Woman’s Health

Question 1

What does prostate do in men

Answer 1

• Acts as additional support for bladder.
• Produces fluid to carry sperm through and out of urethra
• Fibrous, CT outer shell that protects the pulpy insides
• Some fibers go into the internal and external sphincters
• Enlarges with age

Question 2

Prostate cancer

Answer 2

Really common in older men - after 65
Watch and wait is more common lately
Prostatectomy is most common treatment which can result in damage to nerves, muscles, circulation

Question 3

What can a prostatectomy cause

Answer 3

Total or partial urinary incontinence
Impotence

Question 4

PT Considerations post prostatectomy

Answer 4

ADLS!!! You’re taking away a structure that helps support the bladder so have to help it and let it heal.
- Avoid valsalva and lifting
- Strenghten PF
- Address core stability
- Biofeedback super helpful
- diet — avoid things that irritate the bladder

Question 5

When is it considered abnormal to not be potty trained

Answer 5

5 years old

Question 6

Do you do an internal exam/treatment with kids

Answer 6

HECK NO

Question 7

What are common issues that pediatric population suffers from that we can help as PF therapists

Answer 7

1. Enuresis
2. Constipation
3. Encopresis

Question 8

What is enuresis

Answer 8

Nighttime wetting
— Major factors = constipation and overactive bladder.
— PFM and bladder need to mature in tone and coordination
NOT A DELIBERATE ISSUE

Question 9

How can we help enuresis

Answer 9

Ensure adequate fluid intake - don’t want them to become dehydrated
Treat the constipation
Teach exercises to quiet the bladder and strengthen and tone the PFM
Biofeedback with external sensors can be helpful
Desmopressin — Anti-diuretic that can be used with kids over 5
Support for parent

Question 10

Constipation in kids

Answer 10

• Can create holding of urine causing large bladders and reflux
• Impacts overactive bladder and enuresis

Question 11

How can we help constipation in kids

Answer 11

• Bowel massage
• Diet - making sure they are getting enough fiber
• Comfort with their bodies and discussing the topic. Important for them to realize defication is a normal topic
• Teach how to relax PFM - biofeedback helpful

Question 12

What is encopresis

Answer 12

Fecal incontinence or soiling in a sense of underlying disease in a child who has learned voluntary control of bowels.

Question 13

What three components do we look for if we suspect female athlete triad

Answer 13

1. Amenorrhea/oligiomenorrhea
2. Eating disorder/energy deficit
3. Osteopenia/osteoporosis

Question 14

Amenorrhea/oligiomenorrhea associated with…

Answer 14

Athletes secondary to low body fat, physical stress of exercise, and decreased caloric intake.
Can lead to less estrogen which is not good for bone density
3 months without period is warning

Question 15

When do females have peak bone mass

Answer 15

Between 25-30 years old

Question 16

What is the cascade explaining lower estrogen levels in female athlete triad

Answer 16

Energy deficit -> inhibits hypothalamus -> decreased gonadotropin releasing hormone -> decrease in LH and FSH release -> signal for release of estrogen decreases

Question 17

Urinary incontinence in female athletes

Answer 17

High prevalence
Can be stress or urge incontinence but more commonly stress incontinence.
We need to be screening female athletes for this and get them help. Ask for details on SUI episodes to help them
Risk: high impact sports, disordered eating

Question 18

What changes does the body go through during pregnancy

Answer 18

1. Increased blood flow by 40-50%
2. Increased heart rate by 10-15 bpm higher
3. Weight gain
4. Distorted body image and impaired balance (cog more anterior)
5. Posture changes — lordosis, tight hip flexors, forward head

Question 19

Increased estrogen leads to

Answer 19

Increased joint laxity

Question 20

What are the exercise implications during pregnancy

Answer 20

1. Weight gain -> exercise produces greater oxygen debt -> longer recovery time
2. After 20th week = no supine
3. Use L side lying during exercise or resting to decrease pressure on IVC — NO RIGHT SIDE LYING
   If patient has to be supine put a towel under their (R) pelvis to offset the weight and be tipped slightly to (L)

Question 21

What are exercise recommendations for pregnant ladies

Answer 21

Regular, moderate intensity for 30 minutes
Avoid high fall risk activities, scuba diving, exercising at high altitude
Gradual return to exercise of 4-6 weeks postpartum — may help with depression