Perineal re-education

What is perineal rehabilitation?

Perineal rehabilitation is a specialized field of physiotherapy that addresses issues related to the perineal region. A consultation in perineal rehabilitation does not require a medical prescription, since the patients can present themselves in direct access. However, your gynecologist or family doctor may also refer you.

What is the perineum?

The perineum is a set of muscles found in the pelvis that is part of the pelvic floor. It is at the origin of the pubis and fits on the coccyx. It is responsible for supporting the pelvic organs such as the uterus, bladder, vagina and colon.

Interventions in perineal rehabilitation

Physiotherapy interventions are designed to train the perineal muscles to improve their strength, flexibility, tone and endurance. Consequently, they aim to reduce the pain during sexual intercourse (dyspareunia), normalize the urinary system and strengthen the pelvic floor among other things.

Different techniques are used, such as biofeedback, electrical stimulation, manual techniques, re-education and a personalized exercise program. Manual techniques include myofascial techniques as well as different types of stretching.

Why should you consult in perineal rehabilitation?

The perineal muscles should be able to perform an automatic contraction to maintain bladder control. This should be possible even in the case of coughing, laughing or lifting heavy loads. However, these muscles may be weakened due to excess weight, hormonal changes, pregnancy, childbirth or pelvic surgery. A weak perineum can be manifested by urinary and fecal incontinence as well as genital prolapse. Indeed, it is by remaining toned that the perineum retains urine and prevents urinary leakage.

According to the report “Incontinence: A Canadian Perspective” from the Canadian Continence Foundation published in May 2007, about 10% of the Canadian population suffered from incontinence. However, among the older population, the prevalence is even higher. Indeed, more than half of women aged 45 and over suffered from incontinence and this condition affected the daily activities of more than one in five women.

On the other hand, a hyperactive or hypertonic perineum will tend to cause difficulty urinating or constipation as well as perineal pain. In addition to being responsible for continence, the perineal muscles also have a role in posture and sensitivity during sexual intercourse.
Physiotherapists can help you prevent or solve problems related to the perineal region. They will give you the appropriate advice to improve your quality of life.