The Overactive Pelvic Floor

This textbook provides a comprehensive, state-of-the art review of the Overactive Pelvic Floor (OPF) that provides clinical tools for medical and mental health practitioners alike. Written by experts in the field, this text offers tools for recognition, assessment, treatment and interdisciplinary referral for patients with OPF and OPF related conditions. The text reviews the definition, etiology and pathophysiology of non-relaxing pelvic floor muscle tone as well as discusses sexual function and past sexual experience in relation to the pelvic floor. Specific pelvic floor dysfunctions associated with pelvic floor overactivity in both men and women are reviewed in detail. Individual chapters are devoted to female genital pain and vulvodynia, female bladder pain and interstitial cystitis, male chronic pelvic and genital pain, sexual dysfunction related to pelvic pain in both men and women, musculoskeletal aspects of pelvic floor overactivity, LUTS and voiding dysfunction, and anorectal disorders. Assessment of the pelvic floor is addressed in distinct chapters describing subjective and objective assessment tools. State of the art testing measures including electromyographic and video-urodynamic analysis, ultrasound and magnetic resonance imaging are introduced. The final chapters are devoted to medical, psychosocial, and physical therapy treatment interventions with an emphasis on interdisciplinary management The Overactive Pelvic Floor serves physicians in the fields of urology, urogynecology and gastroenterology as well as psychotherapists, sex therapists and physical therapists.

Pelvic Floor Re-education encompasses a variety of techniques for increasing the strength of, and control over, the pelvic floor muscles. These techniques are now emerging as an effective and viable alternative to surgery in the treatment of urinary incontinence and related conditions. This volume presents a reasoned, scientific approach to the use of pelvic floor re-education. Starting with the latest theories on anatomy, pathophysiology and possible causes of pelvic floor damage, the text then describes the importance of pelvic floor evaluation in determining the type of treatment required. A number of re-education techniques are assessed including isolated muscle exercise, vaginal cones, biofeedback control and electrical stimulation. Recent research work is also reviewed which allows the reader to evaluate the different modalities advocated in the management of pelvic floor dysfunction.

As medical knowledge advances we tend to compartmentalise our specialties into smaller units; but, hand in hand with this, there is a growing understanding between the different disciplines within the caring professions. Thus we are able to share our special skills to the benefit of patients. This book is an excellent example of the advantage of interdisciplinary communication and demonstrates a refreshing holistic approach to the problems of incontinence and pelvic pain. Written with physiotherapists in mind, the editors have invited contributions from many distinguished experts in their own field. These have been compiled into a comprehensive book, which will appeal to many healthcare professionals. I have had great pleasure in reading this book. During the time that I have been involved with 'pelvic dysfunction' there have been many exciting advances. These are all included in a most readable sequence, some presented with a refreshing new twist. In particular, I would like to bring to your attention the section on 'pelvic pain'. Because of our lack of understanding it has been a problem that is too often ignored and here at last are some practical ideas for therapeutic management. There is still much progress to be made in the field of incontinence and pelvic pain and as yet, no editors can be expected to produce a definitive work. However, I would like to recommend this book most strongly. It has a new approach to this topic, which is still a major problem for many people.

The remarkably complex pelvic floor and its disorders comprise one of the most interesting -- and challenging -- areas of physical therapy. And recently, common problems once considered taboo, such as incontinence, have become mainstream issues. More than ever before, a solid understanding of the structure and function of the manifold problems of the pelvic floor is vital to successful treatment. This groundbreaking work brings together an international team of world-renowned experts in the treatment of urinary and fecal incontinence, as well as sexual dysfunction, to provide a comprehensive guide to the structure and function of the muscles of the pelvic floor. Using concise text and clear illustrations and helpful photographs, the authors present all phenomena associated with pelvic floor dysfunction. The authors begin with a detailed overview of the anatomy and physiology of the pelvic floor, and then discuss all state-of-the-art diagnostic and treatment strategies, from biofeedback and manual therapy to the causes of different types of pain and psychosocial problems. Detailed discussions of the specific issues associated with children, women, and men, as well as with rectal and anal dysfunction, follow. With its thorough coverage, this highly practical text is essential reading for all health care professionals who wish to provide their patients suffering from disorders of the pelvic floor with the best care available.

This book provides readers with a holistic approach to chronic pelvic pain which is an extremely complex condition with associated pelvic dysfunctions. This approach significantly facilitates and accelerates the clinical assessment and subsequent follow-up. The pathophysiologic mechanisms involving the nervous system, the pelvic organs and the pelvic floor are discussed, deepening the possible implications on mind, sexuality and pelvic dysfunctions. Evaluation and diagnosis are examined for different types of syndromes. Moreover, since the Bladder Pain Syndrome and the Interstitial Cystitis are main causes of pelvic pain, an original diagnostic approach is proposed specifically for these conditions. In order to deliver the best clinical outcomes, this new system provides a multidisciplinary approach, both in the diagnostic phase and in the therapeutic phase The most recent therapies for chronic pelvic pain following a multidisciplinary approach are described in detail. Due to its practice-oriented contents, the book will greatly benefit all professionals dealing with this debilitating disease, supporting them in their daily clinical routine.

This book will enable the reader to gain a sound understanding of contemporary and futuristic evidence-based interventions and assessment procedures for pelvic floor disorders. It gathers the experiences of some of the most important experts on electrical stimulation techniques, offering a multidisciplinary and problem-oriented approach organized according to therapeutic goals. Interventions are recommended that are consistent with theory and display clinical efficacy for specific disorders, including urinary incontinence or retention, fecal incontinence, constipation, pelvic pain, sexual dysfunction and neurological diseases involving the pelvic floor. All of the surgical or rehabilitative techniques requiring electrical stimulation for the treatment of these disorders are explored and essential background information is provided on functional anatomy, neurophysiology and concepts in electrotherapy. This volume will be a very useful tool for urologists, general or colorectal surgeons, gynecologists and anesthesiologists and also physiotherapists and alternative medicine practitioners (a specific chapter focuses on electroacupuncture). It will assist in their clinical practice as they seek to help the very many patients who suffer from any of the wide range of functional pelvic floor disorders.

This book provides to nurses an understanding of female sexual function and dysfunction specifically in relation to common gynecological conditions. It offers evidence based overview of assessment of sexual function, including available questionnaires and provides a multidisciplinary approach to managing sexual dysfunction, from incontinence to pelvic organ prolapse and recurrent urinary tract infections. It also covers a holistic approach including over the counter and home treatments, psychological therapies, physical therapies, pharmacological options and if necessary more invasive interventions. Sexual function and pelvic floor dysfunction is often a neglected area due to the taboo nature of discussions. This book aims to educate nurses, to help them understand the types of treatment options available, and encourage them to engage in conversations about sexual function with women, so that they can be referred to appropriate health professionals and access the right care.

First book devoted to the diagnosis and treatment of sexual pain in women Female Sexual Pain Disorders is a remarkable fusion of clinical and scientific knowledge that will empower women’s healthcare professionals to help their patients in overcoming this common debilitating disorder. Based on the highest level research, it provides state-of-the-art practical guidance that will help you to: Evaluate and distinguish the causes of sexual pain in women Differentiate the many forms of sexual pain Implement multidisciplinary treatments Distilling the experience of world leaders across many clinical, therapeutic and scientific disciplines, with an array of algorithms and diagnostic tools, Female Sexual Pain Disorders is your ideal companion for treating the many millions of women who suffer from this disorder worldwide. All proceeds from this book are being donated to the International Society for the Study of Women’s Sexual Health (ISSWSH).