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Womens Health - Gynaecology Physiotherapy

Women's Health Physiotherapy is a specialist service available privately at Claremont Hospital for the assessment and management of a range of conditions which affect the lower urinary tract and musculoskeletal systems. It can be particularly useful for women who have undergone gynaecology surgery or during/following pregnancy and child birth. Please read the sections below to explore what conditions we are able to treat, how you can book an appointment and to answer some frequently asked questions.
 

Gynaecology (Pre and Post Op) Physiotherapy can treat:

  • Increased urinary frequency/urgency (the need to pass urine often/urgency)
  • Stress incontinence
  • Urge incontinence
  • Mixed urinary incontinence
  • Faecal or flatal incontinence
  • Pelvic Organ Prolapse (pre or post-surgery)
  • Pelvic floor weakness (pre or post-surgery)
  • Pelvic pain – including pain when having sexual intercourse
  • Post operative care for any Gynaecological surgery (eg. pelvic floor repair, hysterectomy)
 
Who will be my Physiotherapist?
We have one Women’s Health Physiotherapist here at Claremont hospital. Her name is Morgan West. She has 12 years experience as a physiotherapist and runs an NHS Women's Health Physiotherapy service in Nottinghamshire.
How can Physiotherapy help me?
Women’s Health Physiotherapy can help with a number of problems. These include bladder and bowel continence problems, prolapse and pelvic pain. Bladder and bowel problems can have a variety of causes, many of which can be treated with physiotherapy. You can self-refer into our service and don’t need a referral from a GP/consultant.
 
Why have I been referred for Physiotherapy?
You may have been referred for a number of reasons. These include bladder and bowel continence problems, prolapse and pelvic pain. Bladder and bowel problems can have a variety of causes, many of which can be treated with physiotherapy.
 
But I’ve already had surgery, why am I being referred now?
Following an operation to correct a prolapse or treat a continence problem, physiotherapy will help to speed up your recovery. It will also ensure that you get the best outcome from your operation. A strong pelvic floor muscle and good habits will prevent your symptoms from reoccurring in the future.
 
What is a prolapse?
The organs within a woman’s pelvis (uterus, bladder and rectum) are normally held in place by ligaments and muscles known as the pelvic floor. If these support structures are weakened by over-stretching, the pelvic organs can bulge (prolapse) from their natural position into the vagina. When this happens it is known as pelvic organ prolapse. Sometimes a prolapse may be large enough to protrude outside the vagina. Although more severe cases may require surgery, physiotherapy to help strengthen your pelvic floor and address lifestyle factors can help to ensure that any surgical repair is effective in the long term.
 
What is the pelvic floor muscle?
Your pelvic floor muscles span the base of your pelvis.They work to keep your pelvic organs in the correct position (preventing prolapse), tightly close your bladder and bowel (stop urinary or anal incontinence) and improve sexual satisfaction. They can become weakened or damage for a variety of reasons including child birth, lifestyle factors and chronic constipation.
 
But I already do my pelvic floor exercises!
Although you may already be doing your exercises, it is beneficial to have your technique assessed to ensure you are performing them correctly. Your physiotherapist will be able to assess your ability to work your pelvic floor muscles and provide any additional help you may need to strengthen damaged or weak muscles. Even if your pelvic floor muscles are found to be relatively good, symptoms can often be improved by learning to use your muscles appropriately - research has shown that over 75% of women are able to significantly reduce or eliminate urinary leakage with coughing by learning to activate their pelvic floor correctly. Additionally, your pelvic floor is only part of the problem and there are other factors which may need addressing to improve your symptoms.
 
What will happen when I come to see the Physiotherapist?
Your first appointment will last an hour. Your physiotherapist will begin by talking through your symptoms and your medical history. This is an important part of the assessment to help build a clear picture of your problem. With your consent, they will then perform a vaginal examination to assess the degree of any prolapse and the strength and technique of your pelvic floor muscle activation. This examination does not involve any equipment and is performed with a single gloved finger and lubricant. The physical examination is important to help fully assess your problem and build an appropriate treatment plan and your physiotherapist will explain the necessity for it and ensure you are comfortable. They will then explain the causes of your symptoms and discuss the treatment options with you. You will have the opportunity to ask questions and be given further explanations of anything you are unsure about.
 
Can I bring someone with me to the appointment?
Of course! Sometimes it is helpful to have someone with you to help take in the information (although you will be given written information to take home). They can be present for as much of the appointment as you would like (you may decide you don’t want them in the room for physical examinations). Some people prefer to attend alone as they are discussing quite intimate problems. This is also fine.
 
Do I need to bring anything to my appointment?
It is often helpful to bring a list of medication you regularly take to your appointment. You do not need to being anything else.
 
How long will it take to see an improvement?
How long it takes to see an improvement varies depending on the nature and severity of your symptoms and how fully you are able to commit to the treatment plan. For example, if you are found to have leakage because of weak pelvic floor muscles, the national guidelines (based on research evidence) suggest that you work with your physiotherapist for 3 months initially. Improvement is sometimes seen before this, and treatment can of course be continued for a longer period if it is beneficial. To get the most from your treatment you need to be prepared to follow any advice given and perform any exercises regularly as prescribed.
 
Will I still need surgery?
A number of women are able to avoid the need for surgery through physiotherapy, and for most women it is appropriate to try conservative (non-surgical) treatments first. However your progress will be regularly reviewed and if at any point you or your physiotherapist feel that your symptoms are not improving sufficiently, close links are kept with the Gynaecology consultants and an appointment can be arranged.
 
I feel nervous/embarrassed about my problem?
It’s easy to put off getting a problem treated because of embarrassment, however, our experts are used to talking about these things all the time and helping patients get better with the right treatment. Whatever your problem, they will have seen it many times before so there’s no need to worry or delay seeing someone.
 
Do I need a GP/Consultant referral, how do I book an appointment?
You can self-refer for gynaecology physiotherapy. Morgan West holds her clinics every Wednesday afternoon. An initial one hour consultation with Morgan at Claremont is £70, follow-up 30 minute appointments are £50. For more information or to book an appointment with Morgan, just call our Private Patient Team on 0114 263 2114 or email privatepatients@claremont-hospital.co.uk.

 

 

 

 
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