Pelvic Floor Physiotherapy 2017-07-14T09:43:53+00:00

PELVIC FLOOR PHYSIOTHERAPY

Highly specialised treatments for pelvic floor conditions

What is Pelvic Floor Physiotherapy?

Pelvic floor physiotherapy is a specialised field that is associated with the pelvic health of both women, men and children.

Treatments are focused on muscle strengthening or relaxation in order to improve bladder and bowel function and offer pain control.

What can I Expect at My First Appointment?

If you would like to receive information regarding what to expect at your first appointment, please feel free to contact us via phone or email, and request a confidential phone call from an experienced physiotherapist.

Visit our contact page.

What Conditions May I Seek Treatment For?

Some of the common pelvic floor conditions which we treat include:

Urinary incontinence

Urinary incontinence refers to a number of conditions:

  • Stress urinary incontinence (leaking of urine with laughing, coughing, sneezing, running, and change of position)

  • Urgency (the experience of a sudden, ‘difficult to defer’, desire to pass urine, not necessarily followed by urinary incontinence)

  • Urge urinary incontinence (incontinence associated with a sudden, ‘difficult to defer’, desire to pass urine)

  • Passive urinary incontinence (urinary incontinence not associated with a desire to pass urine or any particular activity)

Stress urinary incontinence

Continence requires that the urethra (tube connecting the bladder to the outside world) remains closed, particularly during activities which increase the intra-abdominal pressure and pressure on the bladder. Urethral closure is maintained by (1) the tone in the urethra itself, (2) the fascial (connective tissue) support system around the bladder and urethra, and (3) the pelvic floor muscles. When one or more of these structures is impaired or damaged, incontinence can occur.

Stress urinary incontinence is the passive leakage of urine during activities including but not limited to:

  • coughing

  • sneezing
  • laughing
  • change of position
  • walking
  • running/high impact exercise
  • intercourse

Following assessment, your Physiotherapist will discuss with you your treatment options.
Treatment may include:

  • lifestyle modifications/education

  • pelvic floor exercise prescription
  • electrical stimulation
  • intra-vaginal continence devices/pessaries

For more information on stress urinary incontinence, see:
Stress Urinary Incontinence (Continence Foundation of Australia)

Urgency/urge urinary incontinence

Urgency is the complaint of a sudden compelling desire to pass urine which is difficult to defer. When this is accompanied by involuntary leakage, this is termed urge urinary incontinence. When urgency or urge urinary incontinence are accompanied by frequent bothersome voiding and frequent urination overnight, the International Continence Society term this ‘overactive bladder syndrome’. These conditions can severely impact quality of life.

Following assessment, your Physiotherapist will discuss your treatment options, which may include:

  • lifestyle modifications/ education

  • pelvic floor exercise prescription
  • electrical stimulation
  • pelvic floor manual therapy
  • treatment of bowel dysfunction

For further information on urgency/urge urinary incontinence, please see these resources:
Urge Incontinence (Continence Foundation of Australia)

Faecal/flatal incontinence

Faecal/flatal incontinence refers to a number of conditions:

  • Faecal urgency (the experience of a sudden, ‘difficult to defer’, desire to pass a bowel motion, not necessarily followed by faecal incontinence)

  • Faecal urgency incontinence (faceal incontinence associated with the experience of a sudden, ‘difficult to defer’, desire to pass a bowel motion)
  • Passive faecal incontinence (faecal incontinence which is not associated with the desire to pass a bowel motion)
  • Post-defecation faecal incontinence (faecal incontinence or soiling, which occurs directly after passing a bowel motion)
  • Flatal incontinence (difficulty or inability to control wind)

Causes of constipation

Constipation has a number of causes and presentations:

  • Functional constipation (primary slow-transit constipation may be unresponsive to pelvic floor Physiotherapy; however, other forms of constipation may respond well to conservative management)
  • Obstructed defecation (when defecation is obstructed by an anatomical defect, such as pelvic organ prolapse)
  • Dysynergic defecation (when muscle incoordination impedes defecation)

  • Rectal hyposensitivity (when the nerves in the back passage no longer ‘fire’ appropriately)

Pelvic organ prolapse

Pelvic organ prolapse involves a descent of the bladder, uterus, rectum or small bowel into the vagina, and occurs when the pelvic organ supports have been damaged. This can occur following a vaginal delivery, and can also occur slowly over time with age-related changes of the support system.

Symptoms include:

  • Vaginal heaviness, dragging and pain
  • Low back pain
  • Awareness of a vaginal bulge
  • Difficulty emptying the bowel
  • Pain during intercourse

Treatment options may include:

  • Lifestyle modifications/education
  • Pelvic floor exercise prescription

  • Electrical stimulation
  • Pessary placement
  • Treatment of bowel dysfunction

  • Advice regarding the use of other assistive devices (i.e. femeze)

Pessaries

Pessaries are intra-vaginal devices fitted by a physiotherapist or Gynaecologist with the goal of reducing pelvic organ prolapse and related symptoms. Your physiotherapist will determine whether a pessary is appropriate for you, and will discuss with you the risks and potential benefits. If appropriate, your physiotherapist may suggest you review with your GP and/or Specialist, to ensure a collaborative approach to treatment.

For further information on Pessaries, please see the following resources:

What Conditions May I Seek Treatment For?

Acting as part of a multi-disciplinary team, our physiotherapists provide assessment and management for a number of conditions specific to women, including:

  • Urinary incontinence

  • Pelvic organ prolapse (symptoms include vaginal heaviness and dragging, low back pain, awareness of a vaginal bulge, and need to digitate in order to pass a bowel motion)

  • Faecal/flatal incontinence

  • Constipation

  • Genito-pelvic pain penetration disorder (pain during intercourse or inability of have intercourse due to pain)

  • Vaginal flatus (bothersome vaginal wind which occurs upon movement, strenuous exercise or intercourse)

  • Persistent pelvic pain/low back pain (including pubic symphysis dysfunction, sacroiliac dysfunction, anorectal pain/proctalgia fugax/chronic proctalgia, coccydynia)

What services are available to women during pregnancy and the postnatal period?

Our services include:

  • Antenatal and postnatal pelvic floor assessment and education, with the view to optimizing recovery postnatally*

  • Assessment and treatment for women who have sustained obstetric tears (commonly referred to as OASIS – obstetric anal sphincter injuries; or 3rd and 4th degree tears sustained during labour)

  • Postnatal pelvic floor assessment for women wishing to return to exercise/high level sports*

*we do not offer pelvic floor examinations to women during the first trimester of pregnancy or during the first 6 weeks of the postnatal period

What Conditions May I Seek Treatment For?

Acting as part of a multi-disciplinary team, our physiotherapists provides assessment and management for a number of conditions specific to men, including:

  • Post-prostatectomy incontinence

  • Faecal/flatal incontinence

  • Constipation

  • Persistant pelvic pain/anorectal pain/proctaglia fugax/chronic proctalgia (including referred genital pain where no other abnormalities have been detected upon investigation)

MAKE AN APPOINTMENT

Call us on (02) 4759 1485 or fill out the contact form below with your details and we’ll be in touch.

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