Pelvic floor hypertonic disorder is a condition in which the pelvic floor remains in a contracted position, which puts the organs and reproductive system under great pressure every day. With this condition, blood flow is decreased, which can cause the environment to become acidic, which can then begin an inflammatory cascade of side effects. When the inflammatory stage has been reached with pelvic floor hypertonic disorder, it is very harmful and damaging to the muscles and nerves in the area, which can cause them to fire inappropriately and cause chronic and debilitating pain. This condition can affect both men and women equally (CDC/NIH).
In many cases, pelvic floor dysfunction is called just that: pelvic floor dysfunction or PFD. Hypertonia is defined as tight muscle tone and reduced capacity of muscle stretch, which leaves the pelvic floor tense and weak. In ten percent of cases, these constant pelvic contractions cause a fifty-percent decrease in not only blood flow, but oxygen supply to the tissues as well. As this condition progresses, the constant inflammation and lack of oxygen can cause muscles and nerves to deteriorate. The muscles can become very tender and painful to any touch.
This condition can cause painful intercourse, uncomfortable sexual activity, constipation, incontinence issues and many other issues attributed to the pelvic floor region. There are treatment protocols in place to help to bring relief to the contracted muscles and tightness in the pelvic floor, which will help to restore blood flow and oxygen to the tissues.
What happens if I choose to ignore my pelvic floor hypertonic disorder?
In the beginning stages of this condition, you may be able to ignore the signs and symptoms. As time progresses, it will be much harder to ignore and proceed with everyday life without hinderance. The constant contractions can cause damage to the bladder, uterus, bowel, cervix, and many other structures under enormous amounts of pressure. This pressure can lead to:
- A lack of upper body strength
- Weak core muscles
- Hip instability
- Pelvic tilt
- Incontinence
- Sexual dysfunction
- Painful intercourse
- Pain when sitting
- Constipation
- Rectal fissures
- Pressure sores
What are the symptoms of pelvic floor hypertonic disorder?
The symptoms of pelvic floor dysfunction begin with issues with pain and incontinence. Some women may first notice an issue when they are being intimate with their partner. These symptoms tend to develop slowly over time. For some women, these symptoms may have been present and growing since their teenage years. Other symptoms may be:
- Straining with bowel movement
- Inability to push for a bowel movement or incomplete evacuation
- Bloating
- Constipation
- Frequent or hesitant urination
- Emergent urination with no control
- Urge incontinence
- Pelvic pain
- Lower back pain
- Pelvic ache
- Pain in thighs and groin
If you are experiencing any of these symptoms, check in with your doctor at your earliest convenience.
How will my doctor diagnose my pelvic floor dysfunction?
Your doctor will begin with a physical exam and questions about the symptoms you have been experiencing. Be sure to keep a detailed history of your symptoms and how these are affecting your daily life. Next, your doctor will check and evaluate your pelvic floor function. Using their gloved hands, the doctor will check for spasms, weakness, or knots in the tissues. This may also include a vaginal or rectal examination as well.
There are other tests that your doctor may order for you. They are:
- The physician may test your pelvic muscle control by placing surface electrodes, which are self-adhesive pads, on the perineum or sacrum, which is the triangular bone at the base of your spine and perform their test.
- An anorectal manometry, which is a test that measures how well the rectum and anal sphincter are working, may also be performed to test the pressures and muscle strength and coordination.
- Your physician may order a defecating proctogram. For this test, you will be given an enema of a thick liquid that can be detected with an X-ray. The physician will use a special video X-ray to record the movement of your muscles as you attempt to push the liquid out of the rectum.
- Some physicians may also perform a uroflow test as you try to empty your bladder. If the flow of urine is weak or you must stop and start as you urinate, it can suggest pelvic floor dysfunction. This test may be ordered when you complain of a urinary issue.
What are my options for treatment with pelvic floor hypertonia disorder?
Pelvic floor dysfunction can often be successfully treated without surgery. Treatments for pelvic floor dysfunction include the following:
- Biofeedback: The most common treatment for pelvic floor dysfunction is biofeedback, done with the help of a physical therapist. This non-painful, non-surgical technique provides improvement for more than seventy-five percent of people with pelvic floor dysfunction. Physical therapists may take several approaches to biofeedback to retrain the muscles. These include using special sensors and video to monitor the pelvic floor muscles as the patient attempts to relax or contract them. The therapist then provides feedback and works with the patient on improving his or her muscle coordination.
- At home vaginal stretching and moisturizing therapies: Your doctor may suggest you Kegel exercises, which are the contracting and releasing of the muscles that control the flow of urine in both men and women. For women, there are special tools called Kegel balls and dilator sets that can help with these activities. Also, using a daily moisturizer on the sensitive and dry tissues of the genitalia can help to bring back the natural moisture your body has been missing.
- Medication: In some cases, your physician may prescribe a low-dose muscle relaxant to deal with pelvic floor dysfunction.
- Relaxation techniques: Your physical therapist may recommend relaxation techniques such as meditation, warm baths, yoga, and exercises.
- Surgery: If your doctor determines your pelvic floor dysfunction is the result of a rectal prolapse, where the tissue that lines the rectum falls into the anal opening, or rectocele the end of the rectum pushes through the wall of the vagina, surgery may be necessary. By using the defecating proctogram test, your physician should be able to determine if these conditions are causing your pelvic floor dysfunction. Occasionally, your surgeon may decide to inject Botox to relax the pelvic floor muscle.
The prognosis for those diagnosed with pelvic floor hypertonic disorder is generally good, if they do their therapy and stick with the routines to help keep the pelvic floor strengthened. Seeing your doctor when you start to have trouble with your pelvic floor can help you to reclaim your life and get control with your pelvic floor dysfunction!
Citations:
World Health Organization
National Institute of Health and Human Services
Center for Disease Control and Prevention