The base of the pelvis, also known as the pelvic floor, is made up of muscles, connective tissue, nerves, blood vessels and bones. These tissues support the organs of the pelvis, such as the bowel and bladder. They also need to be intact and functioning correctly for normal urination and bowel movements because muscles and nerves have to react at appropriate times, and either contract or relax to enable going to the bathroom.
Changes in the pelvic floor impacts sexual function either physically or neurologically. Contraction of the tissues, inflammation and irritation of key pelvic floor nerves, such as the pudendal nerve, all interfere with healthy sexual function.
Pelvic Floor Muscle Spasms
When there is an irritant in the pelvic area, the muscles of the pelvic floor may go into spasm. This is extremely painful, and also affects normal function. The medical terms for pelvic floor spasm include piriformis syndrome. pelvic floor tension myalgia, and levator ani syndrome. It can also be referred to as nonrelaxing pelvic floor dysfunction which is a broad term that captures many of the same symptoms.
What Happens When the Pelvic Floor Spasms?
Women experience a variety of symptoms when the muscles in the pelvis contract uncontrollably. These include:
Pain that ranges from mild to severe
Inability to control the process of urination
- Difficulty starting the stream of urine
- Sudden overwhelming urge to urinate
- Inability to stop from urinating
- Bladder pain
Inability to control having a bowel movement
- Difficulty emptying the bowels
- Bloating
- Constipation
- A constant sense of having to have a bowel movement
Severe pain during sex
- Pelvic pain during and after intercourse
- Pain that radiates throughout the groin and thighs
How Would Transvaginal (TVM) Mesh Cause Pelvic Floor Spasm?
According to the FDA, erosion of mesh through the vaginal wall, and contraction of the mesh causing the vagina to shorten, are two of the most common complications from TVM. The contraction and irritation serve to hyper-sensitize the tissues in the vagina. It also pulls the tissues and organs out of their natural alignment.
The same principles apply to the pelvic floor as other muscles in the body. If you are in an awkward position for an extended amount of time, and if there is an irritant around your muscles, they often spasm. Once they start to spasm, the inflammation and pain further irritates the muscles leading to more spasm.
How Is It Treated?
Treatment often starts conservatively with education and rehabilitation of the pelvic floor. There are physical therapists specially trained in treating women with this dysfunction. Biofeedback is one approach used to help relax the muscles and gain greater control over bathroom functions.
When transvaginal mesh is suspected as the cause, the treatment may need to be more aggressive. There are a host of complications from TVM, and a complete evaluation is needed to better understand if the mesh is irritating the nerves and tissues of the pelvic floor, and how to treat the underlying cause. Many women have numerous surgeries to release areas of mesh which may have contracted. Sometimes scar tissue forms around nerves, and a neurosurgeon is needed to help restore the nerve or remove the irritant.
If you’ve been injured by TVM contact us today. There is no cost to have your case evaluated by our legal and medical experts.
Butrick C.W. Pathophysiology of pelvic floor hypertonic disorders. Obstet Gynecol Clin North Am. 2009;36(3):699–705.
Hurtado E.A., Appell R.A. Management of complications arising from transvaginal mesh kit procedures: a tertiary referral center’s experience. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(1):11–17.
