Functional pelvic floor physiotherapy in women and men

Pelvic floor dysfunctions can be classified as a public health problem, even being considered a "hidden epidemic." As a result of this term, I feel the deep need to publicize an approach that is so decisive in the recovery of a person's comprehensive pelvic health with the timely and functional intervention of specialized pelvic floor physiotherapy due to the evidence and changes that they represent in the life of a patient who suffers from any of these disorders.

After being dedicated for more than 10 years to obstetric physiotherapy care in Panama and knowing in depth the deficiencies that many women live with daily after going through motherhood and returning to their physiological state as women, the issue of treating pelvic dysfunctions by a physiotherapist is still considered outside the real and everyday scenario, but little by little we are creating awareness and allowing more people to improve and have a full life after a functional pelvic floor treatment.

Some of the pathological conditions treated by pelvic floor physiotherapy together with the specialist doctor (gynecologist, obstetrician, urologist, proctologist, oncologist) are: urinary incontinence, fecal or gas incontinence, presence of postpartum scars, abdominal diastasis, sexual dysfunctions (vaginismus, dyspareunia, vulvodynia), chronic pelvic pain, pubalgia, prostatitis, hemorrhoids, painful perineal and abdominal post-surgical scars, among others. These diseases mentioned seem that even today in Panama they could only be treated by specialist doctors with medications, certain surgical procedures or perhaps living with the condition without solution, but what is certain is that these can greatly affect the quality of life of those who suffer from it and when physiotherapy is allowed to intervene, the scenario and its reality really have another meaning and a drastic change.

That is why, as physiotherapists, we work on the functionality of the perineal muscles (pelvic floor), the ability to respond to continence, the recognition of normal sensations and their effects, contact with the intimate areas and sexual organs of our body and their capabilities, but above all, to have the hope that we can have a better lifestyle by creating awareness of what our pelvic health needs; using the resources, tools and knowledge of the specialists who are trained to treat these conditions that still have a great world to discover.

In recent years, there has been increasing attention from society to the prevention of perineal dysfunctions (pelvic floor), since it has been observed that factors such as a cesarean scar, an episiotomy, constipation, bad urinary (urination) and defecation habits, menstrual pain and the presence of muscular hyper or hypotonia in the medium or long term, if not treated early, can lead to more complex pathologies.

For this reason, physiotherapy plays an important role in the treatment of pelvic floor dysfunctions, which focuses on the prevention and treatment of all types of functional disorders of the abdominal, pelvic and lumbar regions, which is considered a highly prevalent health problem in women, men and elderly people or older adults.

Among the most common clinical indications to treat are stress urinary incontinence. and radical prostatectomy, which are characterized by involuntary urine leaks as the main symptom, and for this, physiotherapy aims to improve strength by training the pelvic floor muscles and coordination of the periurethral muscles as we do in Saheba Therapy, through awareness of the perineal muscles, sexual education and the usefulness of equipment such as urogynecological tecar therapy (innovation in radiofrequency) which aims to seek pelvic balance in all its systems, both osteoarticular, myofascial, muscular and organic.

With urogynecological tecartherapy we work with an endocavitary, transperineal or transpelvic approach that acts on the muscular and nervous tissues of the female and male genital tract, reactivating the natural repair processes and exerting an anti-inflammatory effect thanks to microvascular and molecular activation where we stimulate the balanced creation of collagen and elastin. In addition, it improves vaginal lubrication, restoring its biological balance.

Radiofrequency can be used at all ages, reducing incontinence and therefore improving the quality of life of patients. The treatment is stipulated after a specialized physiotherapeutic evaluation of each patient, and generally has a frequency of 8-12 personalized sessions. It is painless, noninvasive, without any risk of infection and with very effective results from the first sessions.

Personally, when I got involved in this branch of physiotherapy, I really began to change the lives of people who trusted me and thus, over time, to leave a legacy in my patients. Then, the first patients I had inspired me to immerse myself more and more in this specialty that takes an impressive direction when treated in a comprehensive manner.

Physiotherapy is often considered the first choice treatment given its non-invasive nature and positive results in terms of symptom relief and increased functional capacities of everything that comprises the CALP (Abdomino-Lumbo-Pelvic Cavity) in both women and men.