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13 July
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Managing your pelvic floor

Specialist: Dr Brett Locker has been practising in gynaecology since 1997.A common problemIf the thought of running, jumping, coughing or sneezing has you feeling nervous, then you are not alone.
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According to the Continence Foundation of Australia 37 per cent of women in Australia experience some level of bowel or bladder control problems or uterovaginal prolapse –all widely described as pelvic floor problems.

While many women report some level of issue with incontinence, only 1 in 5 will actually seek professional help, preferring to self manage or sometimes shy away from this highly sensitive topic.

Dr Brett Locker is a specialist gynaecologist based in Newcastle and has been practicing in all areas of gynaecology for the last 20 years.

While he refers to the surgical treatment of pelvic floor issues as a relatively ‘simple twenty minute walk-in, walk-out’ procedure he understands the resistance many women have to seeking consultation.

“It’s only a problem if it’s causing a problem.

“If it’s affecting how you live, for instance; you’re not doing things you would usually do, like exercising or playing with the kids, then it can be problematic and there is a solution,” says Locker.

While it’s usual for patients to undertake a degree of initial investigation into how to go about managing pelvic floorissues, it’s important says Dr Locker, to identify the cause of the problem first, to ensure the correct treatment is provided.

“There is a difference between a patient with incontinence as opposed to someone with an urgency to urinate, or to urinate frequently and this needs to be considered as part of the treatment. Surgery for one will not address the other.”

Where tostartIf you are in the throws of considering reaching out for help, or simply educating yourself a little more, Locker suggests visiting the following websites to get some valuable information and contacts ofwhere else to get help:

jeanhailes.org419论坛continence.org419论坛menopause.org419论坛ranzcog.edu419论坛A visit to your local GP is often a good point from which to start.

Dr Locker says that asking for a referral to a pelvic floor physiotherapist with post graduate qualifications can also be a positive first step.

Do your researchWhile pelvic floor issues are often genetic, they are most common in women after the ageof 40.

Risk factors include: pregnancy, childbirth genetics and menopause.

Determining the underlying cause of the issue involves investigative tests and is often a stumbling block for women uncomfortable about disclosing information.

Dr Locker is sympathetic to this and accepts that the first port of call is often to jump online.

“I embrace the fact that Google is often the starting point for people, it’s inevitable with health related scenarios and it’s important that clients feel that they have exhausted all options first.”

For those though considering professional advice, there is merit in asking the right questions of any potential consultant or surgeon.

Dr Locker suggests that a surgeon that shares information about his or her workis worth pursuing.

“There’s strong evidence to suggest that the more procedures a specialist has done the better their success rate, its important that patientsfeel informed and the discussion is transparent.”

“For instance asking a specialist or surgeon about their consultation to surgery rate can be very telling. A surgeon that says yes to treatingeveryone they see isn’t necessarily a good thing.”

What to expect aftersurgeryIf you decide to undergo surgery, normal life can resume fairly quickly and while a level of common sense should be applied, it’s realistic to assume that you can return to most day to day activities within a matter of days.

Heavy lifting, drivingand sexual intercourse can all resume after several weeks and should be discussed with the specialist at the time of consultation to ensure that expectations are clear.

Dr Brett Locker studied medicine at Sydney University and returned to his hometown of Newcastle to study Obstetrics andgynaecology, until1997. After practicing as a specialist in Port Macquarie for 7 years he again returned home and opened hisCharlestown practice.

 
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