Once you become a mother, your life is never the same. From the first gurgling laugh to the late-night feedings, it can be a wonderful, if stressful, time. But does becoming a mother mean your body will never be the same?

Most women can accept a few stretch marks, but pelvic floor disorders such as pelvic organ prolapse - falling of the bladder, bowel, uterus, and/or vagina; and incontinence - bladder and bowel control problems, can take away from your lifestyle and even your love life. In the past, these issues might have been ignored or discussed in hushed tones with friends. Today, many women and doctors are learning that these are common problems for women of all ages, and that there are doctors with advanced training, urogynecologists, who can help with these problems.

A urogynecologist is a physician who has completed a four- or six-year residency in general obstetrics and gynecology or urology, and one to three years of additional specialized fellowship training in the care of women with pelvic floor disorders.  The pelvic floor includes the muscles, ligaments, nerves and other tissues that help support and control the uterus, vagina, bladder and rectum. Whereas childbirth is a significant risk factor for pelvic floor disorders, women may experience prolapse and incontinence as a result of chronic straining, for example repeated heavy lifting, chronic constipation and chronic coughing.  Whether a woman has had children or not, injury to the pelvic floor and loss of pelvic support combined with the increased pressure from chronic straining results in prolapse and incontinence.

According to UAMS physicians, it is important that women and their doctors realize pelvic floor disorders are common and happen to women in all stages of life. They aren’t alone with their problem and there are health care professionals who can help them with these problems.

The division of Urogynecology and Reconstructive Pelvic Surgery at UAMS is dedicated to the comprehensive diagnosis and treatment of pelvic organ prolapse, bladder and bowel incontinence, urinary frequency, difficulty with bladder emptying, constipation, blood in the urine, recurrent bladder and kidney infections, connections between the bladder or rectum and vagina (fistulae) and pelvic floor nerve damage.

UAMS physicians report that the pelvic floor should be looked at as a whole. If there is a problem in one area, it could well be tied to an issue in another.  For example, many women with prolapse have incontinence and vice-versa.  Many of these women also have constipation and weakness of the pelvic floor.

A thorough review of the symptoms and specialized tests can determine the extent of the problem and help decide if the best course of action is physical therapy, medication, surgery or a combination of these treatments. Because prolapse, incontinence and other pelvic floor disorders involve nerve and muscle damage, it is important to determine where the damage is located. 

Pelvic floor physical therapy is an important part of the treatment for most women with pelvic floor disorders.  According to UAMS physicians, most women and their health care providers are not aware pelvic floor physical therapy exists.  In many cases women go to therapy once a week for four to eight weeks to teach them what they can do to improve the problem.  UAMS experts report that it’s more than just doing Kegel exercises.

Most patients with pelvic floor disorders can have their evaluation and treatment in the division of Urogynecology at UAMS.  Certain patients with complicated problems may need evaluation by other specialists.  By working closely with other specialists at UAMS, he added, women often can have their pelvic floor health problems addressed in one setting.

After childbirth, the last thing most mothers want to do is go back into the hospital for surgery. While many women may think surgery is the only answer to their problem, in many cases, physical therapy and/or medications may provide the help they need without taking them away from their families.

Physical therapy or medications can be easier than a surgery which might keep a woman from caring for her family or returning to work for a few weeks or months.  If a woman needs more than physical therapy or other non-surgical treatment, it still doesn’t mean extensive surgery is the only option. Some procedures can be done as an outpatient or short stay with less time away from family and work.

UAMS physicians caution that not every problem has a complete cure since the causes may be complex.  However, most patients can be improved and will see an increase in their quality of life. 

You should talk with your primary care physician or gynecologist if you are having pelvic floor problems.  If you or your doctor would like to schedule an appointment at UAMS, call (501) 296-1745 extension 1227 or toll-free to (866) UAMS-DOC.