Pelvic Floor Physiotherapy

Stress urinary incontinence (SUI) occurs when urine leaks out during activities that put pressure on the bladder. It can happen when you cough, sneeze, laugh, lift, exercise, rise from a chair, walk upstairs or downstairs, or during sexual intercourse. Physical strain increases the pressure on the abdomen, which in turn puts pressure on the bladder. If the pelvic floor muscles or the muscles controlling the bladder are weak, urine can leak out.  While SUI is more common in women, some men can experience it as well. 

Urinary urgency is a sudden, strong need to urinate that’s difficult to delay. It can happen even if your bladder isn’t full and may make you feel anxious about finding a bathroom in time.

Urinary urge incontinence (UUI) happens when you leak urine because of a strong urge to empty your bladder. You may not make it to the toilet in time. It is often caused by bladder muscles that squeeze too often or without warning. 

Overactive bladder (OAB) is a condition that includes:  

• A strong, sudden need to urinate (urinary urgency) 
• Going to the bathroom more than 6 to 8 times during the day (frequency) 
• Waking up more than once at night to urinate (nocturia) 
• Sometimes leaking urine before reaching the toilet (urinary urge incontinence) 

• Pregnancy and childbirth
• Ageing  
• Menopause 
• Obesity
• Pelvic surgery, including prostate surgery
• Overactive bladder muscles  
• Certain medications, for example, diuretics (water pills) 
• Constipation 
• Urinary tract infections, bladder stones, interstitial cystitis 
• Caffeine, alcohol, fizzy drinks, spicy or acidic foods 
• High fluid intake, anxiety, frequent “just in case” urination 
• Stroke, multiple sclerosis (MS), Parkinson’s disease, spinal injury, diabetes 
• High impact activities, for example, trampolining

• Pelvic floor exercises: Strengthen the muscles that support the bladder 
• Bladder training: Helps increase the time between trips to the toilet 
• Lifestyle advice: Includes guidance on fluid intake, diet, and healthy toileting habits 
• Electrical stimulation: A gentle current may be used to activate and strengthen weak pelvic floor muscles 
• Biofeedback: Helps you learn how to properly use and contract pelvic floor muscles 

Constipation is where there are changes to how you move your bowels, including not opening your bowels as often as normal and finding it hard to get your stool (poo) out. Often the stool is hard and lumpy and difficult to pass. Most people will suffer from an episode of constipation at some point in their lives, but usually this is temporary and not serious. Unfortunately, for some people constipation can become a long term issue.  

Faecal incontinence is when there is an unwanted leakage of stool or wind from the back passage. It can be an extremely distressing condition that can be made worse by diarrhoea. It can happen without warning or can be associated with an urge to move your bowel but an inability to make it to the toilet on time. 

Obstructive defecation is a term used to describe having difficulty opening your bowels. It is often associated with frequent visits to the toilet and a feeling of being unable to fully empty the bowel. This can result in excessive straining, which can increase the risk of vaginal or rectal prolapse. 

Normally, when you open your bowels, the muscles around the back passage relax to allow stool to pass. In obstructive defecation, these muscles may not relax fully, or they may even tighten, making it harder to have a bowel movement.

Faecal urgency is when you have a sudden, strong urge to empty your bowels. You may make it to the toilet in time or it may be associated with faecal incontinence.

• Read the POGP Prolapse Leaflet for detailed guidance and advice.
• Strengthen your pelvic floor muscles by regularly performing pelvic floor exercises. These exercises can help improve support and reduce prolapse symptoms over time.

Bladder pain syndrome is a condition that causes pelvic pain and difficulty peeing. It can be difficult to diagnose because there isn’t a single test that can confirm it.

Ongoing or repeated difficulty with allowing vaginal entry of a penis, finger, or other object. This may lead to involuntary tightening of the pelvic floor muscles, along with anticipated fear and pain.

Dyspareunia is painful sex. This can be pain or discomfort at the opening to the vagina or felt deeper into the pelvis.

This may be linked to the causes mentioned above, or to other conditions such as Endometriosis, Adenomyosis, Irritable Bowel Syndrome, Vulvodynia.

• Relieving Pelvic Floor Muscle Tension
• Pelvic Pain
• Painful Sex Part (A)
• Painful Sex Part (B)

• Fit following Surgery: Advice & Exercise Following Major Gynaecological Surgery, POGP  
• Fit following Surgery: advice for trans men, trans masculine and non-binary people following hysterectomy, POGP 
• Promoting Continence with Physiotherapy, POGP 

• Prostate UK 
• Prostate Scotland 
• Pelvic Floor Muscle Exercises for men, POGP 
• Pelvic floor muscle exercises and advice – A guide for trans women, trans feminine and non-binary people (who were assigned male at birth), POGP 
• Promoting Continence with physiotherapy, POGP 
• Squeezy App for Men