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  • Samara Nanayakkara

What Happens During a Pelvic Floor Examination?


According to the 2018 Jeane Hailes’ Women’s Health Survey:


- 22.4% of younger women (aged 18-35) have discussed or need to discuss with their doctor pain when having sex in the past 12 months; 7.4% higher than the average across all age groups

- One in three women older than 65 have discussed or need to discuss incontinence with their doctor in the past 12 months.

- Almost all women knew what pelvic floor exercises were (96.4%) and could feel their pelvic floor muscles working when they tried to squeeze them (95.6%), however less than two out of 10 women (17.6%) did their pelvic floor exercises daily.



Pelvic floor conditions can affect a woman at any stage of her life.



Pelvic Floor Physiotherapy – for Every Life Stage



Pelvic floor conditions can affect a woman at any stage of her life. Changes to the pelvic bones, muscles, connective tissue and organs can occur from:

- Hormonal changes

- high – impact sport

- genetics

- pregnancy

- childbirth

- breastfeeding

- menopause

- surgery

- trauma




Discussion



As there are many bodily functions in and around the pelvis, such as your digestive tract, genitourinary and reproductive system, it is essential to discuss your current situation to meet you where you are. A detailed conversation regarding your bladder, bowel, diet, sexual function, gynaecological history, hygiene, exercise history, genetics, goals and expectations will help guide your treatment goals and program. A doctor’s referral is not required to see a Pelvic Floor Physiotherapist – however, if you have been referred by your GP or specialist, it is recommended that you bring in your reports and scans.




Assessment



Your one – to – one, 60 minute initial assessment will include a real - time ultrasound (RTUS) is a non - invasive scan to assess the function of your pelvic floor and bladder. You will be lying on your back with the ultrasound sensor placed at bladder – level, just above your pubic bone. Your physiotherapist will assess how your pelvic floor is lifting, how your bladder is emptying, and the capacity of the bladder.


An internal examination (vaginal and / or rectal) can be performed, at your discretion. Your physiotherapist may ask you to cough, strain for a few seconds and contract your pelvic floor during the examination to assess for pelvic floor strength, tone, tearing and prolapses.

You may also be asked to keep a bladder, bowel or prolapse diary over a few days to record your symptoms.




Treatment



As every woman is unique, your treatment program will be tailored for you. This may include pelvic floor strength or down - training exercises, dietary modifications, bladder retraining, avoiding strains, pessaries, dilators and a discussion with your GP about using an oestrogen cream. These techniques are not used for every condition, but illustrate how diverse the treatment options are.


Our follow - up consultations will be booked in regularly to assess your function and progress your treatment. Discreet correspondence and communication between myself and your doctor will only be done with your consent.


Some pelvic floor conditions will be outside of the scope of assessment and treatment via pelvic floor physiotherapy. These conditions may require referral onto a specialist, such as a urologist or gynaecologist. A correspondence and referral letter will be sent to them on your behalf.

Private health rebates are available, and most pelvic floor physiotherapists in Australia accept the Extended Practitioner Care (EPC) Plan provides a maximum of five, Medicare – funded physiotherapy sessions.


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