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Guidance on taboo subject welcomed

Pelvic floor muscle training should be a first-line treatment for women with urinary incontinence, the National Institute for Health and Clinical Excellence has said.

Its new guidance on the management of urinary incontinence in women says at least three months of supervised pelvic floor
muscle training should be the first treatment offered to patients with stress or mixed urinary incontinence.

The training should also be offered as a preventative measure for women in their first pregnancy, according to the clinical guideline published jointly with the National Collaborating Centre for Women’s and Children’s Health.

The guidance also says routine digital assessment of pelvic floor muscle contraction should be undertaken before the use of supervised pelvic floor muscle training.

Grace Dorey, a consultant physiotherapist specialising in continence and sexual dysfunction, said the condition of about 80 per cent of patients could be improved with pelvic floor muscle exercises.

Although Professor Dorey said physiotherapists were already treating incontinence patients correctly through exercise and advice, she welcomed its inclusion in the guidance .

‘It may mean that the medical fraternity will send us more patients because they will realise the importance of physiotherapy,’ she said.

Specialist continence physiotherapist Julia Herbert, an independent practitioner who also works at Bolton primary care trust, said the guidance was robust and that she was pleased digital assessment was recommended.

Ms Herbert said it had not been recommended in the draft guideline and she had made a submission in support of its inclusion because, she said, muscle assessment was necessary in order to prescribe appropriate exercise.

Female urinary system revealing posterior views of the kidneys,ureters, bladder and urethra


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