Pediatric Pelvic Floor Dysfunction

The pelvic floor is a group of muscles, tendons, and ligaments that act like a hammock helping to hold the organs. These muscles contract and relax in conjunction with abdominal muscles to help control bowel and bladder function. These muscles can sometime perform incorrectly because they are too weak and/or in spasm.

When these muscles function incorrectly, children can experience the following symptoms/conditions:

• Bedwetting
• Chronic constipation
• Encopresis: bowel leakage/inability to empty bowels
• Enuresis: urinary incontinence
• Excessive gas/abdominal bloating
• Bowel or bladder frequency/urgency
• Painful urination or defecation
• Urinary frequency/urgency
• Urinary retention
• Vesicoureteral reflux
• Pelvic pain
• Endometriosis

Bladder Concerns

Urinary incontinence is the loss of bladder control, which results in the accidental loss of urine. A child with urinary incontinence may not stay dry during the day or night. Leaking of urine can be associated with urgency or the feeling of having to toilet, chronic coughing issues, leaking associated with laughing, and most common, urine loss at night while the child is sleeping. Children that develop incontinence earlier in life are at a much higher risk for pelvic floor dysfunction later in life.

Bowel Issues

Constipation is among the most common pelvic floor issues that affect the pediatric population. Constipation in children has accounted for 35% of all visits to pediatric gastroenterologists. Fecal leaking is another bowel issue that can arise in children. This is a passage of stool into the underwear or in socially inappropriate places in a child with a developmental age of at least four years. Fecal leaking is most commonly a result of constipation. Constipation also has an effect on the bladder and can increase leaking episodes in children.

Pelvic Pain

Pelvic pain is described as pain that is located in and around the pelvis and abdominal region. Pelvic pain can impact a child’s quality of life, limiting the child’s activities, mental health, and sleep. Pelvic pain can be associated with bowel and bladder dysfunction.

The pelvic floor physical therapists at UPMC are specially trained in treating bowel and bladder dysfunction in both the typically and atypically developing child. We take pride in individualized care for your child, and will gear treatments to your own child’s abilities.

What to Expect on Your First Day

Privacy, comfort, and high-quality of care are very important to us at UPMC. At your first appointment, a physical therapist will meet with you and your child to obtain a thorough history of your child’s issue. A physical examination is then performed with the parent present to look at the muscles of the abdomen, legs, and back. Your therapist may also look at the child’s diet, sleep patterns, and exercise, and assess any behavioral issues that may be contributing to your child’s problem. The physical therapist will consult with your child’s referring physician to develop a personalized treatment plan.

Treatment is one-on-one and is focused on individualized treatment for your child. Physical therapists use animated biofeedback and computer programs with animated images to get children to activate and relax the pelvic floor in a fun and motivating way.

Other treatments include:

• Biofeedback-surface “stickers”
• Behavioral and diet modifications
• Hot/cold therapy
• Stretching and strengthening of pelvic floor muscles and the surrounding muscles
• Relaxation techniques
• Bladder retraining
• Pelvic floor muscle re-education
• Soft tissue mobilization
• Balance exercises
• Toileting posture

To schedule an appointment, ask your healthcare provider for a referral. Pediatric services are available at:

Muncy: 570-546-4291
Wellsboro: 570-723-0675