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Women's Health Feature

Pelvic Floor Dysfunction

Special Guest Author
Doctor David Ende, Urologist
St Vincents Clinic and Blacktown Hospital

For more about Dr David Ende see endeurology.com.au (contact details)
 


What is Pelvic Floor Dysfunction?

Pelvic floor dysfunction and its consequences affects many Australian families.

As women age, the pelvic floor muscles and ligaments become weak, which causes the normal continence mechanisms to fail. It may start with urine leakage during exercise or exertion, or even with coughing or sneezing. A weakened pelvic floor can also be associated with having to pass urine frequently during the day and night. In more severe cases, the frequency can be associated with urgency and many women are unable to hold on until they can find a toilet.

Common Causes

Many women have multiple factors all acting to cause pelvic floor problems.

Ageing:

When patients are elderly, it can be difficult to move quickly and even though their symptoms may not be severe, limited mobility and in some cases dependence on carers mean that leakage is more likely.

Decreased Estrogen:

Age leads to a decrease in estrogen levels, which weakens the ligaments of the pelvic floor. 

Surgery:

Women who have had pelvic floor surgery, such as a hysterectomy, may have increased risk of pelvic floor abnormalities as the pelvic ligaments will be damaged during surgery.

Childbirth:

Childbirth via the vaginal canal also stretches and damages the ligaments, causing weakness and pelvic floor dysfunction.

The Impact

Women with these issues are often forced to wear incontinence pads or liners in their underwear to avoid the inconvenience of wet clothes. Many women are able to take care of their own needs, but carers and family members are often needed to help elderly or frail women when incontinence occurs. This may include not only changing into dry underwear or other clothes, but also often changing bed linen. 

Even more significant is the potential for physical harm or injury associated with pelvic floor dysfunction. Elderly and frail women who wake multiple times at night to avoid incontinence are at risk of falls and hip fractures which is unfortunately a common event. 

 

Image copyright Victorian Continence Resource Centre from their booklet "Reclaim Your Core - Exercises To Help Get You Started" available for purchase here >


You're Not Alone

pelvic floor dysfunction clearly impacts millions of women and their families every day in Australia.

- Dr. David Ende -

According to a report by Deloitte Access Economics, 21% of the community population have urinary or faecal incontinence, or both. The prevalence rate is much higher in the Residential Aged Care (RAC) population where 70.9% or almost 129,000 residents have urinary or faecal incontinence (or both). Pelvic floor dysfunction impacts millions of women and their families every day in Australia. Education about potential surgical and non-surgical therapy is critical, as is the imperative for women to have access to continence aids and other services.