"My experience at Locala clinic with Continence services."

About: Huddersfield Royal Infirmary / Gynaecology Locala Community Partnerships CIC / Continence advisory service

(as the patient),

I was referred by consultant to Locala in Huddersfield to be shown how to do pelvic floor exercises following a bladder prolapse. I went along thinking it probably wouldn't make much of a difference and got the impression from the Consultant that it was probably too late to have much impact but worth trying.

However, after seeing Jane Appleyard I felt so reassured and positive in my approach to my exercises. When I returned a few months later she said she could tell a difference and I really felt that the exercises had helped.

When I went back to the Infirmary a different Consultant asked me how the exercises were going and was visibly surprised when I said that I felt they were helping, to which they added 'Oh a lot of people say they don't make much difference'. I thought this attitude was rather negative, given all the reassurance/ positivity /encouragement I'd received at the Continence clinic.

I was surprised at how few exercises I had to do and how it didn't affect my daily routine, it was no bother whatsoever! I no longer attend the clinic and yes I do sometimes forget to do them but it's not the end of the world.

I would advise anyone to try and be positive in this situation and follow advice given regarding the exercises.

Thank you Jane.

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Response from Jane Appleyard, Continence Specialist Physiotherapist, Continence Advisory Service, Locala Community Partnerships

Thankyou for your feedback. You've captured a typical patient journey in your summary! I think it highlights two really important points.

Firstly - if women are just given verbal information and a leaflet about pelvic floor exercises they often don't work. Evidence shows some women don't do the exercises correctly. These muscles are hidden away and it can be a challenge to work out for yourself using an instruction leaflet what you should be doing. I think many consultants are used to getting negative feedback from women about pelvic floor exercises but this is usually because these women have just read a leaflet.

Secondly- the best results are achieved when we can give women's pelvic floor muscles a 'physio' assessment. This involves a gentle examination to assess strength, endurance and the quality of contraction. Women can be then be given a tailor made programme and be shown how to progress their exercise routine.

The POPPY trial, published in the Lancet in 2013, is accessible on the internet and shows pelvic floor training is effective in reducing symptoms of prolapse in women.

I delighted your symptoms are improving and you're settled into an exercise routine (most days!) Keep up the good work.

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