Pelvic Floor Re-education

1. Function and dysfunction of the pelvic floor and viscera: Functional anatomy of the pelvic floor and lower urinary tract.- Neural control of pelvic floor muscles.- The effects of pregnancy and childbirth on the pelvic floor.- Muscle function and ageing.- Urinary incontinence and voiding dysfunction.- Pelvic organ prolapse.- Anal incontinence, constipation and obstructed defaecation.- Overactive pelvic floor muscles and related pain.- 2. Evaluation of the pelvic floor: Clinical evaluation of the pelvic floor muscles.- Examination of patients with pelvic organ prolapse.Urodynamics.- Applying urodynamic findings to clinical practice.- Anorectal physiology.- Ultrasound imaging.- Magnetic resonance imaging.- Introduction and technique. Static MRI: anatomy, normal variation and pathology. Dynamic MRI of the pelvis.- Electrophysiology.- Outcome measures in pelvic floor rehabilitation.- 3. Techniques of pelvic floor rehabilitation and muscle training: Concepts of neuromuscular rehabilitation and pelvic floor muscle training.- Exercise, feedback and biofeedback.- Electrical stimulation.- Extracorporal magnetic stimulation.- Devices.- Alternative methods to pelvic floor muscle awareness and training.- 4. Treatment – condition-specific assessment and approaches: Behavioural treatment.- Stress urinary incontinence.- Evidence for the effectiveness of pelvic floor muscle training in the treatment and antenatal prevention of female urinary incontinence.- Postpartum management of the pelvic .- Role of a perineal clinic.- Overactive bladder.- Sexual dysfunction and the overactive pelvic floor.- Anal incontinence and evacuation difficulties.- Incontinence during sports and fitness activities.- Pelvic organ prolapse.- 5. What to do if physiotherapy fails?: Stress urinary incontinence: choice of surgery.- Genital prolapse: surgery for failed conservative treatment.- The anal sphincter.