Weak brakes: Embarrassing effects of Pelvic Dysfunction

When Joy realised that her urine would involuntarily leak from time to time, she felt self-conscious, isolated and stigmatised. Ashamed of how her “weak brakes were causing social isolation, she opted to resign from work and open a kiosk near her home. At least she could run home and have a change of clothes before anyone realised she was smelling.

Most of us have seen or heard of someone who at some point laughed till they passed urine. If you can comfortably cough, sneeze or laugh out, with an almost full bladder, thank your pelvic floor muscles.

The pelvic floor is a sling of complex muscles and connective tissues that primarily support organs within the pelvis and lower abdomen. So, if the pelvis was thought of as a house for organs such as the bladder, rectum and prostate (uterus in women), think of the pelvic floor muscles at the foundation to that house.

Termed as the supportive dome of muscles at the bottom of your torso, pelvic floor muscles consists of superficial and deep layered muscles that stretch from the tailbone at the rear end to the pubic bone at the front. Since the pelvic floor muscles act by tightening, squeezing, lifting and relaxing, they help to maintain continence, support sexual arousal and orgasmic function and allow bowel and bladder emptying.

According to publications by the Oxford University Hospitals, the pelvic muscles are always under slight tension so that when you pass urine or open your bowels, they should relax and tighten right afterwards to prevent leakage of the same.

Pelvic floor dysfunction

Pelvic floor dysfunction is a common condition characterised by the inability to relax and coordinate the muscles at the bottom of your torso. When pelvic floor muscles do not work as they should, you end up having urine or stool leaking or not emptying your bowel or bladder completely. Urinating may become painful, with lower back pain that has no other cause. That need to pee every now and then should prompt you to seek medical attention.

Causes of Pelvic Floor Dysfunction

In Men

·         Prostate surgery

·         Constipation

·         Obesity

·         Trauma in the pelvic area

·        Long term heavy lifting

·         Chronic cough

Men can experience male urinary dysfunction which involves leaking urine after peeing. Even though erectile dysfunction (ED) is complex and has a wide range of causes, a man can have difficulties maintaining an erection due to pelvic muscle pain and tension. Additionally, pelvic floor dysfunction symptoms are similar to prostatitis — inflammation of the male reproductive gland. Prostatitis is however caused by sexually transmitted infections, bacteria or trauma.

Just like any other muscles that can be strengthened by exercise when weak, pelvic floor muscles are not any different. Kegel exercises are beneficial to both men and women. It is important to note that maintaining the correct weight and adjusting your diet will help in reducing muscle strain and avoiding constipation.

Causes of Pelvic Floor Dysfunction in women

·         Pregnancy ending with long and difficult labour

·         Trauma in the pelvic area

·         Obesity

·         Overusing the pelvic muscles such as going to the bathroom way too often

·         Advanced age

A research published in the National Centre for Biotechnology Information journal estimates that about one-third of women have urinary incontinence and up to one-tenth experience fecal incontinence after childbirth. The Kenya Service Provision Assessment Survey by the Ministry of Health estimates that urinary incontinence affects six per cent of Kenyans. One in nine men experience bladder weakness mostly due to prostate related issues. Women constitute 75 per cent of Kenyans suffering from the condition. The survey warns that incidents of women with urinary continence will increase by 55 per cent in 2050. Thankfully, Joy is currently receiving treatment and her life is gradually returning to normal.

Pelvic Pain

According to the Kenya Laparoscopic Surgery Services, KLASS, pelvic pain or discomfort occurs in the lower abdomen regions — between the belly button and the pubic bone. Pelvic pain is considered chronic when it is on-going, lasting more than six months. Pelvic pain can result from uterine fibroids, endometriosis, painful menses pelvic inflammatory disease, ovarian cancer, urinary tract infection, ovarian cysts or ectopic pregnancy.

At the doctor’s, you will likely have a pelvic exam and a Pap smear test done. Urine tests, blood tests, ultrasound imaging and screening for sexually transmitted diseases may also be conducted to get a clearer picture of the cause of the symptoms. Treatment is often successful regardless of the cause and how sharp or dull the pelvic pain is.