Pelvic Floor Dysfunction

Pelvic floor dysfunction includes a group of conditions that disrupt the band of muscles responsible for holding your pelvic organs in place (pelvic floor). When the pelvic floor becomes weakened or damaged, one or more of your pelvic organs may shift out of place, causing pain or making it difficult for you to use the bathroom.

Our colorectal surgeons specialize in treating pelvic floor dysfunction affecting the bowel and bladder. These organs control your ability to store and eliminate stool and urine.

Pelvic floor dysfunction in the bladder and bowel includes conditions such as:

• Rectal prolapse: Rectal prolapse happens when the band of muscles holding your pelvic organs in place becomes loose, allowing some of your organs, including the rectum, to bulge out (protrude) through the anus.
• Fecal incontinence: Fecal incontinence causes you to lose control of bowel movements. You may pass stool or gas involuntarily.
• Rectocele: This condition happens when the rectum bulges into the vagina.

Rectal prolapse happens when the rectum drops down and pushes through the anal opening. Rectal prolapse creates a bulge that can make everyday activities, such as having a bowel movement, uncomfortable or uncontrollable. 

Our experience from treating a high volume of rectal prolapse patients helps conduct a thorough medical history and physical examination. We use this information along with imaging tests to personalize treatments based on your medical needs and personal preferences.

Rectal prolapse treatments

Our expertise in minimally invasive techniques helps you achieve the best possible outcome in case you need surgery.

During a minimally invasive procedure, we may access the surgical site through the anus (transanal approach). This technique helps you avoid an incision in your abdomen. If we do need to make an incision in your abdomen, our expertise laparoscopic and robotic surgery helps us carry out the procedure using the smallest necessary incision. Find out more about minimally invasive colorectal surgery.

After surgery, additional treatments can reduce your risk of future prolapse. These treatments include: 

• Dietary changes: Making changes to your diet, such as consuming more vegetables, taking a fiber supplement and drinking lots of water can make stool softer and easier to pass.
• Physical therapy: We help you learn how to strengthen and better coordinate your pelvic floor muscles with the help of special exercises (Kegel exercises).
• Biofeedback: Biofeedback uses sensors and special technology to maximize the effectiveness of Kegel exercises. Biofeedback helps you visualize the results of your efforts to engage and relax the pelvic floor by displaying changes in muscle movements on a video screen.
• Lifestyle changes: You may need to avoid activities, such as lifting heavy objects, which can put unnecessary stress on the pelvic floor. Maintaining a healthy weight can also reduce pressure on the pelvic organs.

Fecal incontinence happens when you lose control of your bowel movements. You may experience an increase in the urge and frequency to have a bowel movement, which can lead to accidental leaks of stool or gas. Some people have accidents without even knowing they needed to have a bowel movement.

At UC Davis, our colorectal surgeons are here to offer you relief and control over your bowel movements. When you visit our center, your physician will do a comprehensive physical exam and order diagnostic tests to examine the structures and functioning of your anus and rectum. Once we confirm a diagnosis and the cause of the fecal incontinence, we work with you to determine the best treatment plan.

Fecal incontinence treatments

If you have fecal incontinence, we know you want to receive treatment that works. We're here to determine the best treatment option for you, making sure that you understand your care every step of the way. Read more about our treatments.

Treatments for fecal incontinence include:

• Antidiarrheals: These medications help slow down bowel activity and make bowel movements more predictable.
• Dietary changes: Making changes to your diet, such as consuming more vegetables, taking a fiber supplement and drinking lots of water can make stool softer and easier to pass.
• Developing consistent bowel habits: Going to the bathroom at certain times or after meals can help you develop a more predictable pattern of bowel movements.
• Physical therapy: We help you learn how to strengthen your pelvic floor muscles, which can help you control bowel movements, with the help of special exercises (Kegel exercises).
• Biofeedback: Biofeedback uses sensors and special technology to maximize the effectiveness of Kegel exercises. Biofeedback helps you visualize the results of your efforts to engage and relax the pelvic floor by displaying changes in muscle movements on a video screen.
• Sacral nerve stimulation: If non-surgical treatments fail to control your bowel movements, you may get relief with the help of an implantable device (sacral nerve stimulator). The device stimulates the nerve that controls bowel movements (sacral nerve) similar to the way a pacemaker regulates a person's heartbeat. Sacral nerve stimulation helps coordinate activity between the nerves and muscles that control bowel movements, which can make bowel habits more predictable. 
• Stoma: If other treatments fail to relieve the incontinence, you may enjoy a better quality of life with the help of a stoma. A stoma is a surgically created hole we place within your intestines so that waste bypasses your rectum and anus. Instead of having bowel movements, you eliminate waste into a special bag that sits on your abdominal wall. Living with a stoma can bring big changes to your life. Our team offers information, support and encouragement to help you learn how to take care of your stoma and get back to your favorite activities. Learn more about preparing for surgery.

Rectocele happens when there is a bulge in the wall of the rectum that is large enough to put pressure on nearby organs, such as the vagina. Rectocele can cause uncomfortable symptoms such as difficulty completing a bowel movement, leading to excessive straining, multiple trips to the bathroom and accidents (incontinence).

We diagnose rectocele using a small tube (anoscope) or a gloved, lubricated finger (digital rectal exam) to examine the rectum. We may also examine the inside of the vagina with the help of a special tool (speculum). You may need additional imaging tests, such as defecography to confirm the diagnosis. 

Rectocele often occurs with other problems, such as bladder disease. At UC Davis, you receive seamless care from multiple pelvic floor disorder experts, including colorectal surgeons, urogynecologists and urologists. Our team approach helps you get the best care.

Rectocele treatments

We offer the complete range of treatments for rectocele including non-surgical and minimally invasive treatments. Learn more about our treatments.

Non-surgical treatments for rectocele at UC Davis include:

• Dietary changes: Making changes to your diet, such as consuming more vegetables, taking a fiber supplement and drinking lots of water can make stool easier to pass, which can help reduce swelling and promote healing.

• Physical therapy: We help you learn how to strengthen and better coordinate your pelvic floor muscles with the help of special exercises (Kegel exercises).

• Biofeedback: Biofeedback uses sensors and special technology to maximize the effectiveness of Kegel exercises. Biofeedback helps you visualize the results of your efforts to engage and relax the pelvic floor by displaying changes in muscle movements on a video screen.

• Changing your bowel habits: Making simple changes to your bowel habits can help you avoid putting unnecessary pressure on your rectum. These changes may include avoiding excessive straining during bowel movements and trying not to sit on the toilet for long periods of time.
• Surgery: If non-surgical treatments fail to relieve your symptoms, you may feel better with the help of a surgical procedure. Our colorectal surgeons work alongside gynecologists and urologists to help you avoid multiple surgeries.