Recognition and management of nonrelaxing pelvic floor dysfunction.
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.
Women's Health Clinic, Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA. faubion.stephanie@mayo.edu
Stephanie S
SS
Faubion
Lynne T
LT
Shuster
Adil E
AE
Bharucha
D000367:Age Factors; D005242:Fecal Incontinence / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D008487:Medical History Taking; D017773:Pelvic Floor / Q000503:physiopathology*; D059952:Pelvic Floor Disorders / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D014549:Urinary Incontinence / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D016387:Women's Health