Pelvic Floor Disorders: Other FAQs

There are common questions that we can answer about all health topics, such as "What is it?" and "How many people are affected." Answers to these questions are found under Condition Information. Each health topic frequently has specific questions that pertain only to that topic. We have answered those in this section.

Can pelvic floor disorders be prevented?

Women can take steps to lower their risk of developing a pelvic floor problem¹:

• Maintain a healthy weight or lose weight (if overweight). Women who are overweight or obese are more likely to have pelvic floor problems.¹
• Maintain a high-fiber diet and drink plenty of fluids. This promotes normal bowel function and reduces risk of constipation.
• Do not smoke. Smoking can lead to chronic cough, which stresses the pelvic floor.
• Do Kegel exercises regularly to keep pelvic floor muscles toned. To be effective, Kegel exercises must be done correctly and routinely. A health care provider can help women who are unsure if they are using the correct muscles.²

Some pregnant women wonder if they can prevent pelvic floor problems by having a cesarean delivery rather than a vaginal delivery. The answer is not clear-cut. Women who never become pregnant may develop pelvic floor problems; some women who have multiple pregnancies do not. Undergoing a cesarean delivery presents other significant risks to consider.³

If you are pregnant and concerned about future pelvic floor problems, talk to your health care provider.

What can I do to reduce or ease symptoms?

Some things you can do to reduce symptoms include⁴:

• Avoiding foods and drinks that stimulate the bladder or bowel. Some foods and drinks that can stimulate the bladder and make you need to use the bathroom are caffeinated beverages, citrus fruits and drinks, artificial sweeteners, and alcoholic beverages. Avoiding caffeine and spicy foods may help reduce your chance of having loose stools.⁴
• Eating a high-fiber diet. Fiber helps your body to digest food and prevents constipation, making it unnecessary to strain to have a bowel movement. Fiber is found in fruits, vegetables, legumes (such as beans and lentils), and whole grains. Fiber supplements are also available.
• Losing weight. For women who are overweight, weight loss can reduce problems with bladder control.
• Bladder training. This involves using the bathroom on a set schedule to regain bladder control. A woman starts by using the bathroom every 60 or 90 minutes and slowly, over many months, increases that time with a goal of using the bathroom every 2.5 to 3 hours.

Should I see a doctor about my symptoms?

Yes. Do not wait until your symptoms are "really bad" to get help. Without treatment, symptoms can worsen and may affect your self-esteem, your ability to do your job well, your relationships, and many other aspects of daily living. In addition, buying products to deal with the symptoms of bladder or bowel control problems can be costly.^{5, 6}

Talk to your health care provider if you see or feel a bulge of tissue in your vagina or have other symptoms, including changes in bladder and bowel control.⁷ You may not need treatment right away. Your health care provider can suggest ways to reduce symptoms and monitor you for any changes that treatment can address.

What is "mesh" used for pelvic floor surgery and is it safe?

Surgical mesh is a medical device that is permanently implanted to provide strength and support to weakened or damaged tissue.⁸ With pelvic floor surgery, one of two types of mesh are used:

• Vaginal mesh repairs pelvic organ prolapse by reinforcing the vaginal wall.
• Mid-urethral sling treat stress urinary incontinence by providing support to the urethra.

The mesh can be implanted through the abdomen or the vagina.

Although both types of mesh have been approved by the U. S. Food and Drug Administration (FDA), the agency is investigating reports of problems associated with the vaginal mesh. For more information about the FDA’s investigations and about problems associated with vaginal mesh, visit the Urogynecologic Surgical Mesh Implants page of the FDA website.

1. Nygaard, I., Barber, M. D., Burgio, K. L., Kenton, K., Meikle, S., Schaffer, J., et al. (2008). Prevalence of symptomatic pelvic floor disorders in U.S. women. JAMA, 300, 1311-1316. [top]
2. National Kidney and Urologic Diseases Information Clearinghouse. (2012). Kegel exercise tips. Retrieved May 22, 2012, from http://kidney.niddk.nih.gov/kudiseases/pubs/bcw_ez/insertC.aspx [top]
3. Viswanathan, M., Visco, A. G., Hartmann, K., Wechter, M. E., Gartlehner, G., Wu, J. M., et al. (2006). Cesarean delivery on maternal request. Evidence report/technology assessment no. 133. Rockville, MD: Agency for Healthcare Research and Quality. [top]
4. American Urogynecologic Society. (2008). Fecal incontinence. Retrieved May 21, 2012, from http://www.voicesforpfd.org/p/cm/ld/fid=20 [top]
5. Landefeld, C. S., Bowers, B. J., Feld, A. D., Hartmann, K. E., Hoffman, E., Ingber, M. J., et al. (2008). National Institutes of Health state-of-the-science conference statement: Prevention of fecal and urinary incontinence in adults. Annals of Internal Medicine, 148, 449-458. [top]
6. American Urogynecologic Society. (n.d.). How to talk about PFD. Retrieved May 21, 2012, from http://www.voicesforpfd.org/p/cm/ld/fid=33 [top]
7. National Association for Continence. (2010). Seeking treatment. Accessed May 22, 2012, from http://www.nafc.org/seeking-treatment [top]
8. U.S. Food and Drug Administration. (2012). Urogynecologic surgical mesh implants. Accessed June 27, 2012, from http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/UroGynSurgicalMesh/default.htm?utm_campaign=Google2&utm_source=fdaSearch&utm_medium=website&utm_term=mesh&utm_content=3 [top]