Sunday, August 19, 2012

NICE Guidelines on management of urinary incontinence in patients with neurological disease.

40 page guide looks at all aspects of management.  I am looking for a guest blogger to write a summary / review of these guidelines for posting on this blog.  Review would have to be completed by 8/27.  I know we have lots of good therapists, it’s not hard.  Please email me directly at

Friday, August 10, 2012

Pelvic pain classifications

There have been several classifications proposed in the past, many of which do not include musculoskeletal dysfunction.  These two are more inclusive.  The EAU documents is quite inclusive and a good read. 

European Association of Urology  (EAU) Guidelines on chronic pelvic pain (Engeler 2010)
o   Axis 1
§  Specific disease associated pelvic pain
§  Pelvic pain syndrome
o   Axis 2 – System
o   Axis 3 – end organ pain syndrome
o   Axis 4 - referral characteristics
o   Axis 5 – temporal characteristics
o   Axis 6 – character
o   Axis 7 – associated symptoms
o   Axis 8 – psychological symptoms
IUGA / ICS terminology (Haylen 2010)
o   Bladder pain  - suprapubic or retropubic pain, pressure or discomfort, usually increasing with bladder filling, may persist or be relieved by voiding
o   Urethral pain - inside urethra
o   Vulval pain – in and around vulvar
o   Vaginal pain – within vagina above introitus
o   Perineal pain – between posterior fourchette and anus
o   Pelvic pain – pain in pelvis
o   Cyclical (mentraul) pelvic pain
o   Pudendal neuralgia – burning anus to clitoris, pain associated with tenderness over course of pudendal nerve, Nantes criteria
§  Pain in the region of pudendal nerve
§  Pain worse with sitting
§  No night pain
§  No sensory deficit
§  Relief with pudendal block
o   Chronic lower urinary tract and / or other pelvic pain syndromes

Friday, August 3, 2012

August 8, 2012 Pelvic Physiotherapy Distance Journal Club

Time - 8:30 PM EST for one hour

  • 209-647-1000 access code 436790#
  • Email Beth if you are having trouble accessing the call -
  • Please keep background noise to a minimum (see below for more details)

This month’s discussion

Shek KL, Chantarasorn V, Langer S, Phipps H, Dietz HP. Does the Epi-No® Birth Trainer reduce levator trauma? A randomised controlled trial.  Int Urogynecol J (2011) 22:1521–1528

 Meyvis I, Rompaey BV, Goormans K, Truijen S, Lambers S, Mestdagh E, Mistiaen W Maternal Position and Other Variables: Effects on Perineal Outcomes in 557 Births.   BIRTH 39:2 June 2012