- Foreword
- Preface
- Contributors list
- Chapter 1 Establishing and developing a pelvic floor service: the multidisciplinary team and the approach to patient assessment
- Chapter 2 Radiological workup
- Chapter 3 Anorectal physiology
- Chapter 4 Faecal incontinence: a pathophysiological approach
- Chapter 5 Obstructed defaecation: a pathophysiological approach
- Chapter 6 Chronic anorectal pain: a pathophysiological approach
- Chapter 7 Conservative treatment of pelvic floor disorders
- Chapter 8 Three compartments–working with a multidisciplinary team
- Chapter 9 Internal rectal prolapse
- Chapter 10 Anismus
- Chapter 11 Rectocele
- Chapter 12 Solitary rectal ulcer syndrome (SRUS)
- Chapter 13 Slow transit constipation
- Chapter 14 Perineoproctology (fissures and haemorrhoids)
- Chapter 15 Pudendal pain syndrome
- Chapter 16 Obstetric sphincter injury
- Chapter 17 Rectal sensory dysfunction
- Chapter 18 Laparoscopic ventral rectopexy (with posterior colporraphy and vaginal sacrocolpopexy)
- Chapter 19 STARR and Transtar
- Chapter 20 Complete pelvic floor ultrasound
- Chapter 21 Sacral neuromodulation
- Chapter 22 Anal bulking
- Chapter 23 Anterior sphincter repair
- Chapter 24 Neosphincters and artificial sphincters for treating faecal incontinence
- Index
(p. 75) Conservative treatment of pelvic floor disorders
- Chapter:
- (p. 75) Conservative treatment of pelvic floor disorders
- Author(s):
Karen Nugent
- DOI:
- 10.1093/med/9780199579624.003.0007
Chapter 7 suggests that it is generally good practice to manage pelvic floor patients initially by conservative means: those responding will avoid invasive intervention. Yet for some this approach will simply delay optimal surgical treatment. The challenge is to try and select patients who are unlikely to benefit from a conservative approach and offer early surgery. It remains unclear from biofeedback data if patient subsets do particularly well or badly. We generally recommend that biofeedback, which is very labour-intensive, is used empirically only if patients have mild symptoms or are less fit for surgery. All others should be fully worked up, including proctography. This will ensure that in the future patients are better stratified, and patients with clear-cut indications for surgery and relative contra-indications for biofeedback (e.g. unrecognized external rectal prolapse) are not overlooked.
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- Foreword
- Preface
- Contributors list
- Chapter 1 Establishing and developing a pelvic floor service: the multidisciplinary team and the approach to patient assessment
- Chapter 2 Radiological workup
- Chapter 3 Anorectal physiology
- Chapter 4 Faecal incontinence: a pathophysiological approach
- Chapter 5 Obstructed defaecation: a pathophysiological approach
- Chapter 6 Chronic anorectal pain: a pathophysiological approach
- Chapter 7 Conservative treatment of pelvic floor disorders
- Chapter 8 Three compartments–working with a multidisciplinary team
- Chapter 9 Internal rectal prolapse
- Chapter 10 Anismus
- Chapter 11 Rectocele
- Chapter 12 Solitary rectal ulcer syndrome (SRUS)
- Chapter 13 Slow transit constipation
- Chapter 14 Perineoproctology (fissures and haemorrhoids)
- Chapter 15 Pudendal pain syndrome
- Chapter 16 Obstetric sphincter injury
- Chapter 17 Rectal sensory dysfunction
- Chapter 18 Laparoscopic ventral rectopexy (with posterior colporraphy and vaginal sacrocolpopexy)
- Chapter 19 STARR and Transtar
- Chapter 20 Complete pelvic floor ultrasound
- Chapter 21 Sacral neuromodulation
- Chapter 22 Anal bulking
- Chapter 23 Anterior sphincter repair
- Chapter 24 Neosphincters and artificial sphincters for treating faecal incontinence
- Index