Nocturia – More Than Just a Bladder Issue
Nocturia is often dismissed by patients and their health care providers as a trivial condition and normal part of ageing when in fact it is an independent predictor for early death(1).
Bowel Function & Pelvic Health: The Underappreciated Link
Anorectal or bowel dysfunction is common, yet is under-reported, under-diagnosed and under-treated. Nearly 2% of Australian adults experience faecal incontinence and 4% experience both urinary and faecal incontinence. A staggering 40% of the world’s population are impacted by Disorders of Gut-Brain Interaction (DGBI) eg Irritable Bowel Syndrome (IBS).
Clitoral Curiosity
Every day, we speak with people who seek our support regarding painful sex. Often their stories include fear, confusion and a poor understanding of the vulva, clitoris and vagina. Many people hold unhelpful beliefs and perceptions of what is and isn’t normal. As Pelvic Health Physiotherapists, part of our role is to educate, enlighten and empower individuals to develop a healthier perspective...
Trauma Informed Care In Pelvic Health
Trauma, neglect and attachment disorders are common and create behavioural, physiological and cognitive adaptations that impact daily function and health via the effects on the neurological, endocrine and immune systems. The experience of trauma can result in loss of trust, feelings of guilt and shame, a decreased sense of safety and loss of hope for the future. These changes can affect the way...
How Can We Ensure Competency Standards In Pessary Management for POP?
Pessaries are being increasingly utilised as a component of the biopsychosocial non-surgical management of Pelvic Organ Prolapse (POP), in addition to pelvic floor muscle training, lifestyle changes and topical oestrogen. It is vital that these treatments are provided effectively and safely following evidence based and competency assessed standards.
Remapping Exercises For Sensorimotor Dysregulation: The What & The Why
The concept of sensorimotor retraining gained national and international attention in 2022 when a group of Australian researchers found promising benefits of graded sensorimotor retraining on pain intensity in patients with chronic low back pain. Known as the RESOLVE¹ study, they used a framework that included graded, novel precise exercises which showed statistically significant improvements in...
Highlights From The 23rd Asia-Pacific Prostate Cancer Conference
The 23rd Asia Pacific Prostate Cancer Conference gathered almost 400 of the leading Australian and international Urologists, Oncologists, Pelvic Health Physiotherapists, Prostate Cancer Specialist Nurses, Urology Nurses and other health practitioners in this field together to share the most recent advances in research and treatment and learn about the improved management of prostate cancer. Shan...
Breathe For Pelvic Health
Whilst commonly overlooked, dysfunctional breathing patterns contribute to many pelvic health disorders. In our clinical practice, we regularly screen for and notice altered and suboptimal breathing patterns in people that have pelvic floor muscle (PFM) dysfunction (with increased OR decreased resting muscle tone), persistent pelvic and sexual pain as well as urinary and anorectal dysfunction.
An Endo Story
This article is a personal story written by one of our patients (she/her) with Endometriosis who asked if she could share her experience in both our patient and referrer blog. Her journey highlights the significant impact that a multidisciplinary health care team that communicates regularly can have on supporting people with Endometriosis. We value being included in this MDT and learning from...
The Truth About Lactation Disorders
Lactation disorders may be considered by many to be simple and straightforward, however, they are actually quite complex. The guidelines for diagnosis and management of these conditions is regularly being updated based on emerging evidence. We explore common misconceptions and truths that surround lactation disorders.
Pelvic Floor Muscle Training – Let’s Get It Right!
There is Level 1 evidence (recommendation A) that pelvic floor muscle training (PFMT) should be first line treatment for Urinary Incontinence (UI) and Pelvic Organ Prolapse (POP) in women. This high evidence base is only true in a clinical setting if PFMT is performed correctly and effectively.
Set Great Goals: Achieve Great Outcomes
Patient centered care is gaining momentum in the literature due to its positive impact on improving clinical outcomes, adherence and patient satisfaction. Characterised by considering the patient as a person, patient centred care utilises a biopsychosocial perspective, sharing power and responsibility and developing a strong therapeutic alliance1.
We Can All Support The Psychological Impact of Prostate Cancer
Almost one-third of men with prostate cancer will experience some form of psychological distress across the different stages of the disease and throughout the treatment spectrum.
SUI and Athletes
Stress Urinary Incontinence (SUI) is defined as a complaint of involuntary loss of urine upon effort or physical exertion (eg, sport) or on sneezing and coughing and is often attributed to Pelvic Floor Muscle Dysfunction (PFMD). More and more, we are seeing that SUI as a major cause of reduced performance in female athletes. Why is this happening and how can we treat it?
Time To Re -Think Bladder Training?
Overactive bladder (OAB) is an idiopathic symptom-complex defined by urinary urgency (often with frequency, nocturia and incontinence) that appears to encompass multiple different underlying mechanisms. Despite support for behavioural therapy as first line treatment for OAB, the literature doesn’t address the specific impact of the cognitive aspect of bladder training. We need a better...
Adverse Childhood Experiences: Implications For Adult Health
Did you know that adverse experiences in childhood can have a big impact on health later in life? A landmark study in 1998 known as the ACE (Adverse Childhood Experiences) study followed over 17,000 participants, investigating the impact of emotional and physical trauma in childhood on physical and psychological health later in life. The results were overwhelmingly clear that childhood abuse and...
Impact of Gestational Diabetes on the Pelvic Floor Muscles
Gestational diabetes (GDM) is associated with increased incidence of pelvic floor dysfunction and urinary incontinence, both during pregnancy and post-natally. An interesting study was published late 2020 on this topic, exploring the effect of GDM on the pelvic floor muscles. 110 pregnant women with and without GDM were assessed with 3D ultrasound at 24-28 weeks and 34-38 weeks gestation, and...
Treating Incontinence, Empowering Women
Urinary incontinence (UI) is a significant problem for Australian women. Affecting 1 in 3 women of all ages, this is an issue that needs to be taken seriously. When a woman is not able to control her bladder, it can affect her life profoundly. Women will often stop exercising, withdraw from intimacy, have reduced self-esteem, and avoid engaging in things they enjoy. Shockingly, a large population...
FODMAPs: The Latest In Health And The Irritable Bowel
Irritable bowel syndrome (IBS) is the most common gastrointestinal disorder. Symptoms of bloating, abdominal pain and diarrhoea or constipation (or alternating) are frequent. These impact daily life, mental wellbeing, increase absenteeism from work/school and affect social activities.
Exercise: A Vital Part Of Cancer Management
Exercise is a vital part of cancer management. The benefits are not only physical. Exercise can improve mood, symptoms of depression, and also have an impact on the body’s immune system and chances of overall survival. The benefits of exercise in cancer are so widely supported that it is now recommended by the Clinical Oncology Society of Australia that exercise be a part of everyone’s cancer...
Let's Talk Sex
Life is complicated. Sex is complicated. Sex is profoundly influenced by everything that’s happening in our lives, and sex reciprocally influences what is happening in our lives. They are not separable. Many of the ideas that we develop about sexuality and our bodies begin with familial and socio-cultural beliefs, and the sex education we receive at school. Most of us went into puberty education...
New ‘Magic Pill’ For Treating Erectile Dysfunction
Erectile dysfunction affects up to 1 in 2 men. Current typical treatment options include medication and lifestyle modification. A systematic review published this year has found a new “wonder drug” for erectile dysfunction and premature ejaculation. This magic pill has no side effects, is affordable, and is easy to administer. And you will never guess what it is….. Pelvic Floor Exercises!
How to Improve Life After Gynae Cancer
Gynaecological cancer is the third most commonly diagnosed cancer among women. Thankfully the survival rates are increasing, but, as a consequence, many women are now having to live with the adverse effects of treatment. These often include bothersome bladder, bowel and sexual dysfunction. Research and awareness in this area is improving, with Associate Professor Helena Frawley from Monash...
Fluid Intake And OAB: Less Is More!
Many health professionals endorse drinking 2 litres of water each day, despite a lack of scientific evidence to support this1. In patients with overactive bladder (OAB), excessive fluid intake is known to exacerbate urinary frequency and urgency. A new systematic review has just been published, investigating fluid intake and OAB, and the results are fascinating.
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...
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...
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...
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...
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...
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...
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...
