CORE CLINICS
Pelvic Health and Urinary Clinic
So many women experience problems with pelvic health and urinary continence but struggle to get the help they need or feel too embarrassed to ask.
Here at Core Clinics we want to help women understand the causes of their pelvic health and urinary continence issues, as well as offering treatment to help improve symptoms. Our treatment plans can have a huge effect on day-to-day activities and quality of life for women affected by these issues.
We're here to help you on your journey.
We aim to help you understand more about pelvic health and urinary continence, when to seek help, and what your options are.
Incontinence
When are women most likely to experience problems?
Pelvic health and urinary continence issues can affect a woman at any time in her life, but problems are often noticed or worsen during key life stage transitions.
Some girls continue to have issues with bedwetting well into their teens. In time bed wetting can develop into stress incontinence – when you feel the need to go to the toilet frequently.
Many women feel that things have changed to how they felt prior to pregnancy. You are aware of a heavy feeling in your pelvic area and generally a feeling of weakness along with leakage (urinary/faeces).
Mixed incontinence can occur due to hormonal changes. You may experience urinary leakage when coughing, sneezing, or exercising.
Some who are diagnosed with a neurological disorder such as MS may experience retention in the tummy and struggle to urinate.
If you have been diagnosed with partial or full prolapse (rectal, cervical, bladder) and / or have a family history of these conditions (mother, sister).
Pelvic Weakness
When your pelvic floor is weakened your internal organs may not be sufficiently supported. This can lead you to be unable to control your urine, faeces or wind.
Common symptoms that can affect the pelvic area include:
- Leaking urine when coughing, sneezing, laughing or running
- Urgency to go to the toilet
- Failing to get to the toilet in time
- Passing wind from anus or/and vaginally when bending or lifting
- Reduced sensation in the vagina
- Tampons may dislodge or fall out
- A sensation of heaviness in the vagina
- Discomfort/pain during sex or vaginal penetration
- A distinct bulge at vaginal opening
- Use of pads for incontinence, wet /soaked or worry of leakage
- Stopping certain activities because of leakage or worry of leaking
- Feeling a dry itchy sensation around the vulva
- Pain, bloating, pressure or discomfort in the pelvic area
Our pelvic health protocols can help you if you suffer with any of the above issues.
Common Causes
Your pelvic floor is there to help support your internal organs; bladder, bowel and uterus.
Common factors which can lead to weakening of your pelvic floor include:
- Pressure of excessive weight gain
- Supported weight of uterus during pregnancy
- Vaginal childbirth, which may have over stretched muscles
- Chronic constipation and straining to poo
- Constant coughing
- Abdominal or vaginal surgery
- Change in levels of hormones such as oestrogen (pre-menopausal/ menopausal/ postmenopausal)
Common Symptoms
The pelvic floor consists of various structures which are interconnected. Problems with one part of the pelvic floor can result in wider issues including discomfort (generally or during sex), incontinence symptoms or other issues.
When the muscles holding a woman’s pelvic organs (uterus, rectum and bladder) in place loosen and become too stretched out. Pelvic organ prolapse can cause the organs to protrude (stick out) of the vagina or rectum and may require women to push them back inside.
A chronic bladder condition that causes pain in your pelvis or bladder. Pain from the bladder can cause pain in the pelvic floor muscles and then loss of muscle relaxation and strength.
How we can help you
Comprehensive consultation
Comprehensive consultation, examination and health history
Treatment plans and therapies
A clear diagnosis with recommendations for self-management and treatment protocols
Tailored to your needs
We work in partnership with our patients to deliver consistent results, with regular reviews and follow ups
ABOUT US
How we work
Multi-disciplinary patient-centred healthcare
Lots of clinics have different healthcare professionals under the same roof but they don’t tend to collaborate fully or share care with patients. They also don’t have clear and proven care protocols which have been tested and refined to provide the best possible results, and value for time and money for patients. At Core Clinics all our clinicians and therapists work in an integrated way, adapted to the needs of each patient. So, when you make a first appointment with anyone in our team, you’ll have access to everyone in our team – and we’ll clearly signpost to you who you should see and what you can do to help yourself too. We’ve developed and refined this approach for over 15 years and helped over 13,000 patients.
Don't just take our word for it
We have helped thousands of people to achieve a better state of health, or to reach their sports performance goals.
Sue AdamsHeadaches and migraines Mr Greg WheatleyHeadachesFrequently asked questions
If you are suffering from any of the common symptoms mentioned above it’s best to seek expert advice.
Regardless of your age, if you only have one symptom, or symptoms you have are sporadic or mild, the earlier you seek help the better your chance of achieving a significant improvement.
Seeking help will also reduce the time you are in pain/discomfort and reduce the risk of potentially increasing of weakness in pelvic floor which could potentially lead to more pain/ discomfort and potential prolapse.
It also worth having a pelvic assessment if you are thinking of having children and or want to reduce the risk of starting to suffer with any of these common symptoms which have been mentioned. Proactive and preventative steps can be taken to support your pelvic floor before pregnancy.
During pregnancy your pelvic floor muscles have to work harder than normal because they need to support the weight of a growing baby. Not only that but after giving birth your body has to go back to supporting your organs after your pelvic floor has been softened and stretched by pregnancy hormones and labour (or c- section). So, having a strong pelvic floor before, during and after pregnancy is important because it prevents the involuntary loss of urine and faeces, as well as prolapse of the organs that it supports.
Unless symptoms are severe women unfortunately often find that treatment options offered by the NHS are limited. Self help is an option but it’s beneficial to seek advice about exercises from an expert for maximum benefit.
If you haven’t already done so speak to your GP and ask for a referral to a gynaecologist. Unfortunately waiting lists can be long and they may only treat you for certain significant issues e.g. surgery for prolapse. These types of surgeries can be rather painful and they are not without risk so make sure you have all the facts before deciding on this route.
Self help – doing kegel exercises following an online programme can be helpful. However these exercises are tricky to do effectively to ensure you’re targeting the optimum area. Also, strengthening exercises may not, on their own, solve your issues. In some cases the muscles can be hyperactive requiring relaxation rather than strengthening exercises.
Prior to the pelvic floor assessment we will take an extensive history of your symptoms, and medication, any pregnancies and delivery information and any other potentially-relevant factors.
The examination then consists of 3 parts:
- An external abdominal check, to feel for tenderness or abnormalities
- Observation of external genitalia looking at tissue health, nerve sensation test and rough reflex.
- Lastly we go on to internal examination in which I will use my right index finger (which will be gloved with the use of medical lubricant) to check your vaginal passage for any internal abnormalities. I will also perform a bladder neck test and asses pelvic floor strength.
All 2-3 steps of the vagingal exmaination will require you to have your underwear removed – a modesty cover will be provided
The examination can be stopped at any point if you feel uncomfortable
You may feel some pressure and a little bit of discomfort during examination but it is generally not too uncomfortable
Doing all 3 stages gives us the best diagnosis, but we can still gain useful information from stage 1-2 if you are uncomfortable with an internal examination.
After your assessment and consultation we’ll discuss your treatment options. We will give you a suggested treatment plan that will include visits to the clinic and exercises to do at home.
When you come in to the clinic we will do a combination of exercises and some hands on treatment.
We also have an electromagnetic stimulation machine (physiotek) which targets the pelvic muscles very specifically. It can be hard to isolate and activate your muscles so this machine helps you to do that.
We will also give you recommendations for self care including home exercises, possibly including the use of an internal device to help you train your pelvic muscles, and lifestyle advice.
Holistic treatments, nutrition support, or counselling may also be recommended.
We may also recommend that you see your GP for further investigations or treatment e.g. HRT.
If you are suffering with incontinence you can use pads to help with leakage.
Try to wear cotton and breathable underwear as this will prevent infections. There is now specific underwear on the market for urinary leakage.
Taking painkillers may help with pain but this is not ideal for a long term solution Check with your GP to make sure there are no contraindications with medication you are taking.