Pelvic Medicine and Reconstructive Surgery
792 College Parkway
Fanny Allen Campus, Medical Office Building, Suite 101
Colchester, VT 05446-3052
If you experience urinary or bowel incontinence, difficulty urinating, constipation or pain during intercourse, you may have a dysfunction of your pelvic floor muscles. We understand this can be distressing and may limit your normal daily activities. At the University of Vermont Medical Center (UVM Medical Center), we have treatment options to help you get back to living a full life.
Pelvic floor dysfunction is common and affects affect both men and women. However, it is not a normal part of aging. You do not have to live with incontinence, constipation or pain. Our specialists are the region's experts in treating pelvic floor dysfunction and restoring normal function.
Pelvic Floor Care at UVM Medical Center
Your pelvic floor muscles are important components of your digestive, urinary and reproductive systems. Our experienced specialists can treat all the issues you are having.
- Holistic approach: We treat the whole person, not just the symptoms. We thoroughly assess your condition, treat your muscle dysfunction and give you the tools to maintain proper muscle function going forward.
- Privacy: Our pelvic floor consultations, assessments and treatments are done in private rooms and through one-on-one consultations with our skilled physical therapists. Your privacy and confidentiality are important to us.
- Specialized center: Incontinence is not a normal part of aging, and you should not accept it. At our continence center, we have the specialists and expertise to treat incontinence and improve your quality of life.
- Certified physical therapists: Our physical therapists have extra training and certification in pelvic floor dysfunction and orthopedics. This means you will receive expert care from the most highly skilled professionals in our region.
Pelvic Floor Dysfunction: What You Need to Know
Your pelvic floor muscles are a hammock-like band of muscles that stretch from the front to the back of your groin. They keep the bladder, bowel, uterus (in women) and prostate (in men) in the correct place and help them function properly.
Like all muscle groups, they can weaken or be damaged. Weak muscles may not hold the organs in the correct place and/or make it difficult to control urination or bowel movements (incontinence). Tight muscles can make it difficult to urinate or have a bowel movement (constipation).
Improving muscle function through exercise, relaxation or surgery normally resolves these problems.
We cannot always identify a specific cause for pelvic floor dysfunction. For women, giving birth may contribute to weakening or muscle damage. However, this condition can affect women who have had cesarean sections or who have never given birth. It affects many men as well. Even if we do not know the underlying cause of the pelvic floor dysfunction, we have effective treatments.
Pelvic Floor Dysfunction Diagnosis
In most cases, your family doctor or nurse practitioner will be able to diagnose pelvic floor dysfunction based on your symptoms and a simple pelvic examination. They can refer you directly to our physical therapists who specialize in treating pelvic floor disorders.
Occasionally you may need to see a specialist to confirm a diagnosis or rule out other conditions that may cause the symptoms.
Our diagnostic procedures include:
- Physical exam: A doctor, specialist, nurse practitioner or specially trained physical therapist can examine the pelvic floor muscles externally and internally. This simple and quick exam is often enough to diagnose muscle dysfunction.
- Muscle palpitation: Our specially trained physical therapists can assess the strength or weakness of your muscles by feeling and manipulating the muscles as you contract them. By adding resistance during contractions, we can determine the endurance of your muscles.
- Imaging: If we suspect a tear or other physical damage to your muscles, we may order an ultrasound or other imaging of the pelvic area to confirm the diagnosis.
Pelvic Floor Dysfunction Treatments
At UVM Medical Center, we have effective treatments for pelvic floor issues. You do not have to live with bladder or bowel incontinence, constipation or pain.
We can resolve or improve most pelvic floor issues through exercise and education. In some cases, surgery is the best option.
The most common and effective treatments combine specific exercises with education.
The muscles of the pelvic floor are voluntary, which means you can control them. We teach you exercises and techniques to help you control, strengthen or relax the muscles. More control means fewer problems. Our treatment options include:
- Education: It is important that you know what normal urination, bowel movement and sexual function feel like. When you know what you should expect, you will know when something is not right and can seek treatment.
- Biofeedback and visualization: We place sensors on your skin close to the pelvic floor muscles, or internally, either in the vagina or anus. When you contract or relax these muscles, a screen displays the muscle response. Because you can see the response, you learn how to control the muscles more effectively. Over time, you will be able to control them without the need for biofeedback.
- Kegel exercises: These are a series of exercises that strengthen pelvic floor muscles in both men and women. They involve contracting and relaxing the muscles and are easy to do at home. Read more about Kegel exercises.
- Coordination: We can teach you how to coordinate your breathing with your muscle contractions. Proper breathing can help alleviate painful bowel movements and reduce stress on your muscles.
- Electrical stimulation: If your muscles are very weak, we may begin rehabilitation and strengthening with electrical stimulation. We place electrodes on the skin close to the muscles and send weak electric signals to them. They contract in response to this electrical stimulation and become stronger over time.
- Relaxation techniques: If your pelvic floor muscles are too tight or contract inappropriately, we can teach you simple techniques to relax the muscles. We may use biofeedback to aid these techniques.
Your doctor may recommend surgery if an organ has moved into an incorrect position or if there are tears or other damage to parts of the reproductive, urinary or digestive systems. Learn more about surgery at UVM Medical Center.
Common surgical treatments include:
- Prolapse: This is when a part of the body moves into an incorrect position or slips into another cavity in the body. Weak pelvic floor muscles can cause the uterus, bladder or rectum to shift position. Surgery can anchor them back in the correct position.
- Damage: Sometimes we have to do surgery to repair tears or other damage to the rectum or anal sphincter caused in part by pelvic floor dysfunction.
Pelvic Floor Dysfunction at UVM Medical Center: How We Compare
We pride ourselves on the high quality of care we provide and are constantly benchmarking ourselves against our university hospital peers across the country. Read our Women's Health Quality Reports to find out more.
Incontinence, difficulty urinating or passing stools or pain in your groin area may be caused by many different conditions. Talk to a doctor if you experience any of these problems. Our team provides the full spectrum of care for these conditions. Some of the more common conditions include:
- Gynecological issues: Many of the symptoms of pelvic floor dysfunction may be caused by other conditions affecting a woman's reproductive system. Read more about women's health.
- Prostate problems: An enlarged prostate or other prostate issues can lead to frequent urination and discomfort. Learn more about our urology specialists.
- Chronic back or hip pain: Back and hip pain, especially if they contribute to bad posture, can affect the functioning of your pelvic floor muscles. Read more about orthopedic care at UVM Medical Center.
- Colorectal cancer: If you experience unusual or painful bowel movements, talk to your doctor. Learn more about the tests and screenings for colorectal cancer.
For Women's Health Professionals
Your patients will be in good hands at UVM Medical Center. Our physical therapists are certified in women's health, with specific training in treating pelvic floor dysfunction. A combination of physical therapy, exercises and education resolves or improves most cases of pelvic floor dysfunction.
You can refer your patients to receive nonsurgical treatment at our continence center without having to refer them to a specialist first. Contact us at 802-847-580.
If nonsurgical treatments do not resolve your patients' issues, we can refer them to the appropriate specialist.
We will keep you informed at every step of the process and consult with you regularly.