Thirty million American women suffer from symptoms of vaginal relaxation and urinary stress incontinence. Many women have difficulty controlling their urine in certain situations or notice changes in their bowel habits. These two symptoms may be related to a common set of problems resulting from childbirth, aging or a combination of both. Grouped together these problems are referred to as pelvic floor relaxation.

Appropriate diagnosis and treatment can often restore patients to a life free from the aggravations and discomforts associated with pelvic floor relaxation. Many women suffer unnecessarily from conditions involving pelvic relaxation. If you have any of these symptoms described in this section, contact us at 203-869-8360 or email us at: drjacobson@lvrdoc.com.

Our goal is to acquaint you with the various forms of pelvic floor relaxation as well as their causes, symptoms, and treatment. The pelvic organs include the vagina, uterus, bladder, and rectum. These organs are held in position by three types of supports: 1) muscles, 2) sheets of connective tissue called fascia and 3) ligaments. When these supports become damaged for various reasons, one or more of the pelvic organs may sag and, occasionally, even protrude outside the vagina. These are called pelvic support defects.

During childbirth, as the baby passes through the birth canal, the muscles, fascia, and ligaments separate and may be weakened. This weakening gradually worsens and, in later years, may cause the pelvic organs to drop from their normal positions.

Occasionally, this weakening of the muscles and tissue may occur in women who never have had children. In these women, the cause may be:

• Inherited weakness of the supporting tissues

• Unusual strain placed on the supporting tissues by a chronic cough

• Unusual increases in abdominal pressure due to constipation

• Obesity

The general symptoms associated with pelvic floor relaxation depend on which organs are affected. Often there is a feeling of heaviness or fullness. Small or moderate amounts of urine may be lost with normal physical activities such as laughing, coughing, walking, running or during sex. In more advanced cases a mass may actually protrude from the vaginal opening. Based on the organ or organs involved, pelvic support defects can be defined more specifically as:

• Cystocele

• Urethrocele

• Rectocele

A cystocele occurs when the bladder falls or descends from its normal position. The most common symptom associated with cystocele is a bulge or difficulty in completely emptying the bladder. This can be associated with bladder infections. Large cystoceles can cause the bladder to overfill and allow small amounts of urine to leak. Leakage is most common during activities such as walking, straining down or with bouts of coughing.

A urethrocele usually occurs in conjunction with a cystocele. Both of these conditions result in, among other things, involuntary loss of urine, particularly when there is increased pressure in the abdomen, as well as post void dribbling. Urethroceles can be a consequence of childbirth.

A rectocele usually occurs as a result of injuries sustained during childbirth. With a weakened or bulging rectum, bowel movements become more difficult.

In addition, many women are unable to retain tampons or experience the passage of air from the vagina due to pelvic floor relaxation.

For all practical purposes, definitive treatment is surgical correction of the specific pelvic support defects.