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CONGRESS '09 - Focus on male pelvic floor

Consultant physiotherapist Professor Grace Dorey entertained members with a ‘cultural history’ of the male pelvic floor.

Understanding of the area had evolved over hundreds of years and with advances in research and diagnostic techniques,

she said.

The male pelvic floor plays a role in posture and breathing, and helps to support the abdominal contents. It is important for maintaining urinary and faecal continence, and gaining and sustaining penile erection.

Prof Dorey, of the University of the West of England, described how in the early sixties physios had been restricted in the type of physical assessments they could carry out on male patients. ‘We weren’t allowed to touch the inner third of the thigh,’ she said. She then went on to explain some of the more intimate investigations now possible.

She outlined how pelvic floor muscle training could help in tackling urinary and faecal incontinence and erectile dysfunction. She said her own research study found pelvic floor exercises were more effective than lifestyle changes for erectile dysfunction. ‘I compared my work with Viagra, which was just coming in. My work stands up against Viagra nicely’, she said. Prof Dorey is currently training the therapists for a large multi-centre clinical trial, run by Aberdeen University, comparing pelvic floor exercises with standard treatment for men following prostate surgery.

Earlier, Ruth Lovegrove Jones, a private practitioner and Southampton University PhD candidate, gave a presentation on the ‘dynamic evaluation’ of the pelvic floor muscles. This discussed research using 2D ultrasound imaging and imaging processing methods to measure how the pelvic floor muscles and urethra function during ‘dynamic events’ in continent women and those with stress urinary incontinence.

In a separate presentation on the bladder and bowel systems, Julia Herbert, specialist continence therapist, NHS Bolton, said physios were making increasing use of ultrasound as a therapeutic tool in relation to pelvic floor muscle training.

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