Why Pelvic Floor Dysfunction can Feel like a UTI

By Dr. Rachel Gelman, DPT

Have you ever been tested for a UTI, only to get a negative test result? Or perhaps you were treated for a UTI but the symptoms persisted after the antibiotics, so you went back to your doctor only to learn that the infection was no longer present?  How could this be?

If a person has UTI-like symptoms but no infection is detected, their symptoms could be due to other factors such as pelvic floor dysfunction.

The pelvic floor is a muscular hammock that is inside the pelvis. It supports the pelvic organs: bladder, colon, uterus or prostate. These muscles also surround the urethra, vagina, and rectum. They make sure you don't pee your pants when laughing at a meme your BFF sent you on IG and they keep you from farting while riding a crowded elevator. They are tiny muscles most people don't think about, but they are very helpful!  

But just like any other muscle of the body, the pelvic floor muscles can become impaired. They can become weak or have a difficult time contracting, relaxing or lengthening. They can become spasmodic, guarded, restricted or hypertonic (tight). Tight muscles restrict blood flow, irritate nerves that travel in the area and can lead to the development of muscle knots, known as myofascial trigger points. This is can be a recipe for pain. 

Due to the muscles proximity to the bladder, sometimes the brain mistakes pelvic floor tightness or spasms as the bladder being full and needing to pee. This can be a cause of urinary urgency that seems similar to a UTI, when it is actually the muscles being overactive.  If the muscles that surround the urethra have trouble relaxing, it can make it difficult or even painful when one tries to pee. Sometimes muscles stay guarded after an infection has already resolved. They are still on red alert and worried that a threat still exists, so they remain in protective mode. This can be the reason a person still feels like they have a UTI, even though the tests are now negative after treatment. 

Luckily, pelvic floor dysfunction can be addressed with different treatment options, including physical therapy! A pelvic floor physical therapist can address the muscles in and around the pelvis using different treatment modalities such as myofascial release, connective tissue manipulation and providing education and exercises to improve the range of motion and coordination of these muscles. 

So, if you are feeling UTI-like symptoms but your doctor is sure you don’t have an infection, ask her for a referral to a pelvic floor specialist to determine if pelvic floor dysfunction is the cause of your symptoms. 


About Dr. Rachel Gelman, DPT

Dr. Rachel Gelman is a clinician, writer and educator. She holds a Doctorate in Physical Therapy from Samuel Merritt University. She specializes in treating pelvic floor dysfunction with her passion being sexual health/dysfunction. She is a member of the International Pelvic Pain Society, the International Society for the Study on Women’s Sexual Health, the Sexual Medicine Association of North America and the International Society for the Study on Sexual Medicine. She teaches the pelvic health curriculum in the Doctor of Physical Therapy program at Samuel Merritt University. She has written and consulted for various businesses in the sexual health/tech space including the Ohnut, Genneve, Lioness and Lelo.