Urinary Incontinence

Urinary incontinence is the involuntary leakage of urine. Common types of urinary incontinence include:

• stress urinary incontinence (leakage with exertion such as coughing/sneezing/running)

• urge urinary incontinence (may be associated with an overactive bladder, and an overwhelming urge to empty your bladder, even when not much urine is passed)

• Post-prostatectomy incontinence in men after prostate surgery.
  

Other bladder issues may include urinary frequency, needing to wake multiple times at night to visit the toilet, and difficulty emptying your bladder. Pelvic physiotherapy can help with your bladder symptoms.

Pelvic Organ Prolapse

Pelvic organ prolapse is the descent of pelvic organs such as the bladder, bowel, and/or uterus (yes, all 3 are possible)! Symptoms may include a vaginal bulge, vaginal heaviness/ache/drag, as well as issues with urinating, emptying your bowel, difficulty using a tampon or menstrual cup, and a change in sexual intercourse (decreased sensation, dryness, and/or pain).

Pelvic physiotherapy can guide you through conservative treatment options for pelvic organ prolapse, such as lifestyle advice, exercise advice, pelvic floor muscle training, and the use of a vaginal support pessary.

Vaginal support pessaries are devices that support your pelvic organs like a “brace.” Proactive Physiotherapy is fortunate that all their physios that treat prolapse have training in the application and management of vaginal pessaries in the treatment of pelvic organ prolapse.

Pre- and Post-Natal Physiotherapy

Women may benefit from physiotherapy support throughout their entire child-bearing year (from conception to beyond)! Physiotherapy for our pre- and post-natal clients goes beyond the pelvic floor muscles (although they are ridiculously important)!

We can provide help, not only with continence and incontinence prevention, but advice and guidance regarding:

• How to manage the early post-partum

• Abdominal separation

• Back and pelvic pain
  

• Return to exercise safely
  

• Blocked milk ducts
  

The ideal time for a pelvic floor check post-partum is approximately 6 weeks. However, if you are experiencing any symptoms that you are unsure of after your delivery, especially if they involve pain, or significant incontinence, please reach out as soon as possible. Often our physios that treat pelvic health can provide beneficial advice.

If you are crazy busy (as all new Mums are), it is ok if your pelvic floor check is later if you are going okay. It is important that your pelvic floor is checked before returning to higher intensity exercise or sport.

Pelvic Pain and Dyspareunia

Pelvic pain, including pain with intercourse (known as dyspareunia), can be associated with pelvic floor dysfunction. Pelvic pain conditions can include:

• Pelvic floor muscle overactivity

• Endometriosis

• Adenomyosis
  

• Vulvodynia
  

• Vaginismus
  

• Bladder pain syndrome or interstitial cystitis
  

Your physiotherapist treating pelvic health can help determine what physiotherapy treatments may be helpful for your condition.

Bowel Dysfunction

Symptoms such as faecal urgency, leakage, incomplete bowel emptying, difficulty or painful emptying, and constipation may be helped with pelvic physiotherapy.

Bowel dysfunction often accompanies and can influence bladder issues. Physio treatment will often involve strategies to help manage both areas.

Men’s Pelvic Health

Did you know that men also have pelvic floor muscles? Typically, they are only needed for bladder control/bladder continence after prostate surgery.

Our physios have training to help men train their pelvic floor muscles before and after undergoing prostate surgery. This training can help men regain bladder control more quickly.

If possible, completing pelvic floor muscle training for at least 6 weeks prior to surgery is ideal! Of course, this may not be possible, and that is okay. Starting your pelvic floor muscle training as soon as you can will be helpful. If you have been unable to consult a physio prior to surgery, an appointment a week after your catheter has been removed can help get your pelvic floor firing and help your recovery.

Men can also have overactive pelvic floor muscles. This may cause chronic pelvic pain (including scrotal/penile pain, pain with ejaculation and sexual dysfunction). Pelvic physiotherapists can provide treatment to help reduce pelvic floor muscle overactivity which may reduce your symptoms.