Gynecological, urological and anorectal physiotherapy are specialized forms of physiotherapy that focus on the pelvic area.
These therapies are designed to help people who experience pain, discomfort or dysfunction in the pelvic area. In this article, we will look at what gynecological, urological and anorectal physiotherapy is, what it involves and what benefits it can bring to patients.
Gynecological Physiotherapy
This type of therapy is intended to help women who experience pain, discomfort or dysfunction in the pelvic area. Gynecological physiotherapy can be used to treat a variety of conditions, including:
- Pelvic pain.
It is a common condition that affects many women. This may be caused by various factors, including endometriosis, adhesions, scars, pelvic inflammatory disease, dysbiosis in the vulva, the effects of trauma, abuse, the consequences of treatments, radiation of the area in connection with oncological therapy, as well as dysfunction of muscles, nerves, blood vessels and lymphatics of the pelvic floor. Gynecological physiotherapy can help relieve pelvic pain by re-educating the pelvic floor muscles and improving blood and lymph flow to the area. It may manifest itself as vulvodynia - pain in the vulva, vestibulodynia - pain at the vaginal entrance, vaginism - genital-pelvic pain and penetration disorder, coxycodynia - pain in the coccyx, as well as menstrual, ovulation and other pain in the reproductive organs and pelvis. smaller.
Incontinence is a condition that affects many women, especially those who have given birth or are in perimenopause and postmenopause, but is increasingly affecting young women during their reproductive years. Often associated with weakened pelvic floor muscles, but often hypertonia in this area may reveal similar symptoms. People suffering from neurological or oncological diseases also experience problems with continence. Accurate diagnostics and muscle testing are then crucial. Remember that involuntary loss of urine, gas or feces is not a physiological situation. The feeling of incomplete emptying of the bladder, pressure on the bladder, overactive bladder, weak urine stream, constipation or the feeling of incomplete evacuation are situations that should not be underestimated. Often, correcting toilet habits allows you to feel a great change. Prolapse occurs when the muscles, tendons and ligaments that support the pelvic organs weaken.
Pelvic organ prolapse or prolapse is a condition in which the pelvic organs (such as the uterus, vaginal walls, bladder or rectum) fall into the vaginal canal. This may cause discomfort and pain, but also a number of other consequences. Gynecological physiotherapy can help alleviate prolapse by strengthening the pelvic floor muscles and improving support for the pelvic organs. Gynecological physiotherapy is also crucial before procedures in the case of reproductive organ static disorders, both abdominal and vaginal. In cases of organ depression in degrees I and II, the physiotherapist may select the appropriate type of pessary or special tampons to support statics and the rehabilitation process.
- Preparation for pregnancy, physiotherapy for pregnant women and in the early and late postpartum period.
A urogynecological physiotherapist is a specialist who will help thoroughly prepare a woman's body for pregnancy and guide her until delivery . It analyzes your general health condition and, on this basis, helps you combat ailments such as sciatica . He also deals with the prevention of diastasis of the rectus abdominis muscle and the symptoms of diastasis of the pubic symphysis.
A urogynecological physiotherapist also selects the appropriate activity aimed at working with the respiratory system and helps the woman prepare the muscles for exercise so that the birth is safe and without unnecessary complications. In this case, it is important to learn to relax the muscles and regulate the breathing rhythm. During the consultation, the physiotherapist carefully explains to the patient how to best prepare for childbirth, what exercises to do and what to pay special attention to.
Urological Physiotherapy
Urological physiotherapy is a specialized form of physiotherapy that focuses on the urinary system. This type of therapy is intended to help people who experience urinary dysfunctions such as urinary incontinence, pelvic floor pain, non-inflammatory prostate diseases, physiotherapy after prostalectomy surgery, erection problems and other sexual disorders, urinary retention.
Urological physiotherapy can be used to treat a variety of conditions, including:
- pelvic pain with variable intensity in the lower abdomen, scrotum, testicles, perineum and thighs - CPPS,
- urinary incontinence,
- overactive bladder and urgency,
- erectile and potency disorders,
- Peyronie's disease,
- fertility disorders,
- varicocele and testicular hydrocele,
- difficulty urinating and residual urine.
Pelvic floor problems in men have a slightly different origin than in women. Most often, they are the result of treatments for prostate, testicular or bladder cancer, non-specific inflammation of the prostate, pudendal neuralgia, spine problems, injuries, demyelinating diseases, hard faccid syndrome (pain, shortening or hardening of the penis), Peyronie's disease (disease of the connective tissue of the penis, manifested by sclerosis of the corpus cavernosum).
Appropriately conducted urological physiotherapy at the pre-operative stage and then continued after the procedure significantly increases the chance of improving continence and sexual function. Urological physiotherapy aims to re-educate habits related to micturition, including toilet habits. According to scientific reports, in men with prostate problems and lower urinary tract diseases, it is advisable to adopt a sitting position during micturition in order to reduce the load on the pelvic floor and facilitate micturition.
Anorectal physiotherapy
Anorectal physiotherapy is a specialized form of physiotherapy that focuses on the area of the final section of the large intestine, rectum and anus. This type of therapy is intended to help people who experience pain, discomfort, or dysfunction in this area. Anorectal physiotherapy can be used to treat a variety of conditions, including:
- Gas and fecal incontinence.
Gas and/or fecal incontinence is a condition in which a person is unable to control bowel movements and gases. This can be caused by a variety of factors, including nerve damage or muscle weakness.
- Constipation .
Constipation is a common condition that affects many people. They may be caused by various factors, including improper diet, dehydration, muscle weakness, flatulence, pain during defecation, hemorrhoids, and painful hemorrhoids.
- Pelvic pain.
Pelvic pain is a common condition that can affect both men and women.
Anorectal physiotherapy usually involves a combination of exercises, manual therapy and toileting behavior re-education. Patients can be taught exercises to strengthen the muscles around the anus and anus. Manual therapy may include massage or stretching of the pelvic muscles. Education may include advice on posture, breathing and lifestyle changes that can help improve patients' health and quality of life.
In addition to palpation skills, physiotherapists in this field have many diagnostic tools at their disposal, such as electromyography, anorectal manometry, anorectal biofeedback, EMGBiofeedback, and ultrasonography. In addition, physiotherapy includes individually selected pelvic floor muscle training, preceded by diagnostics using electromyography or ultrasound with sonofeedback and physical examination. Examination for the purposes of urological, gynecological and anorectal physiotherapy, as well as EMG diagnostics and electrostimulation are performed per rectum in men - through the rectum, in women - through the vagina (often using a vaginal speculum) and/or rectum. Similarly to women's therapy, we pay attention to correct posture, appropriate breathing pattern and pattern, and try to modify risk factors and influence habits that impair the functions of the systems. It is important to remember that working with a patient with pelvic floor problems is complex - team work - it requires close cooperation, among others: a urologist and/or oncologist, a physiotherapist, a psychologist, a sexologist, and in the case of working with patients with a history of oncology, also a psycho-oncologist.
Karolina Olszewska