Diagnosis and Treatment of Pelvic Floor Disorders: What's New and What to Do

Bharucha, Adil E.

doi:10.1053/j.gastro.2010.02.036

Cited by 55 publications

(46 citation statements)

References 68 publications

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“…5,6 However, defecography testing is not available in many institutions. Even where it is available, the expertise in recognizing pelvic floor dyssynergia is institution dependent.…”

mentioning

confidence: 99%

Measurements of Pelvic Floor Dyssynergia: Which Test Result Matters?

Bordeianou

Savitt

Dursun

2011

Diseases of the Colon &Amp; Rectum

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“…5,6 However, defecography testing is not available in many institutions. Even where it is available, the expertise in recognizing pelvic floor dyssynergia is institution dependent.…”

mentioning

confidence: 99%

Measurements of Pelvic Floor Dyssynergia: Which Test Result Matters?

Bordeianou

Savitt

Dursun

2011

Diseases of the Colon &Amp; Rectum

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“…2,33,34 Anorectal manometry and rectal balloon expulsion studies can help confirm the diagnosis of defecatory disorders by documenting inadequate intra-abdominal pressure during straining, incomplete evacuation of the rectum, and inadequate relaxation of anal canal pressures. 13 …”

Section: Assessment Of the Pelvic Floormentioning

confidence: 99%

“…This voluntary holding might be attributable to habit, lifestyle, occupation, or constant recruitment of muscles used to avoid bowel or bladder incontinence. 12,13 Conditions that result in dyspareunia (eg, atrophic vaginitis, vulvodynia) may trigger involuntary muscle contraction of the pelvic floor. This pattern is reinforced over time, particularly if intercourse is continued despite pain, and can potentially lead to persistent contraction of the pelvic floor and symptoms of nonrelaxing pelvic floor dysfunction.…”

Section: Potential Mechanismsmentioning

confidence: 99%

“…Retraining to increase (or decrease) rectal sensation is possible in patients with sensory disorders. 13 Women with deep dyspareunia associated with nonrelaxing pelvic floor dysfunction generally should be counseled to avoid penetrative sexual activity until pelvic floor muscles are rehabilitated. Referral to a sex therapist is also important, particularly if the dyspareunia is long-standing, associated with personal or relational distress, or unresponsive to initial physical therapy of the pelvic floor.…”

Section: Therapymentioning

confidence: 99%

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Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction

Faubion

Shuster

Bharucha

2012

Mayo Clinic Proceedings

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181

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Nonrelaxing pelvic floor dysfunction is not widely recognized. Unlike in pelvic floor disorders caused by relaxed muscles (eg, pelvic organ prolapse or urinary incontinence, both of which often are identified readily), women affected by nonrelaxing pelvic floor dysfunction may present with a broad range of nonspecific symptoms. These may include pain and problems with defecation, urination, and sexual function, which require relaxation and coordination of pelvic floor muscles and urinary and anal sphincters. These symptoms may adversely affect quality of life. Focus on the global symptom complex, rather than the individual symptoms, may help the clinician identify the condition. The primary care provider is in a position to intervene early, efficiently, and effectively by (1) recognizing the range of symptoms that might suggest nonrelaxing pelvic floor dysfunction, (2) educating patients, (3) performing selective tests when needed to confirm the diagnosis, and (4) providing early referral for physical therapy.

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“…Approximately 63 million people in North America meet Rome criteria for chronic constipation with prevalence estimates ranging from 2 to 27 % [1]. The causes of chronic constipation are often subdivided into two broad categories: delayed transit through the colon and impaired evacuation of the rectum [2]. Impaired rectal evacuation can either be mechanical or more commonly functional.…”

Section: Introductionmentioning

confidence: 99%