Advanced pelvic floor treatments

By Ellyn Peratikou

In last month’s blog I mentioned Peristeen® anal irrigation as a method of bowel management, and also percutaneous tibial nerve stimulation (PTNS) treatment which sends a very small amount of stimulation to treat bladder and bowel urgency and frequency, when you can’t hang on. You have to attend 12 weekly clinics where we place a tiny acupuncture needle in the tibial nerve by your ankle and stimulate it for 30 minutes. It doesn’t hurt at all and current studies show a good 50-70% improvement.­­

Another form of stimulation also available on the NHS is called sacral nerve stimulation (SNS) which treats bladder and bowel frequency and urgency. SNS can also treat urinary retention, constipation and chronic pelvic pain. This involves surgery; a Colorectal Surgeon implants a programmable stimulator (a small pacemaker) to give continuous low dose stimulation to the sacral nerve. It doesn’t hurt and current success rates are showing as high as 70-90%.

Bulking agents are also becoming popular; a Colorectal surgeon injects a bulking agent into the anal canal to thicken up the muscles and help the closure of your anal canal. This is very good for patients who leak stool in between bowel movements. Similar type bulking agents are used by Gynaecologists to bulk up around the bladder neck to help the closure of your urethra (waterpipe) and stop urinary leakage.

Remember these treatments are provided when the simpler conservative ones haven’t been successful. Always practice your pelvic floor exercises, drink plenty of water, eat a healthy balanced diet containing some fibre and finally don’t strain!

About the author

Sister Sue Ryder is a Pelvic Floor Specialist Nurse working at Central Manchester University Hospitals NHS Foundation Trust. Sue specialises in pelvic floor dysfunction and functional bowel problems. She provides several treatment clinics including Biofeedback treatment, trans-anal irrigation and neuromodulation. She also assists in Specialist Pelvic Floor Clinics jointly with Urogynaecologists and Colorectal Surgeons. Sue teaches on various study days and has written guidelines and protocols about her Specialist Clinical Practice.

Next month is my last 6th blog and it’s all about IBS, irritable bowel syndrome. If you want more blogs on anything to do with your bowels or pelvic floor please add your comments below. I’m enjoying writing these little blogs, sharing my practice with you all! Don’t be shy or think it will just go away, please go and see your GP or practice nurse and get referred to a specialist in your area.

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