Pediatric Pelvic Floor Therapy

October 27, 2022

Pelvic Health Center

In addition to restoring physical well-being, pediatric pelvic floor treatment allows your child to regain self-confidence and regain their quality of life. Your child no longer has to worry about having an accident during the day - they can carry on with normal childhood activities like school, sports and going out without worrying about incontinence. Our main goal is to create a welcoming environment in which your child feels comfortable and encouraged to undergo treatment. We commonly use a combination of exercises and tools such as rehabilitation ultrasound, neuromuscular rehabilitation and pelvic floor muscle strengthening.

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Pediatric pelvic health physiotherapy

By Dr. Zarina Vitebsky, DPT, MSPT, PRPC, LPF, TPS on 02/01/2022

Pediatric pelvic floor physiotherapy is a specific type of physiotherapy for children with challenges related to the pelvic floor muscles or the muscles that are responsible for supporting the pelvic organs and help with bowel and bladder control. There are three contributors to bedwetting:

• Bladder capacity (how much the bladder can hold)

• Urine volume (how much urine is produced)

• Wakefulness (ability of the bladder to wake up the brain)

If a child is past the age expected to control their bladder, they may experience a variety of dysfunctions including overactive bladder, underactive bladder, vaginal reflux, urge or stress incontinence, delayed urination , dysfunctional urination or bowel bladder dysfunction. There are several reasons for pediatric constipation: slow motility (slow bowel movements), tight pelvic floor muscles, weak pelvic floor muscles, tight back muscles pulling on the pelvic structures, tight diaphragm causing shallow breathing, poor sitting posture at the toilet, tense hips and pelvic pain that prevents the child from having a bowel movement due to pain. Physiotherapy has proven to be a helpful adjunct for children and their families who are already seeking treatment for:

• Incontinence, lack of voluntary control over urination or defecation

• Enuresis or nocturnal enuresis, involuntary urination or involuntary urination at night. • Encopresis, involuntary soiling of stools or excrement in clothing

• Chronic constipation, “chronic” often refers to 3 or fewer bowel movements per week

• Painful bowel movement, this is usually due to chronic constipation and can often lead to emotionally negative experiences in the bathroom. • Pelvic pain, discomfort in the pelvic region (or the lower part of the abdomen, genitals or anus). Treatment often consists of muscle rehabilitation, biofeedback, patient and family education, behavior and diet modification, soft tissue massage, stretching and strengthening of the pelvic floor and surrounding muscles and a home exercise program.

What Is Pediatric Pelvic Physical Therapy?

When "accidents" keep happening, pediatric pelvic physical therapy may be an appropriate next step in potty training. Pediatric pelvic physiotherapy aims to help children and their families gain control of their bladder and bowel coordination. This is different from general pediatric physiotherapy because in pediatric pelvic physiotherapy the focus is on the pelvic floor muscles. Many people, including children, have difficulty coordinating the pelvic floor muscles and need the expertise of a pelvic physiotherapist to guide them. Typical pelvic floor symptoms in pediatric patients include:

Increase or decrease in frequency of urination

Urinary incontinence: day or night (enuresis)

Emergency

Nocturia (waking up at night to urinate)

Stool incontinence (encopresis)

Constipation

Difficulty or pain in emptying urine or passing stools

What does a pediatric pelvic physiotherapy assessment look like?

# Video | Pediatric Pelvic Floor Therapy

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PEDIATRIC PHYSICAL THERAPY OF THE PELVIC FLOOR

According to the International Children's Continence Society (ICCS), children should have daytime and nighttime bladder control by age 5 for a typically developing child. Pelvic floor physiotherapy is a non-invasive approach that can be very effective in helping children regain control of their lives and independence of bowel and bladder function. Statistics

15% of visits to gastrointestinal doctors are for lower intestinal dysfunction

20% of visits to the pediatrician are for incontinence problems

5 million children complain of bedwetting

3# visits to pediatricians are for constipation

Citation: Treating pediatric incontinence with physiotherapy. Retrieved October 26, 2021, from http://ptandme.com/treating-pediatric-incontinence-with-physical-therapy

What to expect

During the assessment, a detailed musculoskeletal examination and history taking will take place in the presence of the parents or guardian.

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Pediatric Pelvic Therapy

The consultation may include an examination of your child's strength, range of motion, muscle flexibility, posture, movement patterns, and pelvic and core stability. If necessary, a non-invasive external examination of the pelvic floor muscles will be performed to assess pelvic muscle function. The information gathered will help determine which treatment interventions to include in the plan to improve your child's health. Facts:

20% of visits to the pediatrician are for incontinence problems

15% of visits to gastrointestinal doctors are for lower intestinal dysfunction

Bedwetting affects 5-7 million children in the United States

Nocturnal enuresis affects 15% of girls and 22% of boys over the age of 6

Middle and high school athletes often experience involuntary leaks during sports

These problems should not be ignored! If you would like to receive treatment for your child's pelvic floor symptom, ask your provider for a referral to pediatric pelvic floor physiotherapy.

Pediatric Pelvic Floor Therapy San Antonio

Sexual Side Effects Of Cancer Treatment Often Unaddressed With Female Patients

SAN ANTONIO, October 21, 2022 -- A new study finds that the sexual side effects of cancer treatment are much less frequently discussed with female patients than with male patients, even when the treatment directly affects the sexual organs. Among patients receiving brachytherapy for prostate or cervical cancer at a high-volume cancer center, 9 in 10 men were asked about their sexual health, compared to 1 in 10 women. "There appears to be a huge disparity in how we approach sexual dysfunction with our patients, where female patients are asked about sexual issues far less often than male patients," said Jamie Takayesu, MD, lead study author and a radiologist. . resident physician in oncology at the University of Michigan Rogel Cancer Center in Ann Arbor, Michigan. “Equally importantly, we are seeing this trend nationwide in clinical trials.”

Each year, approximately 13,000 new cases of cervical cancer and more than 220,000 new cases of prostate cancer are diagnosed in the United States. Because these patients can often expect to live a long time after treatment, the potential for long-term side effects, including sexual dysfunction, is important to consider, Dr. Takayesu said. For the institutional analysis, the researchers reviewed the consultation notes in the charts of 201 patients who were treated with brachytherapy for prostate cancer (n=75) or cervical cancer (n=136 ) between 2010 and 2021. They found a marked difference between the number of male versus female patients who were asked about their sexual health at their first visit – 89% of males versus 13% of females (p

The research team also looked at how frequently sexual health was assessed in clinical trials nationwide by analyzing trials from the National Institutes of Health Clinical Trials Database (clinicaltrials.gov) that involved brachytherapy for prostate (n=78) or cervical (n=53 trials) cancer. Prostate cancer trials, compared to cervical cancer trials, were significantly more likely to include sexual function as a primary or secondary endpoint (17% versus 6%, p= 0.04). With prostate cancer, for example, patients often have multiple treatment options, and sexual side effects are a common consideration when choosing between therapies. We see advertisements on television about erectile dysfunction, for example, but there is no equivalent for women.

Currently, there are no FDA-approved drugs specifically for female sexual dysfunction, although several options - drugs, implants, and other treatments - are available for male impotence.