Sexual function is very important in everyday life. The female sexual function depends from the age and is closely related to menopause. Sexual dysfunctions have a high prevalence also in premenopausal woman, making their life very stressful. Female sexual disorders have often been associated with pelvic floor disorders.
What Is the Pelvic Floor?
The pelvic floor normally consists of muscles, ligaments and connective tissue. The main role of the pelvic floor is to support the organs located in the pelvis, like the bladder, uterus and rectum. Pelvic floor not only prevents these organs from prolapsing, but also plays a big role in maintaining their normal function by keeping them in their anatomical positions. Any problem or disorders of the pelvic floor components will lead to female sexual disorders. These conditions are not life threatening. However, pelvic floor disorders affect the quality of life.
Risk Factors for Pelvic Floor Disorders
There are different possible risk factors and conditions that affect the integrity of the pelvic floor. Some of these risk factors include:
- Pregnancy
- Childbirth
- Aging
- Menopause
- Genetic factors
- Trauma
- Race
- Smoking
- Pelvic surgeries
- Obesity
- Chronic coughing, etc.
Disorders with the Pelvic Floor Lead To:
- Pelvic Organ Prolapse – occurs in cases when the pelvic floor fails to support the pelvic organs. This leads to pelvic organ prolapse, including the bladder, urethra, vagina, cervix, uterus and bowls. The above mentioned organs can drop out through the vaginal opening and may be even seen. Vaginal childbirth is often determined as the risk factor for pelvic organ prolapse. Pelvic organ prolapse is classified according to the wall or compartment that is prolapsed. According to this we do have anterior wall prolapse, defined as cystocele, posterior wall prolapse, defined as rectocele. Cases when there is a bowel herniation at the vaginal apex are known as enterocele. There is also a possible prolapse of the cervix and the uterus after a hysterectomy. In these cases it is called apical prolapse.
- Urinary Incontinence – is the involuntary loss of urine. There are three main types of urinary incontinence:
- Stress urinary incontinence
- Urge urinary incontinence
- Mixed incontinence – where both of the above mentioned types of urine incontinence are present
- Abdominal Pain
- Rectal bleeding
The cause of the incontinence is different for each subtype and involves difficulties with the innervation and musculature of the pelvic floor. Pregnancy and childbirth are strongly associated with stress urinary incontinence and the urge to urinate.
- Anal incontinence – results in flatulus incontinence and loss of formed or loose stool. It usually occurs due to pelvic floor problems after pregnancy and childbirth.
The Goals of Pelvic Floor Reconstruction
It has been estimated that about 35% of women will develop some form of pelvic floor disorders during their life. Pelvic floor disorders lead to discomfort and pelvic pain, difficulties urinating, frequent need to urinate, urge to urinate, difficulties holding a full bladder, difficulties with bowel movements, etc.
The goal of pelvic floor reconstruction surgeries is to restore the normal structure and function of the female pelvic organs. By restoring the pelvic floor, the sexual function is also restored.
