Pelvic Floor Disorders

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If you sometimes experience urine leakage (incontinence) then you're not alone, 1.1 million New Zealanders experience some form of this every month. Pelvic floor disorders include incontinence (both bladder and bowel), pelvic organ prolapse, chronic pelvic pain, issues with sexual intercourse and difficulties emptying the bladder and bowel. The good news is it can be helped, so don't wait, it's never too late to regain control of your life.


The two main types of incontinence are stress (where small amounts of urine leak during activities) and urge (a sudden strong urge to pass urine which can lead to a loss of urine).

Pelvic Organ Prolapse (POP) is estimated to affect up to 50% of women who have given birth. A prolapse occurs when the tissues that hold the organ in place become weak or stretched - this results in a drop (prolapse) of the organs from their normal position.

Some of the common symptoms of pelvic floor dysfunction include:

  • Leaking urine when you cough, laugh, sneeze or exercise
  • Having to rush to the toilet and leaking before you can get there
  • Getting up to go to the toilet in the night often
  • Difficulties emptying the bladder and/or a sensation of incomplete emptying
  • A feeling of heaviness, or dragging in the pelvis or vagina

Other symptoms can include:

  • Pain or discomfort felt in the lower abdomen, groin, scrotum, penis, vulva or vagina
  • Pain with sexual intercourse or difficulty with penetration
  • Reduced sensation with sexual intercourse
  • Erectile and premature ejaculation difficulties
  • Constipation and difficulty emptying the bowels
  • Pelvic girdle, buttock or coccyx (tail bone) pain

How physio helps

The good news is physiotherapy can help with all the conditions mentioned above. Including...

During pregnancy and following childbirth

Pregnancy and childbirth put additional strain on your body, especially on your back, pelvis, pelvic floor and abdominal muscles. A physio can help you manage these changes by providing assessment, treatment, education, appropriate exercises and preparation for childbirth. It is important not to ignore small problems after your first pregnancy and delivery, as with the demand of another pregnancy any problems can often become worse.

A physio can help with:

  • Exercises for good bladder and bowel control (women that have had a baby are more likely to experience incontinence)
  • Exercises to regain normal muscle tone and strength
  • Advice on posture and back care
  • Assessment and treatment of problems with joints and muscles, such as back and/or pelvic girdle pain and abdominal muscle separation
  • Explaining how your bladder and bowel should work
  • Assessment and treatment of painful scar tissue, mastitis/blocked ducts and pain with sexual intercourse

With bladder and bowel control problems

Bladder and bowel problems can include incontinence (urine leaking), poor bladder control or constipation. A physio can help with:

  • Exercises to help prevent incontinence
  • Improving bladder and bowel control
  • Pelvic floor muscle training
  • Urge management strategies
  • Toileting techniques
  • Bladder retraining
  • Coughing, sneezing and bracing techniques
  • Guidance with appropriate lifestyle changes.

Other areas physio can help with include pelvic organ prolapse, before and after gynaecological or prostate surgery, pelvic pain, pain during sex and sexual dysfunction.


Often incontinence can be helped by choosing healthy diet and lifestyle habits. This may include appropriate and regular exercise, including strengthening the core, drinking adequate fluid - preferably water, eating healthily and practicing good toilet habits (such as emptying your bladder and bowels using correct positioning and technique, without straining and avoiding constipation).

Pelvic floor exercises can also be very beneficial for both treating and preventing future problems. When these muscles are strong we have more control over our bladder and bowels. Before you start working your pelvic floor it's very important that you are able to correctly locate these muscles. Studies have shown many people have difficulty finding the correct muscles. A pelvic floor physiotherapist can help you correctly identify these muscles and make sure you are performing the exercises correctly.

What to expect

Don't be embarrassed!

Many people with pelvic floor problems don't seek help as they think nothing can be done or they are too embarrassed to talk about their 'private' issues. There are many treatment options available to you so it's important you seek help from a doctor or a pelvic floor physio. They can help you treat these conditions with dignity and privacy. Most patients feel very relieved after finally discussing their problem with an understanding health professional.


Many of the disorders we've mentioned so far are related to weakness of the pelvic floor. But it is important to know that these muscles can sometimes become too tight. A pelvic floor that is too tight (over-active) can also cause problems like pain and urgency. This is why it's important that you see a physio who can correctly diagnose and treat your individual problems.

Yes, there is no need to suffer in silence. Physiotherapy can be very effective in helping you manage pelvic floor problems. In fact research has shown physiotherapy is effective in treating stress incontinence in up to 80% of cases.