Physio Management of Obstetric and Gynaecological Disorders Flashcards
Pelvic floor dysfunction is an umbrella term give an overview of the wide range of symptoms/problems pelvic floor can cause
- Urinary symptoms - incontinence
- Pelvic organ prolapse
- Vulvodynia - chronic pain affecting vulva area without identifiable cause
- Faecal symptoms
- Defaecatory dysfunction
What is the role of physiotherapists the in treating pelvic floor dysfunction ?
Work as part of the wider MDT
Assess and treat patients with pelvic floor/bladder/bowel dysfunction in primary care
Refer on to secondary services as appropriate
What is done in the history part for the assessment of pelvic floor dysfunction ?
- Past medical history (lung disease, surgery, diabetes, neurological)
- Lifestyle – smoking, weight etc
- Drug history
- Obstetric & Gynaecological history
- Social history
- Bladder symptoms – including bladder diary
- Bowel symptoms – including constipation
- Quality of life measures
- Patient set goals
What investigations/examinations are done for the assessment of pevlic floor dysfunction ?
Urinalysis
Post void residual
Visual Assessment of perineum
Vaginal +/- rectal examination – pelvic floor assessment checking for things such as Pelvic organ prolapse
+/- assessment of flow
Go over the grading of pelvic floor dysfunction set by oxford and international contience society (ICS)
What is the treatment provided for bladder symptoms (incontience) in pelvic floor dysfunction in general?
- Caffeine reduction
- Bladder training
- Voiding/ double voiding techniques
- Pelvic floor exercises
- Reduce/avoid constipation
What is the treatment for bowel symptoms in pelvic floor dysfunction ?
- Regulate stool to ‘goldilocks poo’
- Pelvic floor exercises
- Difficulty wiping clean – lepicol or similar
- Urge : holding on programme
- Frequency: holding on programme and caffeine reduction
When are women encouraged to do pelvic floor exercises (PFE)?
During pregnancy and after birth
In NHS tayside when/why would a women following delivery see a physio in regards to pelvic floor exercises and other treatment ?
Women who have had a forceps delivery or third/fourth degree tear (involving anal sphincter complex) have one-to-one contact where exercise technique is discussed
Follow-up clinic for third/fourth degree tears at 10-12/52 postnatally, complete assessment and more tailored programme of exercises and further treatment if indicated
