In simple uncomplicated terms, it means that you have spasticity of the muscles of your pelvic floor. These are the muscles that need to open up to let the urine out; they need to relax when having intercourse or having a bowel movement. If you have spasticity of those muscles, it often leads to symptoms such as pelvic discomfort, lower back pain, a decrease in the force of the urinary stream, constipation, and pain with intercourse. In men it may also be associated with testicular discomfort or pain at the tip of the penis.

    Many patients with this type of problem tell me that they were previously treated with an antibiotic for a bladder (or prostate) infection. The major symptoms of their infection went away but the patient was left with these "residual" problems which just didnt go away, despite further courses of antibiotics (even in the face of negative urine cultures). What I believe is most likely happening here is that during the course of the infection, the voiding "behavior" of patients changes. During a bladder infection, people often push and strain with urination. They do this because the infection gives them the sensation of incomplete bladder emptying. They feel that they need to bear down to get all the urine out. This seems like the right thing to do. Unfortunately, this maneuver often backfires. The act of pushing with urination can sometimes "irritate" the muscles of the pelvic floor. This in turn causes these ill-described pelvic complaints - patients may feel like they dont empty their bladders (when they usually are emptying their bladders effectively). They continue to push, thus irritating the muscles further, perpetuating the process. This is a true vicious cycle. In some cases, the problem is so pronounced that patients dont empty their bladders completely.

    Of course, not all cases of pelvic floor dysfunction start off as an infection. IC can often start the ball rolling. We have identified PFD existing in many of our IC population. Many patients have probably been voiding abnormally since childhood but didnt get associated symptoms until adulthood. Many of these patients have always been "frequent voiders." Lots of these patients also have the "shy-bladder syndrome" (difficult to void in public places). Prostatic problems can also be related and need to be checked out by your physician.