The Pelvic Floor:Function&Dysfunction

This subject has the following teaching availabilities in 2010:

This subject covers anatomy, functional anatomy and neurophysiology of the pelvis and its contents, with particular emphasis on the pelvic floor muscles and fascia, micturition and the urinary tract. Types of incontinence and diagnostic procedures are discussed and physiotherapy assessment and management of different types of incontinence are studied theoretically and practically. Pathology of connective tissue and its relationship to prolapse, and surgical procedures in gynaecology are studied theoretically. The use of electrotherapy for diagnosis and treatment is included. An introduction to evidence based practice and computer database searching are provided.

On completion of the subject, students will be expected to be able to demonstrate the following generic skills:

• The ability to identify the various forms of urinary incontinence seen in adult female patients

• The ability to clinically assess and treat an adult female patient who presents with complex urinary incontinence symptoms, including the use of adjunctive therapy

• The ability to identify the major features of muscle and exercise physiology that influence exercise programming in pelvic floor rehabilitation

• Understanding of the role of a physiotherapist in a clinical continence service

• The ability to understand the specific details of diagnostic procedures in the diagnosis of urinary incontinence, in particular, urodynamics.

• An advanced level of knowledge of the neurophysiology of electrical stimulation as an assessment and treatment of urinary incontinence.

• Knowledge of the theoretical basis and practical application of behavioural modification and bladder training in the treatment of urge urinary incontinence.

• Having viewed continence diagnostic procedures and surgery, be able to integrate physiotherapy clinical skills with that of other continence team members, including surgeons.

3,500 word assignment (60%), practical assessment (40%). Students must obtain a pass in both the practical and theoretical components in order to pass the subject.

• Bø, K., Berghmans, L.C.M., Van Kampen, M., Morkved, S. (eds). (2007). Evidence-Based Physical Therapy for the Pelvic Floor: Bridging Science and Clinical Practice. London: Churchill Livingstone

• Abrams P, Cardozo L, Khoury S and Wein A J (Eds) (2005): Incontinence: 3rd International Consultation on Incontinence, Monaco 2004 .(2005 ed.) Plymouth, UK: Health Publication Ltd.(2 nd edition available online: www.icsoffice.org -> link to Documents)
• Cardozo L and Staskin D (Eds) (2006): Textbook of Female Urology and Urogynaecology (2nd edn). London: Isis Medical Media Ltd.
• Corcos J and Schick E (Eds) (2001): The urinary sphincter . New York: Marcel Dekker.
• Mantle J, Haslam J and Barton S (2004): Physiotherapy in Obstetrics and Gynaecology. (2nd ed.) London: Butterworth-Heinemann.
• Sapsford R, Markwell S and Bullock-Saxton J (Eds) (1998): Women's Health: A Textbook for Physiotherapists . London: WB Saunders Company Ltd.

This subject is not available as a breadth subject.

Generic Skills:

On completion of the subject, students are expected to be able to demonstrate:

• Well developed problem solving skills
• Improved capacities in seeking, evaluating and retrieving information
• An appreciation of a team approach to learning
• A basic understanding of critical evaluation of research literature

Specific Skills:

On completion of the subject, students are expected to be able to demonstrate:

• A sound knowledge of the anatomy, applied anatomy and function of the pelvis and pelvic floor and urinary tract, including the bladder and its outlet.
• The ability to identify the various forms of urinary incontinence seen in adult female patients
• The ability to clinically assess and treat an adult female patient who presents with complex urinary incontinence symptoms, including the use of adjunctive therapy
• The ability to identify the major features of muscle and exercise physiology that influence exercise programming in pelvic floor rehabilitation
• An understanding of the role of a physiotherapist in a clinical continence service
• The ability to understand the specific details of diagnostic procedures in the diagnosis of urinary incontinence, in particular, urodynamics
• An advanced level of knowledge of the neurophysiology of electrical stimulation as an assessment and treatment of urinary incontinence.
• Knowledge of the theoretical basis and practical application of behavioural modification and bladder training in the treatment of urge urinary incontinence
• Having viewed continence diagnostic procedures and surgery, be able to integrate physiotherapy clinical skills with that of other continence team members, including surgeons