Pelvic Floor & Continence
Pelvic floor and continence problems are common, often under-discussed, and usually treatable. Many patients improve with a stepwise approach that begins with simple measures.
Understanding the pelvic floor
The pelvic floor is a group of muscles and supporting tissues that hold the rectum, bladder and pelvic organs in place. Childbirth, ageing, previous surgery and chronic straining can all affect its function.
Common symptoms
- Difficulty controlling wind or stool.
- Urgency or frequent need to use the toilet.
- A sensation of incomplete emptying.
- A bulge or prolapse from the back passage.
- Chronic constipation or straining.
Assessment
Assessment begins with a detailed history and examination. Further investigation may include anorectal physiology, endoanal ultrasound, defaecating proctography or colonoscopy, depending on the symptoms.
Conservative treatment
Most patients begin with dietary advice, fibre and fluid optimisation, bowel habit retraining and pelvic floor physiotherapy. These measures alone resolve symptoms for many people.
Procedural and surgical options
Where conservative measures are insufficient, options include sacral nerve stimulation, repair of rectal prolapse, and treatment of associated conditions such as haemorrhoids or fissures. Treatment is individualised.
Living well with the condition
Pelvic floor problems can affect confidence and daily life. Assessment and treatment are discreet and supportive, and it is worth seeking help early rather than managing in silence.
Common questions
Brief answers to questions patients often raise at consultation.
Questions about this information?
Our practice team can assist with appointments, referrals and preparation questions.