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incontinence, erectile dysfunction, bowel control: our pelvic floors need more attention
urinary and bowel incontinence can be embarrassing to talk about and not only affects quality of life, but also increases the chance of depression and social isolation.
nov 10 2021
4 minute read
there are several types of urinary incontinence including stress incontinence, which is when urine leaks out under pressure. (getty)
have you given much thought to how important your pelvic floor is?
while women have generally been the focus of pelvic floor exercises (kegels) — particularly those who have given birth vaginally — in order to prevent or manage issues like urine leakage and painful intercourse, men can also be impacted by a weak pelvic floor. and while symptoms for men also include urinary incontinence, erectile dysfunction and bowel incontinence can also be sign of a pelvic floor that’s in need of a boost.
what are pelvic floor muscles?
pelvic floor muscles are located between the tailbone and the pubic bone, and are responsible for supporting organs such as the bladder, uterus or prostate, and the rectum. among other things, pelvic floor muscles help maintain bladder and bowel control, but just like many other parts of our bodies, aging can affect their strength and ability to function.
pelvic perineal dysfunction — the scientific name for pelvic floor dysfunction — is especially common post-pregnancy. it’s seen in 21 per cent of first vaginal births, and is known to be associated with urinary incontinence, which is the involuntary passing of urine. there are several types of urinary incontinence including stress incontinence, which is when urine leaks out under pressure, like during coughing or laughing, and urge incontinence, which is when leakage happens as you feel a sudden intense urge to pee.
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when it comes to assessing the pelvic floor muscles in women who have carried a child, we know that the mechanical and hormonal changes that occur during pregnancy also contribute to decreasing pelvic floor strength and endurance. the damage that occurs to ligaments, pelvic floor muscles, and nerves supporting the bladder and urinary tract often leads to stress and urge incontinence, incomplete emptying of the bladder, leakage and a slow urinary stream. birthing large babies, prolonged labor, and the use of forceps during delivery are all factors that can exacerbate this problem by contributing to pelvic organ prolapse (when the organs are pushed down and forward into the vagina).
urinary incontinence can be an agonizing problem as it interferes with daily routines and schedules and can be embarrassing for people to talk about. we often see patients adjusting their routines to accommodate toiletry needs, which not only affects a person’s quality of life, but it also increases the chance of depression, social isolation, and, over time, negatively impacts their perceived health.
while more women struggle with the symptoms of pelvic floor weakness due to childbirth, stress and urge urinary incontinence also affects men. with increasing age, obesity, persistent heavy lifting, and prior surgeries such as prostatectomies, pelvic floor muscles lose the ability to relax and coordinate movement. as the pelvic floor weakens, even anus closure can degenerate to the point of leading to stool incontinence in approximately eight per cent of men. for both men and women, sexual health and wellness is compromised with weak pelvic and perineal muscles — leading to erectile dysfunction in men, and difficulty achieving orgasm as well as painful intercourse in women.
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pelvic floor therapy
while exercises like kegels are still a solid and popular option for strengthening the pelvic floor, technology has come a long way in expanding the range of treatments available. european countries like france and sweden are leading the way in the battle for stronger pelvic floor muscles by considering pelvic floor therapy an important aspect of the postpartum experience (free of charge), recognizing that pelvic floor dysfunction can cause chronic symptoms that impact quality of life.
while in the past various conditions associated with pelvic floor dysfunction were thought to be untreatable and a normal part of aging, today, revolutionary treatments exist to improve or cure symptoms related to weak pelvic muscles.
the emsella technology is first on this list. an innovative, non-invasive device, emsella uses high- intensity focused electromagnetic technology (hifem) stimulation of the pelvic floor muscles for the treatment of urinary incontinence and a range of sexual health disorders. while the patient remains fully clothed, the emsella technology delivers supramaximal muscle contractions that would otherwise be unachievable by a typical kegel exercise. in fact, emsella delivers the equivalent of 11,000 kegel contractions in 30 minutes. these treatments are safe, and have little to no adverse events and no downtime, allowing the patient to immediately resume their normal activities. clinical studies have shown a significant reduction of up to 75 per cent in absorbent pad usage and a 95 per cent improvement in quality of life scores. the protocol for the initial treatment includes six sessions, 30 minutes each, with a follow-up treatment individualized according to the patient’s needs. the treatment is a cost-effective solution as maintenance usually requires fewer sessions and is performed within one year of the initial completion of six treatments. prices range between $1800.00 and $2400.00 cad for a series of six treatments.
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emsella can also be combined with emsculpt as part of the emcore program , a powerful core-to-floor therapy that addresses the whole core area and helps with abdominal remodelling, diastasis recti reduction, and pelvic floor strengthening in postpartum women.
pelvic floor dysfunction is a growing problem, increasing with age for both men and women. in the united states, it’s expected that there will be 43 million patients living with pelvic floor dysfunction by 2050. there is an increasing need for healthcare providers to educate patients about the importance of maintaining pelvic muscle strength for prevention and treatment. new technology such as emsella has been a “game changer” helping postpartum women to find solutions for symptoms such as bladder and bowel incontinence with treatment that is both timely and consistent.
dr. rohan bissoondath, md, is the medical director and founder of preventous collaborative health and preventous cosmetic medicine. he is a board member of the canadian association of aesthetic medicine and is certified by the college of family physicians of canada and licensed through the college of physicians and surgeons of alberta.
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