Pelvic floor dysfunction in general practice

9th May 2022 by Louise Hudman

Pelvic floor dysfunction in general practice

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.

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