This is a new guideline from NICE on pelvic floor dysfunction. It was published in December 2021.
Most of the nuts and bolts of this guideline are what we do already. There are a few details that were new for me and there will be some changes on a community level. I have detailed some of the things that were new for me, then I will do a more general summary.
What is new for GPs in this guideline?
- This guideline encourages the discussion of pelvic floor dysfunction in a much broader range of circumstances, including as part of general exercise programmes, during existing health checks and when discussing menopause. There are several more circumstances listed, which I have summarised below.
- Young women aged 12 and over will be taught about it in school, as well as how to do pelvic floor exercises.
- Women of all ages (eg 12 and older) should be encouraged to do pelvic floor exercises and to continue them life-long.
- Risk factors are many that you would expect. Fibromyalgia is also a risk factor, which I hadn’t realised. A family history of urinary incontinence, overactive bladder or faecal incontinence also increases a woman’s own risk.
- Diabetes is also a risk factor and good diabetes control can help prevent it.
- Pregnant women should be encouraged to do pelvic floor exercises. If they are 20/40 or more and have a first degree family history of pelvic floor dysfunction, then they should be referred for supervised pelvic floor training.
- Supervised pelvic floor training can be done individually or in a group.
What is pelvic floor dysfunction?
The following features are part of pelvic floor dysfunction:
- urinary incontinence
- emptying disorders of the bladder
- faecal incontinence
- emptying disorders of the bowel
- pelvic organ prolapse
- sexual dysfunction
- chronic pelvic pain.
