Pelvic Health and Radiation Treatment 

Radiation to one’s pelvis can lead to several pelvic health related symptoms that can greatly impact an individual’s quality of life. One of the common symptoms treated in pelvic health physical therapy is stenosis of the pelvic cavities, including vaginal and anal stenosis.

Stenosis of the vagina or the anus causes both canals to become narrower. Radiation can also cause these fragile tissues to become dry and thin leaving them more prone to damage such as tearing or hemorrhoids. This of course can cause pelvic pain as well as pain with intimacy, pain with pelvic examinations, pain with menstrual product use, constipation, pain with bowel movements and difficulty with passing stool. Stenosis can occur immediately following a bout of radiation or even years later.

Pelvic health physical therapy can assist with treating the symptoms associated with pelvic floor stenosis. There are numerous manual techniques to mobilize the scar tissue in the pelvic region to decrease pain and limitation in mobility. Some patients may be appropriate candidates for vaginal dilators/trainers to improve mobility in their pelvic floor. Pelvic floor dilators/trainers are cylindrical medical devices, typically of soft silicone, that when inserted into the vagina or rectum with lubrication provide a 360 degree stretch of the tissues affected by the radiation treatment.

Incontinence

Pelvic floor muscle tissues can be traumatized due to transfers of energy intended for cancerous cells impacting surrounding tissues. This damage can cause weakening and/or incoordination of the muscles surrounding the sphincters that control excretion of waste products. Therefore, patients who have undergone radiation to their pelvis may experience incontinence of bladder and/or bowels. Pelvic health physical therapy can be an incredibly helpful treatment for bladder or bowel leakage. In pelvic PT, an individualized and targeted exercise program will be developed to improve muscle tone, strength, endurance and coordination. Incontinence products should not be the expectation following radiation therapy when there are excellent conservative management techniques such as pelvic health PT available to patients.

Radiation Fibrosis of Pelvic Tissues

Following radiation treatment, fibrosis or thickening/scarring of tissue can happen anywhere in the body where the treatment is targeted. Specifically, radiation directed at a patient’s pelvis can cause an increased collection of a protein called fibrin. This fibrin can limit range of motion of tissues and decreases the strength of the tissues. One symptom of this fibrosis of the pelvic tissues is a decreased neural responsiveness of the pelvic tissues. This can cause difficulties with sensations associated with bowel and bladder signals and sexual dysfunction. Pelvic health physical therapists are specifically trained in mobilizing tissues surrounding pelvic nerves to improve sensitivity important for continence control and sexual function.

Olivia Shelton P.T., D.P.T., Cert. D.N., specializes in pelvic floor physical therapy, treating all symptoms involving bowel, bladder and sexual health. Olivia treats pelvic floor dysfunction in all ages and genders. She is accepting new patients at MyMichigan Rehabilitation at the Pardee Cancer Wellness Center, on the campus of MyMichigan Medical Center Midland. Those interested in scheduling an appointment with her may call (989) 794-0460.