Women go through many changes throughout their lifespan. Some have more difficulty managing/during these changes than others. Looking at this from an osteopathic gynecological perspective, internal approaches are very helpful tools to detect, support and help women navigate (some of) these changes. This course aims to refine internal palpation techniques, clarify and discuss our perceptions of the tissues throughout a woman’s life.
The focus will be on practical work, discussion of findings to develop our
palpation skills and gain confidence. Also 3-dimensional visualisation to improve
our understanding of the small pelvis function.
The key area is clearly the small pelvis and its transformations throughout life,
incorporating the influence of the whole body through changes within the pressure
compartments.
Metabolic influences will be included, but the focus will be more functional-
mechanical.
Content: Every section starts with a theoretical introduction followed by practical work.
Theory Pelvic floor :
Pelvic floor and its global functions:
• Continence
• Adaptive system to upper regions
• Birth/ defaecation/micturition
• Sexual function
Pelvic floor: Physiology and pathology
• Different layers and clinical relevance/symptoms
• Levator avulsion: Etiology, signs, symptoms, pessaries
• Episiotomy, tear
Pelvic floor and changes throughout life
• 3-dimensional visualization: Sling system according to Petros/Goeschen
• Aging processes of pelvic floor muscles (PFM) and fascia
Practical Pelvic floor 1:
• Tests Levator avulsion, treatment options-what is our aim?
• Evaluation of pelvic floor muscles with PERFect-scheme
• Episiotomy – scar treatment
• Explore qualities of congestion, fibrosis etc
• Treatment of densifications in deep fascia
Suspension and organs:
Theory bladder
• 3-dimensional visualization: Sling system according to Petros/Goeschen/Ulmsten
• Bladder- stress incontinence, OAB, urine retention, Bladder pain syndromes- pathology, mechanisms, treatment options
Practical bladder:
• Palpation and treatment bladder
• Standing: Palpation and test, provocation stress incontinence
• Visualisation of slings/anterior-posterior pelvic floor muscles and suspension
• Aging processes PFM, urethra, bladder- what to expect
Theory and practical uterus, ovaries, tubes
• Revision dysfunctions and possible symptoms
• Importance of cervix position as centre of small pelvis
• Ovarian cysts- signs, symptoms, red flags
• Transformations during pregnancy, after birth- what to expect and advise?
• Pelvic organ prolapse (POP)- role of vaginal fascias, PFM
• Aging processes-what to expect?
Sexual dysfunctions:
• Clitoral perception- role of arterial supply and venous drainage