Pelvic Health Services

• Urinary urgency, frequency and urinary incontinence (bladder leakage), including overactive bladder symptoms

• Urinary leakage with coughing, sneezing, lifting or exercise

• Difficulty emptying the bladder

• Pessary assessment and pessary fittings for urinary incontinence, where appropriate

• Constipation

• Difficulty emptying the bowels

• Straining or a sensation of incomplete emptying

• Faecal urgency (a sudden, strong need to open your bowels)

• Faecal incontinence (bowel leakage)

• Difficulty controlling wind

• Pelvic floor dysfunction affecting bowel function

• Assessment and management of pelvic organ prolapse, including bladder, uterine and bowel prolapse

• Individualised pelvic floor rehabilitation

• Advice on exercise, lifting and managing prolapse symptoms

• Vaginal pessary assessment and fitting, where appropriate

• Ongoing pessary review and management

• Pelvic and perineal pain

• Vulval and vaginal pain

• Pain with sexual intercourse or penetration

• Vaginismus and difficulty with penetration

• Pelvic floor muscle overactivity, tension and difficulty relaxing

• Support for sexual function concerns related to the pelvic floor

• Trauma-informed pelvic health care

Pelvic health physiotherapy during pregnancy can support pelvic floor function, help manage pregnancy-related concerns and prepare you for birth and postnatal recovery.

Antenatal services include:

• Pelvic floor assessment from 20-25 weeks, including assessment of pelvic floor function, and any bladder, bowel, prolapse, or pelvic health concerns

• Individualised birth preparation from 36 weeks, including pelvic floor preparation, perineal massage and strategies to support pelvic floor relaxation during birth. This appointment includes preparation for vaginal, assisted or cesarean section births, including what to expect and early postnatal recovery.

• Assessment and management of pregnancy-related pelvic girdle pain

• Individualised advice for safe exercise and physical activity during pregnancy

Postnatal pelvic health physiotherapy can support recovery following a vaginal, assisted or caesarean birth. Assessment and rehabilitation are individualised according to your birth experience, symptoms and goals.

Postnatal services include:

• Comprehensive postnatal pelvic floor assessment

• Assessment of abdominal function and recovery

• Rehabilitation following perineal tears and episiotomy, including third- and fourth-degree tears

• Assessment and management following pelvic floor birth injury, including levator ani avulsion

• Management of postnatal bladder, bowel, prolapse or pelvic pain concerns

• Individualised guidance for returning to exercise, physical activity and work

Comprehensive postnatal pelvic floor assessments are generally offered from 6-8 weeks after birth. Earlier appointments for advice and symptom management may be available.

Pelvic health physiotherapy can support preparation for and recovery following gynaecological and pelvic floor surgery. Assessment and rehabilitation are individualised according to the type of surgery, symptoms, recovery stage and personal goals.

Services may include:

• Pre-operative pelvic floor assessment and preparation

• Assessment of bladder, bowel and pelvic floor function before and after surgery

• Individualised rehabilitation following gynaecological, prolapse or continence surgery

• Guidance for returning to exercise, physical activity and work

• Management of pelvic pain and other pelvic floor symptoms following surgery

• Support for pelvic health symptoms associated with vaginal mesh, in collaboration with your treating specialist

During perimenopause and menopause, some women notice pelvic health changes, including:

• Urinary leakage, urgency or frequency

• Difficulty emptying the bladder

• Vaginal dryness and/or discomfort with intimacy

• Symptoms of pelvic organ prolapse

• Recurrent urinary tract infections (UTIs), requiring medical assessment

Care may include individualised pelvic floor rehabilitation, bladder and bowel strategies, advice for comfort and intimacy, and pessary care where appropriate. Jessica can work alongside your GP or gynaecologist to support coordinated care.