Invited Commentary

Abstract

Disorders of bladder control are primarily of neuromuscular origin. This can be expanded to a statement that all pelvic floor dysfunctions have at least a component of neuromuscular dysfunction contributing to the pathophysiology of the condition — at least at its initiation. The application of rehabilitative therapy to pelvic floor conditions is well accepted and recognized as a valuable treatment option for the vast majority of patients with urinary and fecal incontinence. The use of this approach for other pelvic floor conditions such as pain and prolapse is less well recognized and accepted. In Chapter 22, Bø and Di Benedetto review their experience in the management of pelvic organ prolapse (POP) with biofeedback and physiotherapy. Therapy for POP has been limited, until now, to the use of pessaries or reconstructive surgery, but interest in physiotherapy for POP has been increasing, primarily due to patients’ interest in less invasive options. In the realm of self-help options for POP, it is important to educate patients about the importance of early detection of POP, as initiation of physiotherapy once the vaginal mucosa is exteriorized is rather ineffective.