Pelvic Floor Health

Risk Factors

There are many factors that can contribute to the development of pelvic floor conditions. Some are preventable, many are reversible but many are beyond your control. Pelvic floor conditions affect people of all ages. Although more common in those who have given birth vaginally, pelvic floor conditions also can affect people who have never been pregnant.

Other contributing factors:

• Chronic (long-term) constipation
• Chronic cough
• Excessive weight
• Genetics
• Repetitive heavy lifting
• Weakening of the connective tissues over time

Symptoms

There are several common symptoms of pelvic floor conditions:

• Difficulty emptying bladder or having a bowel movement
• Feeling or seeing tissue coming out of the vagina
• Feelings of heaviness, sagging, bulging or even dropping in the pelvic area
• Problems controlling bladder and bowels that include urine, bowel gas or stool leakage
• Problems controlling urinary frequency

Whatever your symptoms are, we encourage you to see a specialist who is trained to diagnose and treat these types of conditions. There are effective non-surgical and surgical treatment options available to improve your quality of life. To learn more, start by speaking with your gynecologist or primary care provider about seeing a Urogynecologist.

Our URPS specialists will spend time with you to understand your symptoms, find the underlying cause and then recommend a customized treatment plan.

For new patients, please call 617-667-4100 to schedule an appointment. If you are already a patient, please use the patient portal to request your next appointment.

Appointment requests are for non-urgent concerns. If you have an urgent medical concern, call 911.

Preparing for Your First Visit

Prior to your first visit to the Pelvic Health Program at BIDMC, you’ll receive an information packet that contains several important forms. Alternately, you can download our urogynecology new patient questionnaire.

Please fill out these forms and bring them with you to your first appointment. This will help us better understand your symptoms and make sure that your first visit is as productive as possible.

Also bring a copy of pertinent medical records. This includes all test results and operative reports (if you previously received care for any pelvic floor disorders). If you have previous records at other hospitals or medical offices and would like us to request them, please fill out a record release form and fax or mail it to us. Please note it can take a few weeks for medical records to reach our office.

During Your First Visit

Expect your first appointment to last up to an hour. During the visit, we will review your medical history and perform a thorough pelvic exam. Depending on the nature of your condition, we also may use a catheter (a thin, flexible tube) to get a urine specimen. If you have pelvic organ prolapse, you may be asked to stand for the examination.

After the exam, your doctor will explain your condition(s) and discuss recommendations.

After Your First Visit

Your doctor may suggest specialized testing or appointments with other specialists in the Pelvic Health Program to help diagnose your condition. We’ll work with you to schedule other visits at a time convenient for you. Our team makes every attempt to coordinate multiple appointments for the same day to limit your trips to the hospital.

Diagnosis and treatment of your condition is a team effort, involving you and the specialists in our clinic. Feel free to ask any questions during your visit. It is important to us that you understand the issue and your treatment plan.

We offer the most up-to-date therapeutic options for pelvic floor disorders, from conservative to surgical. Our team provides you with a personalized treatment plan that focuses on relieving your symptoms as quickly as possible. We also provide ongoing support and long-term care through our collaborative team approach.

Depending on your needs, your treatment may include some combination of these steps:

• Lifestyle modifications
• Exercises to strengthen pelvic floor muscles
• Medications
• Surgical treatment 
  • Colon and rectal surgery
  • Interventional gynecologic procedures
  • Minimally invasive gynecologic surgery
  • Robotic surgery
  • Urogynecologic surgery

Lifestyle Changes

Some cases of pelvic organ disorder are unavoidable. However, there are steps you can take that may help manage your current symptoms or prevent the condition from worsening. 

• Strengthen your pelvic floor muscles by doing regular Kegel exercises. 
• Stay at a healthy weight through diet and exercise. 
• Resolve constipation issues since excessive straining can weaken the pelvic muscles. Speak with your doctor about constipation, making dietary changes and increasing the amount of fiber in your diet. 
• Quit smoking. Smoking may cause a chronic cough that weakens your pelvic muscles. Smoking also weakens the tissues that support your pelvic organs. If you smoke, ask your physician about strategies to quit. 
• Limit heavy lifting. Speak with your specialist about lifting techniques that won't put as much stress on your pelvic muscles.

Advanced Diagnostic Testing

To provide the best possible treatment options, we need to understand the cause of your symptoms. We provide state-of-the-art diagnostic services to evaluate conditions related to your pelvic floor health. We can perform certain tests right in the doctor's office. For more advanced testing, we coordinate your care with other BIDMC specialists.