Pelvic Floor Service
Pelvic floor dysfunction in the general population is common. The aetiology, functional anatomy and physiology of those conditions which result, however, are often poorly understood, but there has been an upsurge of interest in them amongst urogynaecologists and coloproctologists.
It is increasingly apparent that bladder, vaginal and rectal dysfunction frequently co-exist and are often inseparable. Where patients previously may have had to put up with considerable restrictions on their activities with little hope of improvement, some very effective surgical and non-surgical management options now exist. These may make a significant difference to a patient’s lifestyle.
The pelvic floor service at the Fitzwilliam Hospital is aimed at individuals with the following problems:
- Vaginal prolapse
- Urinary incontinence
- Lower urinary tract disorders
- Faecal incontinence
- Difficult or painful rectal evacuation
- Rectal prolapse
Further evaluation might include urodynamics, endoanal ultrasound, evacuation proctography, flexible sigmoidoscopy and cystoscopy. Other investigations may be recommended by the clinician depending upon clinical findings.
1) Conservative. This might include pharmacological treatment or dietary manipulation for faecal incontinence or evacuation difficulties. Some patients will be referred for specialist pelvic floor assessment and treatment which might include the use of biofeedback by a specialist physiotherapist with an interest in pelvic floor disorders.
2) Surgical. The range of operations offered, depending upon the nature of the disorder, includes Trans-vaginal Tape (TVT) for stress incontinence, various vaginal prolapse repairs, rectocele repair, perineal fixation of rectal prolapse, laparoscopic rectopexy and anal sphincter repair.
This will be determined by the nature of the problem or any procedures performed.