Pelvic Floor Dysfunction

New Patient Appointment or 214-645-8300

Pelvic floor dysfunction affects millions of women and men of all ages, often compromising their quality of life. At UT Southwestern Medical Center, our multidisciplinary team offers a full range of state-of-the-art diagnostic techniques, as well as nonsurgical, surgical, and robotic treatment options, for pelvic floor dysfunction.

We also have comprehensive rehabilitation programs to treat pelvic-related conditions in a thorough and patient-centered manner.

Restoring Quality of Life Through Effective Treatment

Chronic pelvic pain and its associated symptoms can be truly disabling. Urinary incontinence, chronic constipation, tailbone pain, pain with intercourse, and other types of pelvic dysfunction can severely limit people’s ability to live life the way they want.

It’s possible to significantly minimize symptoms and restore quality of life with proper treatment of pelvic musculoskeletal dysfunction, even if pelvic problems are caused by a disease such as endometriosis or nonbacterial prostatitis.

Our team of specialists takes a multidisciplinary approach to diagnosing and treating pelvic floor dysfunction, working together closely to facilitate care and provide the best possible outcomes. Among our specialists are nationally recognized experts in the fields of:

Our collaboration with subspecialists from other fields ensures that patients have some of the best medical minds working for them, from diagnosis through every step of treatment.

Conditions

Several factors can contribute to pelvic floor dysfunction, including aging, pregnancy, hormonal changes, and injuries.

We treat a broad range of pelvic floor conditions, such as:

Urinary and fecal incontinence or urgency
Pelvic organ prolapse and mesh complications
Pelvic pain
Overactive bladder
Constipation
Sexual dysfunction
Coccydynia (tailbone pain)
Dyspareunia (pain with intercourse)
Dysuria (pain with urination)
Interstitial cystitis (bladder pain)
Nocturia (nighttime urination)
Chronic low back, hip, abdominal, rectal, groin, buttock, vaginal, or testicular pain
Piriformis syndrome
Sacroiliac joint pain or dysfunction
Chronic nonbacterial prostatitis

Diagnosing Pelvic Floor Dysfunction

Patient care for pelvic floor dysfunction begins with a comprehensive diagnostic evaluation that includes a history, a physical examination, and a thorough discussion of symptoms.

Our physicians might do a postural and structural assessment, a neurological evaluation, and musculoskeletal and neuromuscular examinations. We also offer electrodiagnostic and radiologic evaluations, if necessary, to confirm the diagnosis.

Treatments for Pelvic Floor Dysfunction

We offer nonsurgical, surgical, and robotic treatment options, so patients have access to a broad range of leading-edge care. Among the pelvic floor treatments we offer are:

Nonsurgical Options

Biofeedback
Botox injections
Counseling
Electrical stimulation
Medications
Percutaneous tibial nerve stimulation (PTNS)
Physical therapy
Pessary therapy (vaginal support device)

Surgical Options

Vaginal, abdominal, laparoscopic, and robotic repair of pelvic structures
Sling procedures
Periurethral and injectable agents
Sacral neuromodulation (a nerve-stimulating device that helps control overactive bladder, fecal incontinence, and urinary retention)
Latest robotic technology (dual-console da Vinci robot)

Pelvic Floor Rehabilitation

Pelvic rehabilitation is an effective method for treating pelvic pain, pelvic muscle dysfunction, and back or pelvic pain and associated disorders resulting from pregnancy and the postpartum period. Our goal is to reduce pain, increase function, and restore quality of life.

Treatments are administered by an experienced and skilled team of physical medicine and rehabilitation physicians who specialize in treating disorders of the muscle, bone, and nerves. They’re joined by a staff of certified, specially trained therapists who are experts at working with patients who are suffering from pelvic pain and dysfunction.

Pelvic floor rehabilitation treatments we offer include:

Biofeedback
Bladder retraining
Bowel retraining
Connective tissue manipulation
Electrical stimulation
Home exercise programs
Interventional pain procedures
Manual therapy
Medication management
Myofascial release
Neural mobilization
Neuromuscular reeducation
Patient education
Physical therapy (both general and specialized for pelvic floor muscle problems)
Psychology referral
Strengthening/alignment/stabilization exercises
Support devices and orthotics

Pregnancy and Postpartum Pelvic Issues

Pregnant women who suffer severe low back or pelvic pain can have trouble working, sleeping, and taking care of their families. Also, after giving birth there can be a host of new physical problems, such as urinary incontinence, pain with sexual intercourse, pelvic muscle injuries, and nerve injuries.

Our Peripartum Evaluation and Treatment Around Labor and Delivery (PETAL) program is dedicated to helping women achieve and maintain pelvic wellness during pregnancy and after delivery.

Proper treatment can alleviate these conditions and help patients enjoy their pregnancy and life with their new babies.

Pregnancy and postpartum conditions we treat include:

Back or pelvic pain caused by stress, injury, or the demands put on the pelvic floor by pregnancy and delivery
Sacroiliac joint dysfunction in pregnancy or postpartum
Pubic symphysis pain or dysfunction
Urinary incontinence or other urinary problems during pregnancy or following delivery – often the result of an injury to the bladder neck and/or weakness in the pelvic floor muscles
Urinary retention following delivery, which can happen more often if the mom has had a catheter or an epidural
Fecal/bowel incontinence following delivery, which can result from a bad tear or injury during childbirth or underlying inflammatory bowel disease
Constipation
Painful sexual intercourse (dyspareunia) following delivery, which can be due to injury to the tissues and pelvic muscles during delivery or from dryness caused by fluctuating hormones and/or breastfeeding
Pelvic muscle injuries during delivery
Pelvic organ prolapse
Nerve injuries during pregnancy or delivery
Neck or back pain with childcare/breastfeeding activities
Abdominal and scar pain after cesarean section
Hip, leg, or groin pain or weakness during pregnancy or following delivery

Clinical Trials

Research being performed at UT Southwestern shows promising treatments might reduce the recurrence of pelvic floor dysfunction symptoms. In addition, an ongoing clinical trial led by UT Southwestern’s David Rahn, M.D., is examining the effectiveness of vaginal estrogen – a supplemental, nonsurgical therapy – to reduce symptom recurrence and spare more women the risks and financial implications of revisional surgeries. We’re also studying how vaginal estrogen may impact other pelvic floor dysfunction such as overactive bladder, urinary incontinence, sexual dysfunction and painful intercourse, and postoperative bladder infections.