Anybody who has borne a baby becomes aware of their pelvic floor… that structure at the ground level of the pelvis through which the baby must force its way.
For those among us whose pelvic floor functions normally, it seems irrelevant among the distractions of daily life. But to those of us whose pelvic floor is failing us (and we are many!) it can change our pattern and quality of life every day.
So, what is the pelvic floor? A great way to describe it is a funnel of muscles and tendons, attached by its brim to the inside of the pelvic bones. The anus is the spout of the funnel, and the urethra and the vagina open through the front wall. The pelvic floor is really a complex arrangement of muscles and tendons with a very rich nerve supply and a clever co-ordination system that allows it to respond appropriately to everything from sneezing or coughing to pooing and peeing.
The pelvic floor has a very important job holding in the bowel and the pelvic organs and letting out (under control) other things like urine and faeces. When the pelvic floor doesn’t work properly one of two things happen: either things fall out that shouldn’t, or things that should come out don’t…. or both!
Childbirth is by far the most common thing to cause damage to the pelvic floor. For the baby to pass through the vagina, the front of the pelvic floor must open widely. This process stretches the nerves of the pelvic floor muscles (including the anal sphincter and the bladder sphincter) so that the muscles are weaker. Forceps delivery and prolonged labour with a large baby increase the likelihood of damage. The nerves recover to a greater or lesser extent in the months after childbirth, but they may never recover completely, leading to varying degrees of difficulty with bladder and/or bowel control.
It is very common for the tendon, which holds the left and right halves of the pelvic floor muscles together between the vagina and the rectum, to become stretched or torn. This allows the rectum to fall through the pelvic floor where it causes bulging into the back wall of the vagina (rectocele). This creates a pocket which sometimes traps faeces and causes difficulty emptying the rectum. Some people find they have to support their bottom to help it empty.
A specialist pelvic floor physiotherapist can help with management of a rectocele, but if difficulty emptying the bowel becomes an ongoing problem, a specialist colorectal surgeon can repair the pelvic floor and greatly improve your bowel function.
Intus colorectal surgeons specialise in the diagnosis and management of defaecation and pelvic floor disorders and generally work in a multidisciplinary team with physiotherapists, urologists and gynaecologists to ensure that the best expertise is applied to every individual’s situation.
For more information, contact Intus on 03-977 5977 or visit