Pelvic health physiotherapy

Our experienced team of pelvic health physiotherapists provide assessment and treatment for the following problems:

• stress urinary incontinence: leaking urine during a run, cough or sneeze
• urinary frequency, urgency and urge incontinence: the feeling of needing to empty the bladder frequently and/or rush to get to the toilet in time, often accompanied with loss of control of urine
• faecal/flatus incontinence: the loss of control of bowels and/or wind
• faecal urgency: the feeling of needing to empty the bowel with little warning
• obstructive defecation: difficulty emptying the bowels
• pelvic pain/vulval pain/dyspareunia: pain with sexual intercourse and/or chronic pain in the pelvic region
• perineal trauma: injury to the pelvic floor from childbirth
• pelvic organ prolapse: anterior or posterior vaginal wall and uterine descent
• pregnancy and postnatal-related musculoskeletal conditions: pelvic girdle pain, back pain, coccyx pain, hip pain, rib pain and carpal tunnel syndrome
• men's health: bladder and bowel care after prostate surgery, pelvic floor training for erectile dysfunction, bowel care following bowel surgery, and pelvic pain

When you visit your physiotherapist, they will discuss your current problem with you and ask a few questions to better understand your concerns. Depending on your needs, your physiotherapist may assess your back, hips and pelvis, neck and hands and provide you with appropriate advice. It's recommended that you wear comfortable clothing that allows for movement during the appointment.

If your issue relates to pelvic floor dysfunction, a physical examination may be necessary, which often involves a vaginal examination. It's important to note that your pelvic floor doesn't work alone and relies on many other systems to function correctly. Treatment often includes exercises that focus on improving the pelvic floor muscle and alleviating your symptoms. After the internal examination, your physiotherapist will design an individual recovery program suitable for you.

You are welcome to bring a chaperone with you during the examination if you feel more comfortable. Please inform your physiotherapist if you would like to arrange for a formal chaperone (another staff member) or bring a friend or relative as an informal chaperone. If no chaperone is available, you will have the opportunity to reschedule your appointment.

If you have any questions or concerns regarding the examination or treatment, please don't hesitate to speak to your physiotherapist. They will be happy to discuss any issues with you.

Our gynaecology department is proud to be leading the way in gynaecological surgery by offering the vNOTES (vaginal Natural Orifice Transluminal Endoscopic Surgery) technique for suitable patients. We are one of only around 15 gynaecology units in the UK providing this cutting-edge, minimally invasive procedure. vNOTES represents a significant advancement in patient care, allowing us to perform keyhole surgery through the vagina, completely avoiding abdominal incisions.

The Benefits of vNOTES

vNOTES offers numerous benefits that have transformed the way we care for our patients:

• Minimal Pain: Patients experience significantly less pain compared to traditional laparoscopic surgeries, which means a much smoother recovery.
• No Visible Scars: One of the most remarkable aspects of vNOTES is that it leaves no visible scars in the abdomen as instruments and camera used are introduced through the vagina.
• Quicker Recovery: Most of my patients are able to go home in less than six hours after the procedure, which is a testament to the efficiency and effectiveness of this technique.

How we use vNOTES

We have used vNOTES to treat a range of conditions, including ectopic pregnancies, removing ovarian cysts, performing female sterilisation, and conducting hysterectomies. It is particularly advantageous for patients with a high BMI, where conventional keyhole surgery can be more complex. We are also expanding its use by working closely with our breast surgery colleagues to offer the vNOTES route for the removal of ovaries and fallopian tubes in women who carry the BRCA gene (carriers of this gene have a 60% increase in risk of ovarian cancer), providing a less invasive option for those at higher risk of cancer. Understanding your BRCA status can be vital for making informed decisions about your health, including considering preventive surgeries like those we offer using the vNOTES technique. 

Outpatient referrals

At Barnet Hospital and Chase Farm Hospital, referrals are accepted only from Royal Free London consultants and from the North Central London Integrated Care System for obstetrics and gynaecology. We do not accept Barnet GP referrals.

The Royal Free Hospital can only accept referrals from within the Royal Free London NHS Foundation Trust.

Obstetrics

• Self-referral (any address/GP, if delivering at the Royal Free London)
• Camden CCG GPs.

Gynaecology

• via Royal Free London consultant (any address/GP)
• Camden CCG GPs.