Can Incontinence Affect Pelvic Floor Disorder?

In episode 28 of the Masterful Art of Self Care I briefly discussed the different types of incontinence since there is some uncertainty amongst most about what incontinence is and what it consists of. I talked about the five different type of urinary incontinence: stress, urge, overflow, functional and mixed and how each of them present with their own type of symptoms and there are different ways to help minimize urinary leakage.

There may be the question of whether pelvic floor dysfunction, PFD, affects or may even cause incontinence or if incontinence affects or again causes PFD. It is almost like the chicken or the egg question and I think I think at the end of the day, the answer may be that it depends. Either way, addressing both are important for the overall health of your pelvic floor. If we were to look at how incontinence may affect the pelvic floor muscles, there is an absolute correlation. If we are talking about stress incontinence, the ability for the pelvic floor to contract during times of stress (sneezing, coughing, bending over) can be a huge factor for urine leakage. If a person has uterine fibroids that are big enough to cause obstruction of the urethra or any flow channel for urine, that can absolutely impact how urine is flowing. Although uterine fibroids are not a pelvic floor disorder, the weight of the fibroid, the pain that may accompany it and the subsequent symptoms that come along with it can also affect the pelvic floor.

Lastly, I will leave you with two for examples. this was something that I did notice while completing one of my clinical internships at a skilled nursing facility. If a patient had a UTI or urinary tract infection, there was most likely a urinary incontinence issue. Given that many of the residents wore adult diapers either for incontinence reasons or for the ease of staff not having to worry about them tripping and falling on the way to the bathroom, the subsequent symptoms that arose probably also included an irritated vulva and thus an acute episode of pain. Since I spoke about functional incontinence being another factor that could also lead to PFD, you might be wondering why that is. If you were to think about a time where you may have been temporarily disabled and unable to go to the bathroom independently but the urge was there, yet you couldn’t make it there on time. You want to avoid an embarrassing situation and you also don’t want to be sitting in your own pee, so you squeeze and squeeze to hold off the inevitable. All of that squeezing is affecting what? Most likely all of your pelvic floor muscles and surrounding hip musculature. Imagine if you were doing that all the time, constantly squeezing all of those muscles to hopefully prevent pee from coming out or leaking. It is a recipe for some type of pelvic floor dysfunction over time. So, yes, incontinence can have an affect on your pelvic floor and maybe in some cases, cause a PFD, even though it might be seen as just an issue with your bladder or urethra, they are all connected and should not be considered separate issues or conditions.