Pelvic organ prolapse

No.  You can make your appointment without a referral.  ACC and private appointments are available. If you do have a referral from your doctor or health care provider, then they will send it to Pelvic Solutions directly. To book now click here.

Physiotherapists are experts at working with the musculoskeletal and neuromuscular systems of the body. With their additional specific training, Pelvic Floor Physiotherapists are well-placed to assess and treat muscle groups, including the pelvic floor. The muscles of the pelvic floor are found at the opening of the vagina (in women), urethra, and rectum. Thoroughly assessing the function of the pelvic floor is possible with an examination performed with one finger (gloved) inserted into the vaginal or rectal canal. There is a strong anatomical basis for this seemingly unconventional exam. Pelvic Floor Physiotherapists train in both internal and external evaluation and treatment techniques and current medical research backs this approach.

An internal assessment is the “gold standard” for a comprehensive assessment of the pelvic floor. Some patients may be hesitant at first but then choose to go ahead with internal assessment. However, for patients who are not comfortable with internal examinations, there is no obligation to have one. Pelvic Floor Physiotherapists can assess the function of the pelvic floor by using external observation and cueing. A surface EMG (electromyography) biofeedback test can be used to assist this examination.

No. To be able to practice in this highly-regulated profession, our therapists have completed extensive post-graduate training in this field to gain the knowledge and clinical skills necessary to treat this complex clinical area. Our therapists study through The Women’s Health Training Associates and Melbourne University, as they offer a comprehensive training for Physiotherapists in this field. To be competent to work in this area, our therapist’s professional development has included hundreds of hours of theory and practical study, and multiple workshops, courses and monthly peer review meetings with other trusted colleagues in this field. Although our therapists can treat musculoskeletal injuries like ankle or shoulder sprains, they focuses on treating those with pelvic floor dysfunction, rather than standard injuries, but take a whole body and mind approach to treatment.

To help patients achieve optimal health, Physiotherapists usually work very closely with surgeons. Surgery can repair a structural problem, but it is equally vital to restore muscular control and function to accomplish the best results after surgery. Research has shown that physiotherapy prior to and after surgery improves patient outcomes, as well as reducing the need for future surgery. Pelvic Floor Physiotherapy can also help after procedures such as vaginal botox, to help with restoring muscle function, retraining of the complex core system including the breath, and optimising sexual functions.

While we strive to be family-friendly it can be beneficial for Mums if children are not present, so they can focus completely on the treatment. There is often a lot of new information to absorb and if internal treatment is required we want you to be as relaxed as possible. However, we will do our best to accommodate the needs of your family.

During your initial appointment extra time is allocated to gather detailed information about your presenting complaint, bladder and bowel function, medical, gynaecological and surgical history, birthing history, sexual function, dietary habits, toileting behaviours, and lifestyle.

A thorough physical examination is then performed which includes assessment of posture, breathing mechanics, musculoskeletal testing, and if appropriate may include an internal vaginal or rectal examination. This examination is performed by observing and/or palpating the perineal region including the vagina and/or rectum. This evaluation will assess skin condition, reflexes, muscle tone, length, strength and endurance, scar mobility and function of the pelvic floor region (note: your therapist will explain the procedure completely and only proceed with your consent).

This allows us to form a working diagnosis. Your Pelvic Floor Physiotherapist will explain the diagnosis to you and discuss the different treatment approaches which may be appropriate. In some cases, referral back to your GP or another practitioner may be required.

Up to 60 minutes is allowed for the initial consultation. This allows for a thorough understanding of your condition and for initial treatment to take place.

Follow-up appointments will likely be required to achieve best results. Return appointments are up to 30 minutes. Extended 45 and 60-minute appointments are available for more complex and chronic problems. Your progress is reviewed at every appointment and the treatment adjusted accordingly. Some conditions may improve quicker with a prescription of specific exercises: your Physiotherapist will advise you.

Most people feel fine after an internal vaginal examination, no different than after a pap smear test usually. If treatment involves extended internal body work, releasing the pelvic floor muscles and trigger points, then some people can experience some aching after treatment (like after a massage!), but this generally resolves within a few hours. Some people can feel thirsty, have headaches, and feel tired after internal body work, especially if the muscles are chronically tight. Listen to your body and rest as you need to. It is important to hydrate with plenty of water. It is recommended that after an internal examination you drink a large glass of water, and empty your bladder as standard care. You will be provided with detailed aftercare instructions after your treatment.

If you have any concerns about how you are feeling after internal body work then please get in touch with us by email here.

Some results can be felt immediately after the first session, however for permanent changes to be made it usually takes longer. Usually 3 treatments are indicated initially one week apart, then usually a follow-up anywhere between 2-4 weeks later, and then further treatments less often as required. This is due to the complex nature of most cases our therapist treats, and usually the problems are chronic, meaning it takes time to change behaviour, and strengthen muscles and co-ordinate body systems to improve function. We will strive to resolve your problem in the minimum number of treatments; the greatest success occurs when you are an active participant in your treatment program, and follow the advice given. Our therapists communicate directly with patients outside of appointments and are always available by email or phone to discuss any problems or concerns you may have with your program.

For our out of town clients, it may be difficult to get to the follow up appointments.  We will discuss with you the suitability or an online follow up, if you are unable to make it in person.

**Due to high demand we encourage all new patients to book their initial and two follow up appointments two weeks apart to ensure you get the most out of your treatment.

There is strong evidence that treating prolapse (Grade 3 or less) conservatively with Pelvic Floor Physiotherapy (for up to 6 months) can significantly improve or even reverse prolapse and symptoms. Grade 4 prolapse (outside of the vagina completely) usually needs surgical intervention to resolve.