If you are reading this, I imagine that you or someone you know have experienced incontinence. You are amongst friends. Incontinence, especially of urine is common – but not “normal.” And from my physio and personal perspective, not okay. Or perhaps you are wanting to optimise your wellness, which is great.
The pelvic floor, the bottom of our pelvic “basket” has three openings – for the urethra, the bladder outlet, the vagina and anus. The pelvic floor, abdominal muscles and diaphragm are inextricably linked, so surgery and/or radiotherapy here may affect their function including their role in continence.
The pelvic floor can come under pressure when straining or carrying extra weight (including a baby). Abdominal/pelvic surgery and any weakness/disturbance of function can cause a few drops or a steam of urine to escape from the body when we cough or sneeze. (stress incontinence)
As I get older and work with more people who use a urostomy/colostomy bag, I have discovered how important care of the pelvic floor is even if it is not being used as it used to be before surgery. It still needs to be working well to optimise movement, stability and fluent movement throughout the body.
Pelvic floor exercises are discreet and can be practiced almost anywhere and at anytime – but they need to be done several times a day, over a period of months (a lifetime!) to be effective.
Especially after surgery and/or radiotherapy, as a physio, I hope to enable people to find joy in their body again through pleasurable movement, confidence in the body and delight in sensation. Continence is important as is the opportunity to enjoy sexual and sensuous expression.
If you have stress incontinence, some sessions with a women’s health physio may be what you need, so please ask your GP or consultant to refer you to a local women’s health physio. You are likely to have a thorough verbal and physical assessment, which may or may not include an internal examination. This will depend on what you need/want and also the level of post graduate training that the physio has had. There are women’s health physios working in the independent sector as well as the NHS.
If your local services are embarrassed or don’t have sufficient experience, I hope that you have the courage, strength and determination to get a referral to someone who loves this area of work and is keen to work with you. Specialist Physiotherapist, Elaine Miller’s interview on BBC Radio4’s Woman’s Hour August 4 2017, might give you the impetus you need to request some physio. If you have more specific sexual questions that your physio doesn’t feel able to answer, someone like Samantha Evans may be able to help you.
I hope this is useful and wish you the very best in finding who you need to enable you to be continent.
Leah Dalby MCSP