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Pelvic floor dysfunction: the care you should expect

The muscles and ligaments that support a woman’s pelvic organs (bowel, bladder, uterus and vagina) are known as the ‘pelvic floor’. If these muscles are not working properly it can lead to problems like urinary or faecal incontinence (leaking urine or faeces when you don’t mean to) and other distressing symptoms such as prolapse (where the pelvic organs slip down), chronic pelvic pain, or sexual problems. Pelvic floor dysfunction is very common, but it could be prevented in many women by following lifestyle advice and simple exercises.

We want this guideline to make a difference to women who have or are at risk of pelvic floor dysfunction by making sure:  

  • more women and girls aged over 12 know about pelvic floor dysfunction and how to avoid it
  • better support and advice is given to women most at risk of pelvic floor problems, including women who have given birth, are overweight or have a family history of pelvic floor dysfunction
  • more women are offered pelvic floor muscle training
  • fewer women go on to need specialist care or surgery.

For some women, specialist care or surgery may be the right option. You can find out more about specialist care and surgery in our guideline on urinary incontinence and pelvic organ prolapse in women. We’ve also produced patient decision aids for that guideline, to help women and their healthcare professionals discuss the different types of surgery for these conditions and make a decision that is right for each woman.

Making decisions together

Decisions about treatment and care are best when they are made together. Your health and care professionals should give you clear information, talk with you about your options and listen carefully to your views and concerns.

They should also:

  • explain how lifestyle changes can help to prevent and ease symptoms, including that it can take time to notice an improvement
  • explain the range of non-surgical options that may help your symptoms
  • ask about the psychological effect that symptoms have had on you.

If you need more support to understand any of the information you are given, tell your healthcare professional.

Read more about making decisions about your care.

Where can I find out more?

The NHS website has more information about urinary incontinence, faecal (bowel) incontinence and pelvic organ prolapse. The Royal College of Obstetricians and Gynaecologists have patient information leaflets on long-term pelvic pain and pelvic organ prolapse.

The organisations below can give you more advice and support.

NICE is not responsible for the content of these websites.

To share an experience of care you have received, contact your local Healthwatch.

We wrote this guideline with people who have been affected by pelvic floor dysfunction and staff who treat and support them. All the decisions are based on the best research available.

ISBN: 978-1-4731-4365-4


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