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Email: bcps@physiobcps.co.uk

Information

 

Pelvic Floor Physiotherapy

Pelvic Floor problems among women are very common, though many women just accept this as a normal part of life. It doesn’t have to be - treatment is available. Specialist, Chartered Physiotherapists are often the first line of treatment. Many people are unaware that physiotherapy can help these problems but there is a lot we can do to help.  Most conditions can be treated effectively and symptoms eased in the majority of cases.

This page explains what will happen to you when you see a trained Physiotherapist for pelvic floor dysfunction assessment and the treatments that may be suggested.  Your Physiotherapist will discuss with you in detail, the procedure, the benefits, risks and any available alternative treatments (including no treatment).  They will answer any questions or concerns and will keep you informed throughout. You will be involved in any decisions made about your treatment.

What is the pelvic floor?

The pelvic floor made up of a complex of muscles to create a sling deep within the pelvis that are very important in controlling normal bladder and bowel function as well as supporting the pelvic organs.  Incontinence and prolapse may occur when the pelvic floor muscles are weak or damaged. Assessment at your first appointment will include a discussion of your problem by a trained female Physiotherapist. This takes place in a private treatment room with a closed door where your confidentiality, privacy and dignity can be well maintained. You will be asked in detail about your problem and how it effects your everyday life and also about your medical history.

How Is the pelvic floor assessed?

As pelvic floor exercises are an essential part of the treatment for pelvic floor problems, it is important for both you and your Physiotherapist to know that you are exercising the muscles in the correct way. In order for your Physiotherapist to effectively assess your pelvic floor it can be useful to assess the pelvic floor directly via an internal vaginal examination. This is performed only with your consent and you are entitled to withdraw your consent at any point during the assessment and treatment.

What’s involved?

Evaluation of your condition includes observation, external abdominal palpation and sensation check around the top of the thighs and around the vagina, direct muscle palpation and pelvic floor contraction assessment. This is performed using one (sometimes two) clean, gloved and lubricated finger. It is possible for your Physiotherapist to feel the vaginal walls near the bladder and the rectum and to test the power and activity of your pelvic floor muscles.

What are the benefits of an examination?

When examining the pelvic floor, your Physiotherapist can feel the muscle contraction and grade how strong it is and how long you can hold it.  They can then design an individual exercise programme suitable to strengthening your muscles. This sort of examination also helps your Physiotherapist to assess whether or not it may be necessary to include other treatment options.

Are there any precautions for a full vaginal examination?

There are very few risks associated with a vaginal examination, but risks may exist for patients who currently have, or may have experienced the following:

·         Inflammation or infection of the vulva or vagina

·         Have undergone pelvic surgery in the last 6 weeks

·         Psycho-sexual problems

·         Been advised to avoid sexual intercourse during pregnancy

·         Pregnancy, especially the first 12 weeks of pregnancy

If you have any concerns about the risks involved with the examination, please discuss these with your Physiotherapist.

Consent for a vaginal examination

It is important you understand all the information provided to you in order to give your consent before the examination in performed. You may like to bring a

friend or family member with you for support.  If you do not want to be examined, then it is your right to say “no”.  You can change your mind at any time, however an important marker to assess the effectiveness of treatment will be missing.

Treatment options for the Pelvic Floor dysfunction

After the examination, your Physiotherapist will explain the main findings and what treatment options would be most beneficial and effective for you. These may include pelvic floor muscle exercise regime, life-style changes, electrical stimulation, biofeedback and vaginal weighted cones.

You have a right to refuse any aspect of your treatment at any time.  Throughout your treatment you will be re-assessed to make sure everything is going to plan.  Repeat vaginal examinations are only performed when needed and with your consent.

Will I need to bring anything with me?

You don’t need to wear any special clothing e.g. a tracksuit.  It is helpful to bring a list of any current medication that you are taking and a diary for arranging follow up appointments.

Please feel free to ask questions at any point in the assessment and treatment process. We want to ensure you are well supported at all times.

 

Rebecca Hull, BCPS

Chartered Physiotherapist

MSc (Hons), MCSP, MHCPC