Pelvic Health Blog

Case Study: Chronic Pelvic Pain after Hysterectomy

8/4/2012

Patient: 83-year-old female

Chief Complaint: 4/10 R posterior pelvic pain and rectal pain increasing in the evening, that started after hysterectomy 6 years ago

Past Medical History: surgical revision vaginally, local estrogen; gallbladder removal, irritable bowel syndrome

Physical Therapy Treatment: abdominal bowel massage; review of proper bowel evacuation methods and stool formation; manual therapy to gluteal muscles, pelvic floor, and hip adductors; nerve gliding techniques; TENS unit training for home; HEP

Results: 0 out of 10 pelvic and rectal pain after 13 visits

Recommended Resource: Physiological Quieting

8/4/2012

Connect PT is a fan of Physiological Quieting, a CD for clients and clinicians. It is produced by Janet Hulme, a physical therapist that has been practicing for over 30 years. Breathing, autogenics, and muscle scanning are just a few of the components that have been included to help treat conditions like pelvic pain, bladder irritability, and sleep disturbances. Listening to guided CDs like these can facilitate balance in the autonomic nervous system.

Did You Know: "Women with Vulvodynia" Tutorial

8/4/2012

The NVA, or National Vulvodynia Association, has a free tutorial for Women with Vulvodynia. It reviews anatomy, normal and abnormal symptoms, and vulvar self-examination, for starters. Check it out at www.nva.org.

What the Research Says: Effects of Pelvic Floor Muscle Strengthening on Bladder Neck Mobility

8/4/2012

Written by Michelle Dela Rosa, PT.

A recent study in Taiwan has reported on the effects of pelvic floor muscle strengthening for urinary incontinence (UI) and bladder neck mobility. 23 female participants performed a specific pelvic muscle strengthening program over 4 months. After 4 months, the ability to elevate the bladder neck with a contraction improved, as measured by transperineal ultrasonography. Everyone reported a decrease in UI, and demonstrated an increase in pelvic floor muscle strength and maximal vaginal squeeze pressure.

(Hung HC et al., “Effect of pelvic-floor muscle strengthening on bladder neck mobility: a clinical trial”. Phys Ther. 2011 Jul; 91(7): 1030-8.)

Pelvic Rehabilitation Recommended as First Line of Defense for Stress Incontinence

8/4/2012

Written by Michelle Dela Rosa, PT.

An article in Advances in Urology was published by Dr. G. Willy Davila of the Cleveland Clinic Florida that describes non-surgical management of female stress urinary incontinence (SUI). He reviewed the literature for prospective trials and included only studies that followed participants for at least 12 months. The article confirms earlier research reviews that identify pelvic floor rehabilitation as a low cost, low risk treatment, with 60-77% of patients showing improvement in SUI symptoms.

(G. Willy Davila, “Nonsurgical Outpatient Therapies for the Management of Female Stress Urinary Incontinence: Long-Term Effectiveness and Durability,” Advances in Urology, vol. 2011, Article ID 176498, 14 pages, 2011. doi:10.1155/2011/176498)

BLOG

Case Study: Chronic Pelvic Pain after Hysterectomy

Recommended Resource: Physiological Quieting

Did You Know: "Women with Vulvodynia" Tutorial

What the Research Says: Effects of Pelvic Floor Muscle Strengthening on Bladder Neck Mobility

Pelvic Rehabilitation Recommended as First Line of Defense for Stress Incontinence

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