it requires a great deal of practice, patience and motivation to achieve maximal effect.

In prospective, comparing the effectiveness of pelvic floor exercises with vaginal weights
in combination of these two techniques produced greater improvement in urinary incontinence.