The magnitude and negative impact on personal and social life make urogynecological disorders a public health problem.
Despite the negative impact and high prevalence, there is a deficit of epidemiological and diagnostic data that may be due to the lack of investment in epidemiological research, health illiteracy, various psychosocial barriers (e.g., omission) and lack of knowledge and/or lack of skills to the use of available diagnostic and therapeutic resources.
Pathologies such as incontinence (urinary, anal, fecal), sexual dysfunction (dyspareunia), prolapse, chronic pelvic pain, endometriosis, among others, are quite common in our population and highly affect the quality of life and require differentiated attention. As urinary incontinence is just the tip of the iceberg among urogynecological disorders, its prevalence in Portugal is well over 20%.
With a high probability and inferring from the ubiquity of different pelvic floor disorders, approximately 50% of the female population would benefit from clinical care and could significantly resolve and/or improve their quality of life through pelvic floor rehabilitation, among other treatments. Men require the same interventions despite tending to be lower in terms of conditions across genders.
In addition, it is of great importance to act in a preventive way in perineal dysfunctions because a cesarean section, an episiotomy, abdominal diastasis, inadequate urinary and defecation habits, dysmenorrhea, alterations in the tone of the pelvic floor, can lead to pathologies complex and chronic diseases that could be avoided through the evaluation and implementation of preventive measures.
Given the recent scientific evidence, the intervention must be supported by a global view where the pelvic floor and pelvic viscera are studied, but also, and additionally, their relationship with other structures such as the deep muscles of the abdomen and with posture.
The performance of a systematic and complete physical examination, as well as the critical interpretation of the collected elements and/or recorded measurements, derives from the anatomical and physiological knowledge of the abdominopelvic cavity, biomechanics and relationship with other structures, pathology and pathophysiology, and the skills and performance in the clinical assessment and physical examination.
Carrying out these steps is crucial and should lead to the potential identification of red flags, differential and functional diagnosis and, finally, an evidence-based treatment plan tailored to each case.
There is a significant and pressing need for professionals to gather solid knowledge and differentiated skills in order to intervene safely and effectively in the treatment of people with urogynecological disorders. The different health professionals must intervene collectively and interdisciplinary, developing a framework of clinical care where physiotherapists, specialized in urogynecology, exercise technical and deontological independence in assessment, planning and rehabilitation.
What we propose to you in this course, aimed exclusively at physiotherapists, is the development of knowledge and skills for safe and effective prophylactic and therapeutic intervention in a set of urogynecological disorders.
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