New NICE Pelvic floor dysfunction guideline released9th December 2021
Pelvic floor dysfunction is common and a cause of number of symptoms: urinary and faecal incontinence, disorders of bladder and bowel emptying, pelvic organ prolapse, sexual dysfunction and chronic pelvic pain.
BSUG welcomes the new Pelvic Floor Dysfunction guideline which focusses on a community-based pathway for initial assessment and treatment. It is hoped that this should reduce the number of women who develop complex symptoms requiring specialist care including surgery.
Guidance is included on increasing awareness in the media, gyms and in healthcare settings such as when women attend for a smear test or for advice about menopause. The BSUG particularly supports the recommendation to teach young women (between 12 and 17) in education settings about pelvic floor anatomy, pelvic floor muscle exercises and how to prevent pelvic floor dysfunction .
The importance of pelvic floor muscle therapy during pregnancy has previously been acknowledged however with the large amount information women receive during pregnancy this message may not be clear. The new guidance reinforces the importance of this as well as recommending a 3-month programme of supervised pelvic floor muscle training for selected women during pregnancy and defining those women who may best benefit from post-natal treatment.
The guidance acknowledges that pelvic floor muscle therapy may take months before benefit is noticed and other risk factors such as weight loss and diet should also be addressed as part of a pelvic floor package of care. Of note, pelvic floor muscle training is recommended where the symptomatic pelvic organ prolapse does not extend greater than 1 cm beyond the hymen upon straining.