Pelvic Health Via Telehealth

By Liz Lush February 2024

There is a strong move towards health care in the home through the use of digital technologies and telehealth. Biotech companies are investing billions and consumer interest increases. Excitingly, telehealth is shown to be effective for pelvic health physiotherapy as well.

A large body of evidence shows us that pelvic health physiotherapy delivered via telehealth is very effective at reducing incontinence, improving pelvic floor muscle function and overall quality of life.^4,5 There is positive reception from patients, especially where barriers or concerns are directly addressed.^2,8,4 An excellent range of studies has demonstrated the effectiveness of telehealth for pelvic floor muscle function improvement, urinary function, bowel continence and pelvic pain for a range of circumstances; post gynecological cancer surgery^3, breast cancer treatment⁶ perinatally and general gynaecological presentations to community hospitals^1,2,4. Telehealth is an appropriate means to provide many forms of assessment, education plus exercise or training supervision.

Telehealth offers a number of advantages both in patient comfort and treatment quality. Patients appreciate the accessibility of telehealth where travel, parking or child care costs for face to face appointments is a deterrent. Telehealth can provide convenience and a familiar home setting for those with sensitive histories and difficult past experiences. It can also increase patients’ empowerment in their own role in treatment and management.

Telehealth allows clinicians to see patients’ actual physical environments in which movement or postural strategies need to be implemented. Telehealth can promote more effective use of digital technologies that assist pelvic health where they form part of the treatment reviews, for example Apps that guide pelvic floor muscle training^7. There are so many wearable devices, or downloaded apps that are underutilised so it terrific that telehealth brings them to the centre.

This is great news and provides both rural and metro patients with a vast improvement in accessing quality pelvic health physiotherapy!

Is there anyone that telehealth isn’t good for? Interestingly, studies show that other than personal preference, or in the instance of certain physical investigations, there are few exclusions. So long as you have access to a device, internet and the language being used is easy to understand, then telehealth is an option for you. If there is a high level of fear or anxiety that your pelvic floor muscle action is incorrect, that is, you might be straining when you should be squeezing, or squeezing when you should be relaxing, then it’s a good idea to consider hybrid care. This is a combination of face to face assessments for physical examination and then resuming treatment, monitoring and review through telehealth.

Would you like to enjoy your treatment via telehealth?

Talk to our team today.

Liz Lush provides telehealth to AWH on Tuesday afternoons and Saturday mornings.

1.     Coad, B., Ramani, S., Michel, L. et al. Effectiveness of telehealth physical therapy for patients with pelvic floor disorders in a community hospital setting. Arch Gynecol Obstet308, 661–665 (2023). http://doi.org/10.1007/s00404-023-07078-6

2.     Barrett, F., Stewart, L.E. & Brucker, B.M. Evidence for the Appropriate Use of Telemedicine in Female Pelvic Medicine and Reconstructive Surgery. Curr Bladder Dysfunct Rep 16, 97–104 (2021). http://doi.org/10.1007/s11884-021-00635-2

3.     Brennen R, Soh SE, Denehy L, Lin KY, Jobling T, McNally OM, Hyde S, Kruger J, Frawley H. Pelvic floor muscle training delivered via telehealth to treat urinary and/or faecal incontinence after gynaecological cancer surgery: a single cohort feasibility study. Support   Care Cancer. 2023 Sep 23;31(10):589. doi: 10.1007/s00520-023-08050-5. PMID: 37740820; PMCID: PMC10517895.

4.     Woodley S, Moller B, Clark A, Bussey M, Sangelaji B, Perry M, Kruger J, Digital Technologies for Women’s Pelvic Floor Muscle Training to Manage Urinary Incontinence Across Their Life Course: Scoping Review. JMIR Mhealth Uhealth 2023;11:e44929 URL: http://mhealth.jmir.org/2023/1/e44929DOI: 10.2196/44929

5.     da Mata KR, Costa RC, Carbone ÉD, Gimenez MM, Bortolini MA, Castro RA, Fitz FF. Telehealth in the rehabilitation of female pelvic floor dysfunction: a systematic literature review. International urogynecology journal. 2021 Feb;32(2):249-59.

6.     Colombage UN, Soh SE, Lin KY, Kruger J, Frawley HC. The feasibility of pelvic floor training to treat urinary incontinence in women with breast cancer: a telehealth intervention trial. Breast Cancer. 2023 Jan;30(1):121-130. doi: 10.1007/s12282-022-01405-6. Epub 2022 Sep 26. PMID: 36163601; PMCID: PMC9512983.

7.     Jaffar A, Mohd Sidik S, Foo CN, Muhammad NA, Abdul Manaf R, Suhaili N. Preliminary Effectiveness of mHealth App-Based Pelvic Floor Muscle Training among Pregnant Women to Improve Their Exercise Adherence: A Pilot Randomised Control Trial. Int J Environ Res Public Health. 2022 Feb 18;19(4):2332. doi: 10.3390/ijerph19042332. PMID: 35206520; PMCID: PMC8872112.

8.     Zoorob, Dani MD, MBA, MHA, MHI‚àó; Yunghans, Sara DPT‚Ć; Methenitis, Allison MD‚Ä°; Garcia, Emilie BSc¬ß; ElShariaha, Rand MD‚Ä°; Wahl, Heather MD‚Ć. Patient Receptivity to Integration of Telehealth in Pelvic Floor Physical Therapy Regimens. Urogynecology 29(2):p 281-286, February 2023. | DOI: 10.1097/SPV.0000000000001294