What Is Pelvic Floor Dysfunction and How Does It Affect the Bladder?

Pelvic floor dysfunction refers to a condition in which the muscles and tissues of the pelvic floor are too weak, too tight, or do not coordinate properly. The pelvic floor is a group of muscles that stretch like a sling across the bottom of the pelvis, supporting important organs such as the bladder, uterus (in women), and rectum. When these muscles do not function as they should, they can affect bladder control in several ways.

One of the most common effects of pelvic floor dysfunction is urinary incontinence, where urine leaks without control. This may happen when coughing, sneezing, laughing, or during physical activity—referred to as stress incontinence. In other cases, it may cause a sudden and strong urge to urinate, called urge incontinence, even if the bladder is not full.

On the other hand, if the pelvic floor muscles are too tight or do not relax when needed, it can lead to urinary retention, where the bladder does not empty completely. Some people may feel as though they still need to urinate even after finishing, or they may struggle to start the urine stream.

Pelvic floor dysfunction can result from several causes. In women, it is often linked to pregnancy, childbirth, and menopause, all of which may stretch or weaken these muscles. In both men and women, chronic constipation, heavy lifting, pelvic surgery, aging, or nerve conditions such as multiple sclerosis or spinal cord injuries can contribute to muscle damage or poor coordination.

Symptoms that suggest pelvic floor dysfunction include:

  • Frequent urination or urgency
  • Leaking urine during activities
  • Difficulty starting or fully emptying the bladder
  • Feeling pressure in the pelvic area
  • Pain while urinating without infection

Treatment often begins with pelvic floor physical therapy, where trained professionals guide exercises to strengthen or relax the muscles. These may include Kegel exercises, biofeedback, or electrical stimulation. In some cases, medications or other treatments may be needed, depending on the underlying cause.

When properly diagnosed and treated, many people with pelvic floor dysfunction see significant improvement in bladder symptoms and overall quality of life.

Looking for more questions?

Visit the Bladder Questions Answered in Plain Language page.

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