1. Early intervention and management of pelvic organ prolapse can improve quality of life
Pelvic organ prolapse (POP) occurs when one or more of the pelvic organs descend into the vagina.
A suitably trained physiotherapist can help in the management of POP by:
- educating lifestyle modifications to reduce symptoms such as weight loss, treating constipation, avoiding straining and heavy lifting
- teaching pelvic floor muscle training individualized to the woman
- fitting vaginal pessaries to support the prolapse
- providing prolapse-friendly exercises and activities
- discussing medical options such as local oestrogen (Grade B recommendation) or surgical outcome rates.
Although not life-threatening, prolapse symptoms can negatively affect a woman’s biopsychosocial wellbeing.
2. First-line interventions can enhance management of urinary incontinence symptoms
Urinary incontinence (UI) is the complaint of an involuntary loss of urine.
UI affects all genders; however, women are more commonly affected. Some risk factors for the development of UI include pregnancy and childbirth, obesity, menopause, certain types of surgery and some neurological and musculoskeletal conditions.
UI is common and affects up to 30 percent of women.
Physiotherapists are well placed to provide first-line intervention to assist women to manage their UI symptoms. This can then result in improvements in their QOL and participation in social and work environments.
Physiotherapy intervention can include a thorough assessment to determine the likely cause of the UI, education, individualized pelvic floor muscle training, continence pessaries, bladder retraining and lifestyle advice.
3. A targeted approach is essential in the management of faecal incontinence
It is estimated that between two and 20 percent of the general population experience FI; however, many do not report bowel concerns. And only one in four will seek help.
A study has shown that people experiencing FI are four times more likely to be afflicted with anxiety, and five times more likely to be affected by depression, with FI sufferers also being more likely to report anxiety, frustration and shame.
Management of FI by suitably trained physiotherapists can involve education regarding stool type modification, retraining the pelvic floor muscles, coordination of muscles to relax during defecation, correct toileting postures and assessment of possible prolapse.
Physiotherapists working in this area can also help to identify when referrals to other health professionals such as colorectal specialists and dietitians are indicated.
4. Identifying biopsychosocial factors can improve the management of pelvic pain
Pelvic pain (PP) is defined as pain located between the umbilicus to the mid-thigh.
One in four women will experience persistent PP.
Some common conditions include endometriosis, bladder pain syndrome/interstitial cystitis, proctalgia fugax and pudendal neuralgia. In all of these conditions, pelvic floor muscle dysfunction occurs in 70–90 percent of patients.
Addressing pelvic floor muscle dysfunction results in significant changes to QOL and pain reporting.
This can be achieved by improving motor control with pelvic floor relaxation and biofeedback training, manual therapy to improve range of motion and distensibility, pain education, paced and gradual return to exercise, and improved bladder and bowel functioning.
5. Physios play a vital role in after birth and surgery recovery
What is not common knowledge is research-based evidence that pelvic floor muscle training supervised by a trained physiotherapist significantly reduces the risk of pelvic floor dysfunction in the postpartum population.
A postnatal physiotherapy assessment includes detailed questioning to determine the individual woman’s goals and may involve an internal pelvic floor assessment, abdominal wall and/or musculoskeletal assessment.
Women recovering from vaginal or cesarean deliveries can greatly benefit from the guidance of their physiotherapists.
Physiotherapy can also assist in the recovery following gynecological surgery such as hysterectomy or prolapse surgery.
Evidence suggests that pelvic floor physiotherapy before and after surgery may help to prevent recurrent symptoms, and optimal post-surgical reconditioning is crucial for women to be able to return to their lives including work and exercise.
* https://australian.physio/inmotion/five-facts-about-%E2%80%A6-female-pelvic-health