When considering how the human body works, most people know how the brain functions or how the heart pumps to keep us alive. Every system of the body has a unique function and purpose. However, few people know about the pelvic floor region and the important role it plays in supporting our organs and maintaining their function.
The pelvic floor is made up of muscles, ligaments and fascia that support the pelvic organs namely the bladder, uterus/vagina and the large bowel (rectum), from front to back. There are three openings in the muscle through which these organs pass to the outside. Typically, the pelvic muscles stay contracted all the time and keep the organs properly supported and keep the openings closed. During the act of urination or bowel movement, the appropriate part of the pelvic floor relaxes to allow the contents (urine or stool) to come out of the body.
For the proper functioning of these muscles not only should they be intact but also the nerves supplying these muscles should be firing correctly. The pelvic floor muscles help maintain urinary and bowel control and prevent the organs from falling down and out of the orifices.
To understand the muscles and ligaments , let us consider the example of a boat at the dock. The water under the boat keeps it afloat and this is the pelvic muscle. The moorings keep the boat from drifting and these are the ligaments that hold or tether the pelvic organs in correct position on top of the pelvic muscles.
So, how does prolapse occur according to this example?
If the water starts drying up (pelvic muscle starts weakening), the boat will start sinking and put a lot of stress on the moorings (ligaments). Eventually as the pelvic muscle weakness continues, the ligaments will stretch, tear and break and the organs will fall downwards resulting in prolapse.
There are several factors that can negatively impact the pelvic floor muscles, ligaments and nerves. These include childbearing, chronic constipation, heavy lifting, smoking, menopause, prior surgery such as a hysterectomy. Genetics also plays an important role as it is not uncommon to see similar problems in siblings or mother-daughter.
When the pelvic floor is compromised, it could result in conditions such as urinary or bowel leakage, vaginal bulge or prolapse, rectal (large bowel) prolapse, constipation, feeling of incomplete bladder emptying etc.. Sexual function may also be affected.
At Advanced Urogynecology of Michigan P.C., we provide state-of-the-art, evidence-based and minimally invasive management options that focus on correcting the anatomy while taking into account the woman’s viewpoint, beliefs and her concerns. With this in mind, Dr Khandwala has pioneered several unique procedures that have not only improved the success rates but also enabled patients to get back to their normal life with minimal disruption, pain or side-effects. A few of these unique procedures are the in-office DISST procedure for urine leakage, Botox procedure for overactive bladder and hysteropexy ( save the uterus) procedure when the uterus is falling out.