Specialist Services
Knowing that your patient has pelvic floor dysfunction is a great start, but then what should you do next? Many pelvic floor related conditions are interlinked. Urge urinary incontinence can come hand in hand with constipation, and stress urinary incontinence can be a sign of overactive pelvic floor.
With the information you have gathered from your patient, discerning what is the most appropriate treatment option for them is the next step. Most of the time, a referral will be needed to a specialist service particularly if you are already treating your patient for another condition. What services are out there and what do they offer?
Continence Clinics
Continence clinics are connected to most health services and usually have continence nurses or nurse practitioners and physiotherapists. Some services may have a geriatrician or other specialist doctor linked in with the clinic. Continence clinics can provide a specialised assessment and treatment which can include:
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Catheterisation
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Uroflow/urodynamics
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Access to continence products and funding
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Symptom and lifestyle advice
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Pelvic floor muscle training and/or exercise programs
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Appropriate referral for specialist review
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Recommendations for medications
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Bladder and bowel charting
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Bladder and bowel retraining techniques
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Paediatric interventions
Specialists to consider may be:
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Gynaecologist - for antenatal or postnatal women; prolapse; women who sustained tears during birth; complex pelvic pain
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Colorectal - for bowel incontinence; loss of sensation of bowel movements; anal pain or fistulas; rectocele; chronic constipation
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Urologist - for frequent infections of urinary tract; urinary incontinence; cystocele; prostate diseases; underactive bladder
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Neurologist - for sensation changes or if there is an underlying neurological condition with new onset of pelvic floor dysfunction
However, initial referral to a continence clinic or women's health nurse or physiotherapist is the best starting point. They will be able to complete a more thorough assessment and may have links with particular specialists who are most appropriate for particular presentations.
