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 understanding of the rationale of bladder training and specifically develop urgency management strategies that are more effective in those presenting with a central component to their symptoms.
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So many of our patients diagnosed with a prolapse stop exercising. Exercise may exacerbate their prolapse symptoms, or they may be worried about making their prolapse worse. But exercise is so crucial to look after both physical and mental health. One of the most common questions we get from our patients with prolapse is: what type of exercise am I able to do?
Shan, Leonie, Jane and Kathryn attended the ICS conference in October, which was held virtually this year. Associate Professor Helena Frawley, the original founder of Women’s & Men’s Health Physiotherapy was on the scientific committee and contributed to bringing together a stimulating program. There were so many fascinating and inspiring workshops and presentations (which we watched bleary eyed very early in the morning or late at night!). We have included some of our favourite ‘pearls’ from the conference below.
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Recently, there has been an explosion of research into endometriosis associated pain and the influence of central mechanisms in the pain experience. Endometriosis-associated pain syndrome (EAP) is defined as “chronic or recurrent pelvic pain in patients with laparoscopically confirmed endometriosis”, and the term is used when the symptoms persist despite adequate endometriosis treatment.
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Traditionally, high impact exercise (including heavy weight lifting and running) has been discouraged in women with pelvic organ prolapse (POP). There is little research to support this, however, expert opinion hypothesised that high impact exercise results in significant increases in intra-abdominal pressure (IAP). This pressure may contribute to worsening POP symptoms by weakening the pelvic floor structures. This is a logical and reasonable assumption, however, is it correct?
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The inspiration for this piece is from one of our favourite books, “Come As You Are”, by Dr Emily Nagoski. Dr Nagoski has pulled together 10 years of research into women’s sexuality, and shares an essential exploration on how female arousal, desire, autonomy, pleasure and orgasm works, and provides tools for women to create and sustain a fulfilling sex life.
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 family dysfunction had a profound effect on adult mental health and wellbeing and increased the chance of developing chronic illnesses such as heart disease, diabetes, cancer, persistent pain and obesity.
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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 levator ani thickness and hiatal area were measured.
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Bladder leakage 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 stop doing things they love.

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-based study found that 75% of affected women don’t seek help, and among those who do seek help, only 12% actually ended up receiving care1. Incontinence is highly prevalent but very treatable – and pelvic floor muscle training is the grade A, first line recommended treatment for stress, urge or mixed incontinence2. We know that you know this – but do women know this? It is our job to ensure the message is heard, understood and acted upon.

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Our Locations

Camberwell
549 Burke Rd, Camberwell VIC 3124
T: 03 8823 8300
F: 03 8823 8399
Hampton
170 Thomas St, Hampton VIC 3188
T: 03 9521 0444
F: 03 9521 0777 

Also consulting at:

Box Hill:  Epworth Eastern Ekera, Level 2, Suite 2.10, 116-118 Thames Street
East Bentleigh: Southern Urology, 7 Chester Street
East Melbourne: Urology Consultants Victoria, Suite 102, Freemasons Hospital, 320 Victoria Parade
Malvern: Australian Urology Associates, Ground Floor, 322 Glenferrie Road
Malvern: Cabrini Mother and Baby Centre, Area E, Level 2, Cabrini Hospital, 183 Wattletree Road

If you’d like to make an appointment for one of these locations please call our Camberwell rooms on 03 8823 8300