Urogynecological physiotherapy - consultation (first visit)

Urogynecological physiotherapy is an effective method of treatment and prevention of problems such as urinary incontinence, severe painful menstruation, endometriosis, and vaginal prolapse. Untreated diseases of the urinary or sexual system lower the quality of life and can lead to serious diseases. Even though they are common, many women still find them embarrassing.

Urogynecological physiotherapy will help ease your symptoms if:

• you suffer from severe menstrual pain or endometriosis,
• you have problems with urinary incontinence with exertion, sneezing or coughing,
• you feel discomfort in the area of scars after surgery, e.g. after a caesarean section,
• your doctor has told you to strengthen your pelvic floor muscles.

Physiotherapists ensure a sense of comfort and privacy for patients during therapy.

A visit to a urogynecological physiotherapist is recommended both as part of preventive health care and in the case of specific ailments, for women of all ages. It is especially important for pregnant women, those planning pregnancy, postpartum women, those entering the menopausal period, before and after pelvic surgery, and those who want to increase sexual satisfaction.

As part of preventive care, it is recommended for women who want to:

• prepare for pregnancy,
• prepare for childbirth,
• prepare for urogynecological surgery,
• assess the pelvic floor and abdominal muscles after delivery,
• assess the scars after a caesarean section,
• reduce discomfort in the coccyx.

It is recommended for women who have the following health conditions:

• urinary incontinence - stress and urgency,
• vaginal prolapse,
• faecal and gas incontinence,
• vaginal gases,
• discomfort caused by scars after caesarean section or perineal incision,
• dyspareunia - pain during intercourse,
• increased menstrual pain,
• rectus abdominal muscle dehiscence,
• pain and disruption of the pubic symphysis,
• difficulties with getting pregnant, as supplementary multidisciplinary treatment,
• endometriosis,
• conditions after abdominal surgery,
• pain in the coccyx,
• vulvodynia - severe pain or discomfort in intimate areas and vestibulodynia - pain in the opening of the vagina when touched, as supplementary multi-specialist treatment,
• supplementary therapy for pain in the hip joints, spine,
• supplementary therapy for exercises for back pain, pelvic area in pregnant women,
• discomfort when using tampons.

Additional service of kinesiotaping can be provided during the visit (applying special tapes to the painful area). The service is paid separately.

Contraindications of urogynecological physiotherapy

• Haemorrhoids - for rectal or vaginal examination
• Hypertension in the third trimester of pregnancy
• Sudden weight loss
• Complicated pregnancy - consent of a gynaecologist is required
• Haemorrhagic diathesis
• Swelling all over the body

Scope of the consultation

During the consultation, the physiotherapist will:

• ask about your medical history,
• determine the purpose of physiotherapy and body posture,
• perform a manual examination of the abdominal wall, pelvis, spine, diaphragm, and ribs,
• optionally, she will also perform a vaginal or rectal examination for strictly defined indications and with the patient's consent,
• conduct individually selected therapy for reported ailments related to the spine, pelvis, abdominal integuments, or transvaginal therapy,
• provide instructions on exercises, helping you increase awareness of your body,
• define a further plan of physiotherapy and provide recommendations.

Duration of visit

• Medicover Center: 60 minutes
• Medicover Hospital: 45 minutes
• CMD: 45 minutes
• Dom Lekarski: 60 minutes

You can buy your next visit HERE.

Benefits of Urogynecological Physiotherapy

• Stronger pelvic floor muscles.
• Preparation for childbirth.
• Faster recovery after delivery and abdominal surgery.
• Elimination of problems related to urinary incontinence and vaginal gases.
• Reduction or elimination of pain associated with menstruation, back pain.
• Increased satisfaction with sex life.
• Learning exercises to increase body awareness.
• Learning healthy habits and movement.

• Wear comfortable clothes.
• Bring test results with you if you have had: urogynecological examinations, MRIs, spine X-rays.
• Write down questions for the physiotherapist.

It is very important to be honest and to ask questions when you have any doubts, as well as follow the recommendations and perform the exercises. Only the cooperation and commitment of both the physiotherapist and the patient will give the best end result.

For pregnant women, it is recommended to visit a urogynecological physiotherapist in the second trimester of pregnancy.

After childbirth, an initial visit is recommended at least 6 weeks after the birth, regardless of whether it was a vaginal delivery or a caesarean section.

Improvement depends on the patient’s symptoms. Depending on the problem, the physiotherapist will propose a therapy and approximate the time of improvement, but the progress will depend on many factors, which will also be discussed during the visit (following the recommendations received during the visit, nature of work, physical activity, stress, diet, etc.).

The examination is similar to a gynaecological examination. Before the examination, the patient is given a surgical skirt to wear. During the examination, the patient lies on her back with legs bent, hip-width apart. The physiotherapist puts on gloves and, using the examination gel, places one or two fingers inside the vagina, and the other hand on the abdominal wall. She asks the patient to tighten the pelvic floor muscles, and examines the internal tissues. The examination also teaches the patient about the conscious work of the pelvic floor muscles. The examination can only be performed with the consent of the patient.

Before the examination, the patient puts on surgical shorts with an opening in the back. She lies on her stomach during the examination. The physiotherapist puts on gloves and, using a special gel, places a finger in the anus, while placing the other hand on the sacrum area, and examines the internal tissues. The examination can only be performed with the consent of the patient.