New Research On Vulvodynia Management

Vulvodynia affects 10-20% of women, and its prevalence is on the rise. It affects women across the lifespan, and its pathophysiology is still poorly understood. Associate Professor Melanie Morin, Canadian researcher and Pelvic Floor Physiotherapist, recently presented an update on Provoked Vestibulodynia (PVD) at the International Continence Society 2018 in Philadelphia. Her fascinating...

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Case Study: Faecal Incontinence

Jill was referred by a Urologist to WMHP for management of Urgency Urinary Incontinence, but during subjective assessment disclosed that Faecal Incontinence was actually her most bothersome symptom. This case study highlights the absolutely devastating effect Faecal Incontinence can have on a person’s quality of life, and how a structured treatment program can cure this highly bothersome...

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International Continence Society 2018 - Key Highlights

Leonie Yeap, Clinical Manager at WMHP, and I were fortunate enough to travel to Philadelphia, USA to attend the 48th annual meeting of the International Continence Society held in August. The meeting, attended by around 1500 delegates from across the globe, is a forum for researchers, clinicians and students to explore the latest research on urinary and faecal incontinence and pelvic floor...

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Better Bowels With Rectal Balloon Biofeedback

Rectal balloon therapy is emerging as an exciting biofeedback tool to effectively treat a variety of benign anorectal disorders. Wald and co-authors recently published the American College of Gastroenterology Clinical Guideline: Management of Benign Anorectal Disorders1, and strongly recommended the use of biofeedback with rectal balloon therapy for treatment of defecatory disorders, chronic...

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Case Study: Post Prostatectomy Incontinence

Fred was referred to WMHP with significant incontinence after surgical treatment for prostate cancer. This case study is a fascinating example of the complexity and diverse etiological factors which can contribute to post-prostatectomy incontinence, and explores Fred’s journey on the road to recovery of continence.

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Faecal Incontinence: The Role Of Ageing And Gender

Faecal incontinence (FI) affects up to 1 in 5 Australian men and 1 in 8 Australian women. This is higher than the prevalence of diabetes (6%) and asthma (11%). Dr Danette Wright, colorectal clinical fellow, recently delivered a fascinating presentation at the Continence Foundation Australia NSW State Meeting, discussing the role of ageing and gender in FI. Males and females are both affected by...

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Weight Loss: The "Wonder Drug” For Incontinence

Australians are getting fatter, with 7 in 10 Australian men, 1 in 2 women and 1 in 4 children now being overweight or obese. Unfortunately these numbers are continuing to rise. Dr Lucy Bates, Urogynaecologist at Westmead Hospital in Sydney, recently presented at the Continence Foundation Australia NSW State Meeting, exploring the relationship between obesity and incontinence, and what we can do...

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Case Study: The Power of “Explaining” Pelvic Pain

Tracey was referred to WMHP with dyspareunia, vulvodynia, and pelvic floor muscle dysfunction following gynaecological surgery. This case study explores the impact of psychological and social factors on Tracey’s pain experience. It highlights the importance of following a biopsychosocial approach incorporating therapeutic neuroscience concepts when developing an effective treatment program....

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PFD In Sportswomen: A Silent Epidemic

Urinary incontinence and pelvic floor muscle dysfunction are too often considered disorders of post-partum and postmenopausal women. However, recent research shows an alarmingly high prevalence of urinary incontinence among nulliparous female athletes – particularly in those participating in repetitive, high impact sports such as gymnastics, netball and running. Urinary incontinence in women...

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New Treatment Option For OAB: TTNS

Professor Suzanne Hagen, Scottish pelvic floor research guru, recently delivered a key note address at the 26th National Conference on Incontinence 2017. She discussed Transcutaneous Tibial Nerve Stimulation (TTNS) as a treatment option for overactive bladder (OAB). The research base supporting this treatment technique is growing. A systematic review published this year concluded that TTNS can...

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Prolapse: Treat Early For Best Results

Pelvic Organ Prolapse (POP) affects HALF of all parous women, however it is still surrounded by taboo. At the recent 26th National Conference on Incontinence, Professor Suzanne Hagen, Scottish Pelvic Floor research guru and international keynote, presented her soon-to-be-published Cochrane systematic review on conservative management of prolapse.

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Stacey: A Case Study Of Post-Natal Urinary Incontinence

Urinary Incontinence after childbirth is a very common problem. However, too often it is dismissed by health professionals and women as 'normal', with a reminder to 'do pelvic floor exercises'. This case study highlights the complexities than can exist after childbirth, and the importance of a thorough subjective and objective assessment.

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Incontinence: Worse Than Death!

In a recent study, 55% of people considered having bladder and bowel incontinence to be 'worse than death'. Being incontinent was rated higher than 'relying on a breathing machine to live' (50%), 'being bed-bound' (45%), and 'being confused all the time' (40%). This result is staggering, and highlights the stigmatisation of incontinence. Professor Adrian Wagg, Canadian Geriatrician, shared this...

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Does Cranberry Work For Preventing UTI?

Urinary tract infections (UTIs) are incredibly common, affecting 1 in 2 women and 1 in 20 men in their lifetime. Twenty to thirty percent of women who contract a UTI will experience recurrence. A common treatment for recurrent UTIs is low dose antibiotic prophylaxis, however such treatment programs can lead to antibiotic resistance. The increase in antibiotic resistance has re-ignited interest...

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Highlights from the Post Prostatectomy Incontinence Masterclass

A Post Prostatectomy Incontinence Masterclass at the Asia-Pacific Prostate Cancer Conference 2017 was convened by Shan Morrison and Rachel Heerey. The masterclass brought together experts in urology, pelvic floor physiotherapy, nursing, and psychology. We were very lucky to have such an expert faculty presenting on the day, including surgeons Mr Daniel Moon, Mr Peter Sutherland and Mr Homi...

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Case Study: Increased Tension In The Pelvic Floor Muscles

Sonya was referred to WMHP for obstructed defecation and pain with bowel emptying. However, following a thorough biopsychosocial assessment, it emerged that Sonya’s main concern was dyspareunia. This case study explores the complex inter-relationships of bladder, bowel, and sexual function, and highlights the sequela of increased tension in the pelvic floor muscles (previously termed an “...

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CPPS: The ‘Black Hole’ Of Men’s Health

Chronic Pelvic Pain Syndrome (CPPS) is only recently being recognised as the “black hole” of men’s health. It’s not well understood by health professionals and has a huge impact on men’s physical, emotional and social health and wellbeing. A holistic management approach is needed to address the complex influences of psycho-social factors as well as the biological ones.

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Case Study: Provoked Vulvodynia

Provoked vulvodynia is one of the many chronic pelvic pain syndromes we see presenting in women. This complex and multifactorial condition has a significant impact on every aspect of the lives of these women who are often young. There is increasing evidence supporting a multi-disciplinary, biopsychosocial approach. This case study illustrates Physiotherapy best practice.

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Hot Off The Press: The ICI Book

The recently published and highly anticipated 6th edition of the ‘International Consultation on Incontinence’ book highlights the very strong evidence base supporting pelvic floor muscle training as an effective treatment for many bladder and bowel disorders. Pelvic floor muscle training is Grade A recommended treatment for female urinary incontinence and pelvic organ prolapse.

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10 Tips For Managing IC / PBS From Professor Curtis Nickel

Interstitial cystitis / painful bladder syndrome (IC/PBS) is a complex condition, and often difficult to treat. Professor Curtis Nickel, urologist and pelvic pain guru from Canada, was a key note speaker at the recent USANZ conference, and shared ‘10 Tips For Managing IC/PBS’. His overwhelming message, loud and clear, was that IC/PBS is a multi-factorial condition, and a multidisciplinary...

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Exciting New Resource For Nocturia Management

Dr Wendy Bower, physiotherapist and researcher at Royal Melbourne Hospital, is leading a research team in Australia, Europe and Asia, investigating nocturia, its multifactorial aetiology, and how to most effectively treat it. They have developed a new screening tool TANGO, which aids the user in targeting the aetiology of nocturia and guiding individualised treatment.

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Painfree Sex After Childbirth

Sexual dysfunction after childbirth is incredibly common, with nearly two thirds of women experiencing sexual problems six months after delivery1. Physical and psychosocial factors both play a role in its development. Unfortunately, only 15% of women with sexual problems reported discussing it with their healthcare professional1 which is very sad as it can be successfully treated!

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Transperineal Ultrasound (TPUS): An Exciting New Technology

Real time 2D transperineal ultrasound imaging is emerging as an exciting new technique for both pelvic floor muscle assessment and training. Far superior to the transabdominal approach, it’s a valuable tool to use with patients before or after radical prostatectomy, prolapse, pelvic pain, obstructed defecation, or voiding dysfunction.

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Understanding Urgency And Centralisation In OAB

There is an emerging body of research that supports the role of centralisation in patients with overactive bladder (OAB). Urgency is no longer considered a direct representation of detrusor overactivity, rather it’s a multidimensional sensory experience. This knowledge enables reconceptualisation of current first-line conservative treatments for OAB, with the potential to improve their efficacy.

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The Importance Of Pain Science Education

Chronic pain is a huge health problem, and is expected to cost the western world as much as diabetes and cancer combined.  Dr David Butler and Professor Lorimer Moseley have pioneered the understanding and treatment of chronic pain internationally and, luckily for us, they live right here in Australia and work at the University of South Australia.  Their latest research tells us that...

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The Evolution Of Bladder Diaries

I recently received an email from a referring GP asking for a copy of our bladder diary. This request made me think about the importance of bladder diaries because patients are typically very poor historians regarding their bladder function. Often their subjective history will be quite different from what is actually happening!  Bladder diaries are an extremely useful diagnostic tool and...

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Patient Adherence: The Key To Success

Patient motivation and adherence is the most important predictor of treatment success.  The International Continence Society (ICS) acknowledges the importance of this and recently invited an expert panel to review the literature in this area and provide recommendations for research and clinical practice.

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When Patients Don't Listen

A 2010 Harvard Medical School study showed that about 20 percent of first-time prescriptions are never filled. This means that 1 in 5 patients don’t follow their doctor's recommendations. This was reinforced recently when we received some feedback from a patient who had been struggling with bladder symptoms for two years. She was seeing both a urologist and gynaecologist and had been referred to...

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A Small Muscle With Big Impact

When I first graduated from Physio I never imagined I would spend my career rehabilitating one small internal muscle and that it could be so interesting and rewarding! Pelvic floor disorders can impact social and physical activities, intimate relationships and workforce participation, leaving sufferers isolated, embarrassed and lacking confidence. Together we can help them.

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PPI – The Benefits Of Prehab Pelvic Floor Training

Urinary incontinence is a common problem after surgery for prostate cancer and it has a huge impact on quality of life. Over 15 years ago, when we started seeing men post-operatively, there was minimal research and understanding of the contribution of the pelvic floor to the male continence mechanism. Since then we have learnt so much about how to optimise recovery of post-prostatectomy...

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