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Conservative treatment of pelvic floor disorders 

Conservative treatment of pelvic floor disorders
Chapter:
Conservative treatment of pelvic floor disorders
Author(s):

Karen Nugent

DOI:
10.1093/med/9780199579624.003.0007
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date: 25 January 2021

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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