Topic:

Women's Health Physiotherapy: Differential

Diagnosis in Pelvic Floor Dysfunction

Presented By:
Wajeeha Arshad
Student of Doctor Of Physical Therapy at
University Of South Asia
 Contents

o Introduction

o Common disorders

- Definition

- Symptoms

- Differentiation

- Physical Therapy Intervention

2
 Introduction

Pelvic floor dysfunction (PFD) in women can manifest

in various ways and may result from a range of
underlying causes.

Pelvic floor dysfunction is a common condition where

you’re unable to correctly relax and coordinate the
muscles in your pelvic floor to urinate or to have a
bowel movement.

3
Common Pelvic Floor
Dysfunctions
 Pelvic Organ Prolapse

• Definition: POP occurs when the pelvic organs, such as the bladder, uterus, or rectum,
descend into the vaginal canal due to weakened pelvic floor muscles and connective
tissues.

• Key Symptoms: Sensation of pelvic heaviness, bulging in the vagina, and discomfort.

• Differentiation: Physical examination, often performed in a supine and standing position,

helps assess the extent of prolapse.

• Physiotherapy Intervention: Pelvic floor exercises to strengthen and support the

muscles, biofeedback, and lifestyle modifications.

5
6
 Urinary Incontinence

• Definition: Urinary incontinence is the unintentional passing of urine. It's a common problem thought to
affect millions of people.
• Types: Stress incontinence (leakage during activities like coughing or sneezing), urge incontinence
(sudden and intense need to urinate), mixed incontinence (combination of stress and urge incontinence).
• Key Symptoms: Leakage of urine during activities, sudden urges to urinate, or a combination of both.
• Differentiation: Thorough history, bladder diary, and specific assessments (e.g., stress test for stress
incontinence, urodynamic studies).
• Physiotherapy Intervention: Pelvic floor muscle training, bladder training, and behavioral strategies.

7
8
 Pelvic Floor Muscle Tension (PMT)

• Symptoms: Chronic pelvic pain, pain during intercourse, difficulty with urination or
bowel movements.

• Key Features: High or low muscle tone, trigger points, and muscle weakness.

• Differentiation: Pelvic floor muscle assessment, including palpation, biofeedback, and

electromyography.

• Physiotherapy Intervention: Manual therapy, relaxation techniques, and pelvic floor

muscle release exercises.

9
 Interstitial Cystitis/Bladder Pain Syndrome
(IC/BPS)

 Definition: Interstitial Cystitis (IC) or Bladder Pain Syndrome (BPS) or IC/BPS is an issue of
long-term bladder pain. It may feel like a bladder or urinary tract infection, but it's not. It is a
feeling of discomfort and pressure in the bladder area that lasts for six weeks or more with no
infection or other clear cause.

• Symptoms: Urgency, frequency, and pelvic pain often related to bladder filling.

• Physiotherapy Intervention: Bladder training, pelvic floor relaxation techniques, and lifestyle
modifications.

• Key Features: Painful bladder syndrome with no other identifiable cause.

• Differentiation: Cystoscopy, bladder diary, and exclusion of other urological conditions.

10
Interstitial Cystitis/Bladder Pain Syndrome
(IC/BPS)

11
 Endometriosis

o Definition: Endometriosis is a disease in which tissue similar

to the lining of the uterus grows outside the uterus.

o Symptoms: Pelvic pain, painful menstruation, pain during

intercourse.

o Physiotherapy Intervention: Pain management strategies,

pelvic floor exercises, and lifestyle modifications.

o Key Features: Presence of endometrial-like tissue outside

the uterus.

o Differentiation: Laparoscopy, imaging studies, and clinical

history.
12
 Pelvic Inflammatory Disease
(PID)

o Definition: Pelvic inflammatory disease is an

infection of a woman's reproductive organs. It is a
complication often caused by some STDs, like
chlamydia and gonorrhea. Other infections that are
not sexually transmitted can also cause PID.

o Symptoms: Pelvic pain, fever, abnormal vaginal

discharge.

o Key Features: Infection of the reproductive organs.

o Differentiation: Clinical evaluation, laboratory tests,

and imaging studies.
13
 Pelvic Floor Weakness

• Symptoms: Incontinence, organ prolapse, lower back pain.

• Physiotherapy Intervention: Pelvic floor muscle training, core stabilization exercises,

and postural education.

14
 Coccydyni
a

o Definition: Tailbone pain is pain in or around the

bony structure at the bottom of the spine. This part
of the spine is called the coccyx. Tailbone pain is
sometimes called coccydynia or coccygodynia.

o Symptoms: Pain in the tailbone area, aggravated

by sitting.

o Key Features: Inflammation or injury to the

coccyx.

o Differentiation: Physical examination, imaging

studies, and history of trauma.

o Physiotherapy Intervention: Tailbone cushion

use, manual therapy, and pelvic floor exercises. 15
 Pregnancy-Related Pelvic Girdle Pain (PGP)

o Symptoms: Pelvic pain during or after

pregnancy.

o Key Features: Altered biomechanics and

pelvic joint instability.

o Differentiation: Clinical assessment,

imaging studies, and history of pregnancy-
related factors.

o Physiotherapy Intervention: Pelvic

stabilization exercises, posture correction,
and pain management strategies.
16
17