Women's Health / Bladder & Bowel Physiotherapy

Kirsten Barrett is our specialist Pelvic, Obstetric and Gynaecological Physiotherapist with over 12 years experience in women's physiotherapy. 

What does a Pelvic, Obstetric and Gynaecological Women's Physiotherapist do?

  • A women's physiotherapist specialises in the physiotherapeutic care of women in relation to childbirth, both antenatally and postnatally, including the delivery of antenatal classes for the woman and her partner.
  • Physiotherapy is an excellent conservative treatment for bladder and bowel incontinence for men and women, and is often more effective than drugs.
  • A women's physiotherapist can also assist in the care of women undergoing gynaecological surgery.
  • Women's physiotherapy is an effective treatment for musculo-skeletal conditions both during pregnancy, and immediately postnatally.
  • May also be specialists in the treatment of sexual dysfunction in relation to pelvic floor muscle problems for men and women.

Common conditions Kirsten will treat:

  • urinary and faecal incontinence
  • prolapse
  • sexual dysfunction
  • dyspareunia
  • pregnancy-related musculoskeletal conditions
  • Post perineal trauma (3rd and 4th degree perineal tears during childbirth)
  • Post episiotomy

Physiotherapy for Bladder Incontinence 

We don't give the bladder a thought when we can control it, when it starts to control us, it can become a huge problem. The good news is, bladder problems often respond very well to physiotherapy treatments.

Types of urinary incontinence

There are two major forms of urinary incontinence:

Stress incontinence, unwanted leakage during physical activity. This may happen during exercise or even when walking, laughing or standing up.
Urge incontinence, leakage on the way to the toilet, or even simply the feeling that leakage might happen if you don't get to the toilet quickly enough.
Many people suffer a combination of  both of these, which is called mixed incontinence.

There is a myth that urinary incontinence is something to be expected as you get older. While prevalence is greater in older people, it can affect people of any age and it is treatable.

Kirsten offers an individualised approach to physiotherapy treatment for bladder issues. 

This involves, in the first instance, a detailed interview to find out what your symptoms are and how they affect your life. Based on this interview, a plan of treatment can be put together, agreed and reviewed.

NICE guidance suggests that pelvic floor exercise is a very effective first line treatment for  urinary incontinence, but, for these exercises to be effective, it is important that they are taught correctly. This is why Kirsten offers specific assessments to ensure that you are doing them right. Pelvic floor exercises are quick and easy to do and can be performed anywhere.

Urinary incontinence can be part of a range of conditions including neurological conditions, following child birth, following urinary tract infection or it may simply arise because of lifestyle and drinking habits. This is why treatment does not focus solely on exercise. Dietary and fluids advice will also be given and suggestions made if appropriate.

Bladder problems can have a significant impact on every day life making sufferers unwilling to take general exercise, afraid to drink before going out, fear of going to new places due to fear of not being able to find a toilet, poor sleep patterns due to the need to get up to empty over night. More concerning, answering that urge can lead to increased risk of falls.

All the research suggests that Women's Health Physiotherapy can and does help, and people of all ages can benefit.

Prolapse - there are three different types of prolapse. Whilst in their most severe forms, surgery may be the best solution, in the early days symptoms can be improved or even reversed with a range of good management techniques including - pelvic floor exercise and diet and lifestyle advice.

Bladder prolapse (or cystocele)  often characterised by a feeling of heaviness down below, this may get worse as the day goes on. Bladder prolapse often responds well to pelvic floor exercise and possible alterations in general exercise choices. It also may benefit from dietary advice promoting gradual weight loss and good bowel management.

Bowel prolapse (rectocele) often characterised by difficulty passing a bowel motion, possible faecal leakage and feeling of heaviness prior to defaecation. This can respond well to good bowel management advice, defaecation advice  and pelvic floor exercise.

Uterine prolapse (enterocele) characterised by a feeling of heaviness which often increases as the day progresses. This can respond well to pelvic floor exercise, general exercise advice and dietary advice. Many prolapse sufferers may also complain of low back pain, coccyx pain or discomfort during intercourse. These symptoms too can be improved with appropriate targeted advice and exercise.

Sexual dysfunction - pain and dyscomfort during intercourse can be extremely distressing and difficult to talk about. Kirsten has recently completed a postgraduate qualification through the Institute of Psychosexual Medicine, in London, which combines both counselling and physical examination with a view to providing a service which offers both the chance to explore the route of the problem and suggestions for managing this most intimate aspect of any relationship.  

Sexual dysfunction can have many causes, both physical and psychological, so an approach which combines both can yield very positive results. In dealing with this and, indeed any other aspect of pelvic health, the utmost discretion is always employed to ensure that clients feel safe, secure and able to move forward with the best possible advice.

In Kirsten's experience, the thing clients need most, in these areas of health, is time. Time to listen to your concerns, time to explore fully how your symptoms affect your life and time to find the solution that suits you best.  

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