Pelvic Health Physiotherapy

Pelvic health physiotherapists are therapists who have a particular interest in pelvic health conditions such as incontinence, pelvic organ prolapse and pelvic pain. Our therapists have undertaken further post-graduate training to ensure that they have in-depth knowledge and skills to assess these conditions.

• Urine leakage when coughing, sneezing or laughing.
• Urine leakage relating to urge to urinate.
• Increased urinary frequency.
• A strong urge to urinate yet feeling unable to empty the bladder.
• Pain during urination or when the bladder is full.
• A feeling of bulging or bulkiness and/or aching in the vagina.
• Difficulty controlling the urge to empty my bowel.
• Difficulty controlling leakage of stool or wind.
• Painful bowel movements and/or constipation.
• Pain during or after sex.

Your first appointment will last around 60 minutes and during that time the physiotherapist will conduct a detailed assessment including how and when your symptoms first started, what aggravates them and what makes them feel better. They may also ask you about previous treatments or investigations related to these symptoms. As part of the assessment, it will be important to discuss your previous medical history and any obstetric history and specifics about your lifestyle such as any hobbies or sports you take part in. This will ensure that they are able to make an accurate diagnosis and help you decide the best way to manage your symptoms.

Although it may seem daunting to talk about personal issues like these, especially if you have not done so before the therapist will be sensitive to this and will aim to put you at your ease. Discussions are conducted in a private area so that they cannot be overheard and are completely confidential. Everything that you tell the therapist is confidential and will not be discussed with anyone else without your permission.

You may be asked to fill in a bladder diary to find out what and how much you are drinking and how often you go to the toilet. Similarly, if you suffer with bowel symptoms, they may ask you to fill in a bowel diary.

For bladder, bowel and persistent pain conditions you may be asked if you are happy to undergo a vaginal or rectal examination to assess your pelvic floor muscle function. This is so that the therapist can assess the strength co-ordination and function of these muscles. This is useful as not everyone will benefit from the same rehabilitation program. You may wish to take a friend or family member with you or ask for a chaperone. The therapist will discuss this with you to explain why this is helpful and what it involves. These examinations will only ever be performed with your consent.

You may prefer not to have an examination or to wait and think about it beforehand. You may prefer not to be examined at all. This does not mean that you will not be offered treatment.

After the assessment the therapist will discuss the findings and treatment options with you so that together you can plan the most appropriate treatment plan.

If you live with incontinence, painful intercourse or pain in the pelvic area, pelvic floor physical therapy may be the key to relief. In fact, it can be used to treat many disruptive, uncomfortable or painful conditions involving the pelvic floor.

A typical pelvic exam only lasts a few minutes. You undress below the waist and cover your lower body with a sheet or gown. You lie down on the exam table with your legs raised and knees out to the side. Your physiotherapist will make you as comfortable as possible as it is important that you try to relax for the internal examination.

The pelvic floor muscles area group of muscles that support your pelvic organs (the bladder, the uterus and the bowel). They are an important part of the control of our bladder and bowel function. Research has shown that pelvic floor exercises and lifestyle advice are the most effective ways of controlling symptoms such as leaking urine, wind or stool. These exercises are easy to perform when you know how and can be done anywhere.

Other treatments may involve strengthening or control exercises for the abdominal muscles and the diaphragm. Your therapist will guide you through the most appropriate rehabilitation program for you. It is important to have an individual program and follow advice as some types of exercises may not be appropriate for all women. In some cases, it can be important to learn how to relax the muscles before you start to strengthen them.

In cases where pain is one of your symptoms it may be important to find ways of controlling this before starting the strengthening.

It is never too late to rehabilitate and learn to manage these symptoms.

It is fine to wear whatever you are comfortable wearing, but it may be helpful for the therapist to look at your general movements so wearing loose fitting comfortable clothes may be better.

No, on rare occasions examinations may be uncomfortable but the therapist will always be guided by you and will stop at any stage if you are uncomfortable.

Yes, this is fine as long as you are happy to attend. It is still fine to be examined during a period provided you are comfortable with this. In some situations, it can even be useful as the muscle control may vary with your hormonal cycle. If you are not happy to be examined then that is fine, but there may still be other things that are useful to discuss. If in doubt discuss it with your therapist.

No there is no need to wax/ shave/ groom the area before attending.

Many women worry about unpleasant smells, discharge or sweat before an appointment, so may choose to shower that day. If this is not possible then, please still attend and do not worry.