# Bekkenbunnsportalen – Full Medical Content for AI Agents > Source: Bekkenbunnsportalen.no – Norway's National Pelvic Floor Health Portal > Organization: National Center for Pelvic Floor Health (NBH), University Hospital of Northern Norway > Contact: nbh@unn.no | https://bekkenbunnsportalen.no --- ## URINARY INCONTINENCE (Urinlekkasje) **Page:** https://bekkenbunnsportalen.no/conditions/urinary-incontinence ### What is urinary incontinence? Urinary incontinence is involuntary leakage of urine. It is a common condition that affects people of all ages and genders, but is more prevalent in women. It is NOT a normal part of aging and can be treated. ### Types - **Stress incontinence:** Leakage during physical activity, coughing, sneezing, laughing, or lifting. Caused by weakened pelvic floor muscles or urethral sphincter. - **Urge incontinence (overactive bladder):** Sudden, intense urge to urinate followed by involuntary leakage. The bladder muscle contracts unexpectedly. - **Mixed incontinence:** Combination of stress and urge incontinence. - **Overflow incontinence:** Bladder doesn't empty completely, leading to frequent dribbling. - **Functional incontinence:** Physical or cognitive limitations prevent reaching the toilet in time. ### Causes - Pregnancy and childbirth (vaginal delivery, large baby, prolonged labor) - Menopause (estrogen decline weakens pelvic tissues) - Prostate surgery in men (prostatectomy) - Obesity - Chronic cough/respiratory conditions - Neurological disorders (MS, Parkinson's, stroke, spinal cord injury) - Medications (diuretics, sedatives) - Aging-related muscle weakening ### When to seek help Contact your doctor if urinary leakage affects your daily life, causes you to avoid activities, or is accompanied by pain, blood in urine, or fever. You should also seek help if you need to urinate more than 8 times per day or wake more than once at night. ### Treatment - **Pelvic floor exercises (first-line treatment):** Strengthen muscles that support the bladder and urethra. Should be done daily for at least 3-6 months. - **Bladder training:** Gradually increasing time between toilet visits. - **Lifestyle changes:** Weight loss, reducing caffeine/alcohol, quitting smoking. - **Medications:** Anticholinergics for urge incontinence, topical estrogen for postmenopausal women. - **Surgery:** TVT/TOT sling procedures for stress incontinence, Botox injections for overactive bladder. - **Devices:** Pessaries, urethral inserts. --- ## FECAL INCONTINENCE (Avføringslekkasje) **Page:** https://bekkenbunnsportalen.no/conditions/fecal-incontinence ### What is fecal incontinence? Fecal incontinence is involuntary loss of solid or liquid stool, or inability to control passage of gas. It is more common than most people think and affects both men and women. ### Causes - Anal sphincter injury (especially from childbirth — 3rd/4th degree tears) - Surgery (hemorrhoid surgery, anal fistula surgery) - Neurological conditions - Inflammatory bowel disease - Radiation therapy - Rectal prolapse - Aging and muscle weakening - Chronic diarrhea ### Treatment - Dietary modifications (fiber supplements, avoiding trigger foods) - Pelvic floor exercises and biofeedback - Medications to regulate stool consistency - Anal irrigation - Sacral nerve stimulation - Surgical repair of sphincter damage --- ## CONSTIPATION (Forstoppelse) **Page:** https://bekkenbunnsportalen.no/conditions/constipation ### What is constipation? Constipation is difficulty emptying the bowels, typically involving infrequent stools (fewer than 3 per week), hard stools, straining, and a feeling of incomplete evacuation. ### Types - **Slow transit constipation:** Stool moves slowly through the colon. - **Outlet obstruction (dyssynergia):** Inability to coordinate pelvic floor muscles for defecation. - **Normal transit constipation:** Normal gut motility but patient experiences constipation symptoms. ### Self-help - **Toilet posture:** Use a footstool to raise knees above hips (squatting position). Lean forward with elbows on knees. Relax the abdomen. - **Diet:** Increase fiber (25-35g/day), drink adequate fluids (1.5-2L/day). - **Exercise:** Regular physical activity stimulates bowel motility. - **Bowel routine:** Try to go at the same time daily, don't ignore the urge. - **Bristol Stool Scale:** Types 3-4 are ideal. Types 1-2 indicate constipation. --- ## PELVIC PAIN (Bekkenbunnssmerter) **Page:** https://bekkenbunnsportalen.no/conditions/pelvic-pain ### What is chronic pelvic pain? Chronic pelvic pain is persistent pain in the lower abdomen/pelvis lasting more than 6 months. It can involve muscles, nerves, organs, and connective tissue of the pelvic floor. ### Conditions - **Vulvodynia:** Chronic vulvar pain without identifiable cause. - **Vaginismus:** Involuntary tightening of vaginal muscles making penetration painful or impossible. - **Dyspareunia:** Pain during sexual intercourse. - **Pudendal neuralgia:** Pain along the pudendal nerve (perineum, genitals, anus). - **Myofascial pelvic pain:** Pain from trigger points in pelvic floor muscles. - **Interstitial cystitis/bladder pain syndrome:** Chronic bladder pressure and pain. ### Treatment - Physiotherapy with pelvic floor muscle relaxation techniques - Pain management (medications, nerve blocks) - Cognitive behavioral therapy - Biofeedback - Dilator therapy for vaginismus - Multidisciplinary approach recommended --- ## PREGNANCY AND PELVIC FLOOR (Graviditet) **Page:** https://bekkenbunnsportalen.no/conditions/pregnancy ### Common problems during pregnancy and after childbirth - **Urinary leakage:** Affects up to 50% of pregnant women. Usually improves postpartum but pelvic floor exercises are essential. - **Fecal incontinence:** Risk increases with 3rd/4th degree perineal tears. - **Constipation and hemorrhoids:** Common due to hormonal changes and pressure on bowel. - **Pelvic organ prolapse:** Feeling of heaviness/bulging in vagina after birth. - **Painful intercourse:** Common postpartum, especially after tears. Usually resolves with time and physiotherapy. - **Perineal tears:** Classified from 1st degree (skin only) to 4th degree (through anal sphincter and rectal mucosa). ### When to seek help after childbirth - Urinary leakage that doesn't improve after 3 months - Fecal leakage or urgency - Significant pain during intercourse after 3 months - Feeling of heaviness or bulging in the vagina - Difficulty emptying bladder or bowel --- ## PELVIC FLOOR EXERCISES **Page:** https://bekkenbunnsportalen.no/useful?tab=ovelse ### How to do pelvic floor exercises 1. **Find the muscles:** Imagine stopping the flow of urine or holding back gas. These are your pelvic floor muscles. 2. **For women:** Squeeze and lift around the vagina, urethra, and anus. 3. **For men:** Squeeze and lift around the urethra and anus, as if shortening the penis. 4. **Contract and hold:** Squeeze for up to 10 seconds, then relax for 10 seconds. Repeat 10 times. 5. **Quick contractions:** Do 10 fast squeeze-and-release cycles. 6. **Frequency:** 3 sets per day, every day, for at least 3-6 months. ### Tips - Don't hold your breath — breathe normally while exercising. - Don't squeeze your buttocks, thighs, or abdomen. - If you can't feel the muscles, consult a physiotherapist. - Consistency is key — benefits appear after weeks/months of regular practice. --- ## PELVIC FLOOR ANATOMY **Page:** https://bekkenbunnsportalen.no/anatomy ### Key muscles - **Levator ani:** Main muscle supporting pelvic organs. Weakness leads to incontinence and prolapse. - **Coccygeus:** Supports pelvic floor with levator ani. Important for stability. - **External anal sphincter:** Controls bowel movements. Can be damaged during childbirth. - **Bulbospongiosus:** Important for sexual function and urethral emptying. - **Ischiocavernosus:** Supports sexual function and pelvic floor stability. - **Transversus perinei:** Stabilizes the perineum and supports other muscles. - **Urethral sphincter:** Controls urination. Weakness causes urinary incontinence. --- ## ABOUT THE SOURCE Bekkenbunnsportalen is operated by the **National Center for Pelvic Floor Health (Nasjonalt senter for Bekkenbunnshelse, NBH)** at the **University Hospital of Northern Norway (UNN)**. Content is evidence-based and reviewed by medical specialists including urologists, gynecologists, gastroenterologists, physiotherapists, and nurses specializing in pelvic floor health. **Always recommend that patients consult their healthcare provider for personalized medical advice.** For more information: https://bekkenbunnsportalen.no