Pelvic Floor Dyssynergia: Types, Symptoms, Causes, Risk & Treatment

There are two main types of pelvic floor dyssynergia types: dyssynergic defecation and dyssynergic voiding. Dyssynergic defecation is a condition that affects the bowel movements. It occurs when the muscles in the pelvic floor fail to relax properly during defecation, leading to difficulty in passing stool. Dyssynergic voiding, on the other hand, affects the bladder function. It occurs when the muscles in the pelvic floor fail to relax during urination, leading to difficulty in emptying the bladder.

Pelvic Floor Dyssynergia (PFD) can cause a range of symptoms that can significantly impact an individual's quality of life. Common pelvic floor dyssynergia symptoms include:

1. Constipation: Individuals with PFD may have difficulty passing stools, leading to chronic constipation. This can occur because the muscles in the pelvic floor are not relaxing correctly during bowel movements, making it challenging to pass stools.
2. Difficulty Emptying the Bladder: PFD can cause difficulty emptying the bladder, leading to incomplete emptying, frequent urination, or urinary incontinence. This can occur because the muscles in the pelvic floor are not contracting or relaxing correctly during urination.
3. Pain During Intercourse: Women with PFD may experience pelvic floor pain during intercourse due to tension in the pelvic floor muscles. This tension can cause discomfort or pain during penetration, making sexual activity challenging or unpleasant.
4. Pain in the Pelvic Region: PFD can cause chronic pain in the pelvic region, including the lower abdomen, genitals, and rectum. This pelvic floor pain may be dull or sharp and may be constant or intermittent.
5. Rectal Pain or Bleeding: PFD can cause pelvic floor pain or bleeding during bowel movements, particularly if the stools are hard or large. This can occur because the muscles in the pelvic floor are not relaxing correctly, causing straining during bowel movements.
6. Anxiety or Depression: Living with PFD can be challenging and stressful, leading to anxiety or depression in some individuals. The condition can affect an individual's ability to participate in daily activities, leading to feelings of frustration or isolation.
7. Urinary Tract Infections: PFD can increase the risk of urinary tract infections due to incomplete emptying of the bladder. Bacteria can accumulate in the bladder, leading to infections and discomfort.

If you experience any of these symptoms, it's important to speak with a healthcare provider to determine if PFD is the underlying cause. Early diagnosis and treatment can help manage symptoms and prevent complications.

Pelvic Floor Dyssynergia (PFD) is a condition that occurs when the muscles in the pelvic floor do not relax or contract inappropriately during bowel movements or urination. Several factors can contribute to the development of this condition.

1. Muscular Dysfunction: PFD can occur when the muscles in the pelvic floor are weak, tight, or spastic. Weakness can occur due to trauma or injury to the pelvic area, while tightness or spasticity can result from chronic tension in the muscles.
2. Nerve Damage: Damage to the nerves that control the pelvic floor muscles can also contribute to the development of PFD. Conditions that can cause nerve damage include diabetes, multiple sclerosis, and spinal cord injuries.
3. Chronic Constipation or Diarrhoea: Chronic constipation or diarrhoea can cause the muscles in the pelvic floor to become weak or strained over time. This can lead to PFD as the muscles struggle to control bowel movements.
4. Pelvic Surgery: Surgery in the pelvic region can cause damage to the muscles and nerves in the pelvic floor, leading to PFD.
5. Childbirth: Women who have given birth are at increased risk of developing PFD due to the trauma that occurs during delivery. The muscles in the pelvic floor can become weak or damaged, leading to difficulty controlling bowel movements or urination.
6. Psychological Factors: Stress, anxiety, and other psychological factors can contribute to the development of PFD. These factors can lead to tension in the muscles in the pelvic floor, making it difficult to relax or contract them properly.
7. Genetic Factors: Some research suggests that genetic factors may play a role in the development of PFD. However, more research is needed to fully understand this link.

In many cases, PFD is caused by a combination of these factors. It's essential to work with a healthcare provider to identify the underlying cause of PFD to develop an effective treatment plan. Treatment may include medication, physical therapy, and lifestyle changes to manage symptoms and prevent complications.

While anyone can develop Pelvic Floor Dyssynergia (PFD), there are several factors that can increase an individual's risk of developing this condition. Some of the risk factors for PFD include:

1. Gender: Women are at higher risk of developing PFD than men. This is because the pelvic floor muscles are essential for childbirth, and the trauma that occurs during delivery can damage the muscles and nerves in the pelvic region.
2. Age: PFD is more common in older adults. As individuals age, the muscles in the pelvic floor can weaken, leading to difficulty controlling bowel movements or urination.
3. Chronic Constipation or Diarrhoea: Chronic constipation or diarrhoea can put strain on the pelvic floor muscles, leading to weakness or damage over time. This can increase the risk of developing PFD.
4. Pelvic Surgery: Surgery in the pelvic region can damage the muscles and nerves in the pelvic floor, increasing the risk of PFD.
5. Neurological Conditions: Conditions that affect the nerves, such as multiple sclerosis or spinal cord injuries, can increase the risk of developing PFD.
6. Psychological Factors: Stress, anxiety, and other psychological factors can cause tension in the muscles in the pelvic floor, making it difficult to relax or contract them properly. This can increase the risk of developing PFD.
7. Genetics: Some research suggests that genetics may play a role in the development of PFD. If a close family member has been diagnosed with PFD, you may be at higher risk of developing the condition.
8. Obesity: Being overweight or obese can put additional strain on the pelvic floor muscles, leading to weakness or damage over time. This can increase the risk of developing PFD.

It's important to note that having one or more risk factors for PFD does not necessarily mean that an individual will develop the condition. However, if you have any of these risk factors, it's essential to speak with a healthcare provider about ways to reduce your risk of developing PFD and manage any symptoms you may experience.

Preventing PFD involves adopting a healthy lifestyle and making some lifestyle changes. Some of the preventive measures include:

1. Eating a fibre-rich diet
2. Drinking plenty of water
3. Regular exercise to strengthen the pelvic floor muscles
4. Avoiding heavy lifting
5. Maintaining a healthy weight
6. Proper management of chronic conditions like constipation or diarrhoea

Pelvic floor dysfunction diagnosis involves a comprehensive evaluation of the patient's medical history and physical examination. The doctor may perform a digital rectal exam or a pelvic exam to assess the muscle tone and strength. Other diagnostic tests include anorectal manometry, defecography, or urodynamic testing.

PFD has four stages, ranging from mild to severe. The stages include:

• Stage 1: Mild dysfunction, with only occasional symptoms.
• Stage 2: Moderate dysfunction, with symptoms that occur more frequently.
• Stage 3: Severe dysfunction, with constant symptoms and difficulty in performing daily activities.
• Stage 4: Total dysfunction, with complete inability to control bowel or bladder movements.

Pelvic Floor Dyssynergia (PFD) can be challenging to treat, but several treatment options can help manage symptoms and improve an individual's quality of life. The type of pelvic floor dyssynergia treatment recommended will depend on the severity of the condition, the underlying cause, and the individual's overall health. Some pelvic floor dyssynergia treatment and management options for PFD include:

1. Physical Therapy: Pelvic floor physical therapy involves exercises and techniques to strengthen or relax the muscles in the pelvic floor. This can help improve bowel or bladder control and reduce pain or discomfort.
2. Biofeedback: Biofeedback uses sensors to monitor the muscles in the pelvic floor and provide visual or auditory feedback on muscle activity. This can help individuals learn to relax or contract the muscles more effectively.
3. Medications: Medications, such as laxatives or muscle relaxants, may be prescribed to help manage symptoms of PFD. Antidepressants may also be prescribed to manage pain and improve mood.
4. Dietary Changes: Changes to the diet, such as increasing fibre intake or avoiding trigger foods, can help manage symptoms of constipation or diarrhoea.
5. Behavioural Therapy: Behavioural therapy, such as cognitive-behavioural therapy (CBT), can help individuals learn coping strategies to manage the stress or anxiety that can contribute to PFD.
6. Surgery: In rare cases, surgery may be recommended to repair damage to the muscles or nerves in the pelvic floor.
7. Pelvic Floor Massage: Pelvic floor massage can help relieve tension and reduce pain in the muscles of the pelvic floor. A trained therapist can perform the massage manually or using a device.
8. Acupuncture: Acupuncture involves inserting thin needles into specific points on the body to relieve pain or tension. Some individuals with PFD may find this therapy helpful in managing their symptoms.

It's essential to work with a healthcare provider to determine the best treatment plan for your individual needs. In addition to treatment, managing PFD may involve lifestyle changes, such as managing stress, staying hydrated, and maintaining a healthy weight. With proper treatment and management, many individuals with PFD can improve their symptoms and maintain a good quality of life.

The road to recovery from PFD varies depending on the severity of the condition and the effectiveness of treatment. It may take several months to a year to fully recover from PFD, and in some cases, ongoing treatment or management may be necessary.

Aftercare for PFD involves ongoing self-care measures to prevent symptoms from recurring. This may include following a healthy diet, staying hydrated, engaging in regular physical activity, and practicing relaxation techniques. Regular follow-up appointments with a healthcare provider may also be necessary to monitor symptoms and adjust treatment as needed.

1. Can PFD be cured?
   PFD is a chronic condition, but it can be managed effectively with a combination of medication, physical therapy, and lifestyle changes.
2. What are the long-term effects of PFD?
   Untreated PFD can lead to chronic constipation, faecal incontinence, urinary tract infections, and other complications.
3. Can PFD affect men?
   Yes, PFD can affect both men and women, but it is more common in women due to pregnancy and childbirth.
4. Can PFD be prevented?
   Yes, PFD can be prevented by adopting a healthy lifestyle, maintaining a healthy weight, and managing chronic conditions like constipation or diarrhoea.
5. What is the most effective treatment for PFD?
   The most effective treatment for PFD depends on the severity and underlying cause of the condition. A combination of medication, physical therapy, and lifestyle changes is often recommended.
6. Can PFD cause sexual dysfunction?
   Yes, PFD can cause sexual dysfunction, including pain during intercourse or difficulty achieving orgasm.
7. How common is PFD?
   PFD is a common condition that affects millions of people worldwide.
8. What is the difference between PFD and pelvic organ prolapse?
   PFD is a condition that affects the muscles in the pelvic floor, while pelvic organ prolapse is a condition where one or more pelvic organs drop or bulge into the vaginal wall or anus.
9. How is PFD diagnosed?
   PFD is diagnosed through a comprehensive evaluation of medical history and physical examination, including anorectal manometry, defecography, or urodynamic testing.
10. Is surgery necessary for PFD?
    Surgery is typically considered a last resort for severe cases of PFD, and the type of surgery will depend on the specific symptoms and underlying cause of PFD.