the vaginal canal or outside the vagina, are primarily
caused by pregnancy and childbirth. Weakness
in the pelvic muscles and connective tissue also
happens over time, so aging is a factor, as are lack of
exercise, obesity, chronic constipation, and smoking.
Q: How are PFDs treated?
A: The foundational, nonsurgical treatment is
physical therapy, and frequently it may be the only
treatment required. A certified physical therapist can
offer training and exercise options, including Kegels,
which can be done at home to strengthen the pelvic
muscles. Some patients use a pessary, an insertable
device that sits in the vagina and provides support
to the bladder and other organs. There are also
surgical options where weakened tissue is repaired
and reinforced; sometimes the repair is augmented
with biologic material or mesh. Primarily an outpatient
procedure, the surgery is minimally invasive.
Patients are encouraged to resume nonstrenuous
activity immediately after surgery, allowing them to
return quickly to normal daily functions.
Q: Are there ANY misconceptions
A: The main misconception is that PFDs are an
inevitable fact of aging. Having surgery can offer
cost savings, due to the expense of years’ worth
of incontinence supplies. Finally, given how these
disorders can impact activities in daily life, including
intimacy, women experiencing symptoms should not
be afraid to speak up and have a candid conversation
with their gynecologist or primary care provider.
Silence—and resignation—should not be options.
→ Physical therapy can help women with PFDs.
View a video featuring Kate Divine, PT, one
of Valley Health’s therapists specializing in
women’s health, at valleyhealthlink.com/PFD.
Support, not silence: help
for pelvic floor disorders
Some women regard their struggle with pelvic floor
disorders (PFDs), including urinary incontinence and
vaginal prolapse, with resignation and embarrassment.
Many in this “sisterhood of silence” are hesitant to talk
about their condition with their physician. “Women
need to know that there are viable treatment options,”
says urogynecologist George F. Craft II, MD. “Providers
in women’s health work hard to challenge the notion
that ‘it’s just something I have to suffer with,’ given how
incontinence and prolapse impact quality of life for an
estimated one-third of women over 40.” Dr. Craft, an
advocate for “support, not silence,” answers questions
about this frequently taboo topic.
Q: What causes pelvic floor disorders?
A: Urinary incontinence, the involuntary leakage of urine, and prolapse,
when the upper portion of the vagina and other pelvic organs drop into
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