PELVIC FUNCTION - Ingress Healthcare

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Ingress Healthcare
Ingress Healthcare

Individualised, highly specialist physiotherapy treatments are offered for a variety of pelvic health and pelvic floor conditions for men, women and children. Our primary goal is to help you maintain, achieve and restore optimal bladder, bowel, pelvic and sexual function. This is all done in a space that ensures your confidentiality, privacy, comfort and care.

Ingress Healthcare

About Pelvic function

Pelvic Physiotherapy is a special interest field within physiotherapy.

We take time. Time to talk and time to listen – we unpack your fears and your goals. We listen to all those unpleasant symptoms that no-one wants to mention related to bladder, bowel and sexual function.

You are given space and time to share your experience – be it after an easy or traumatic birth, elective or emergency surgery, concerns you have about your child’s bladder or bowel challenges, or how to make it across the finish line without leaking!

We assess and manage (including self-management, therapist-led interventions, and community rehabilitation) with the aims of decreasing pain whilst improving function and quality of life.

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Pelvic Floor Physiotherapy for Children

Paediatric Pelvic Floor Physiotherapy can help your child address issues with Urinary incontinence (day time leaking due to sneezing, laughing, giggling, holding pee too long, and more) Urinary frequency or urgency. Nighttime bedwetting (Enuresis)

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Pelvic Floor Physiotherapy for Men

Physiotherapy is very beneficial to the treatment of issues such as urinary incontinence, prostatitis, chronic pelvic pain [pudendal neuralgia], overactive bladder and erectile dysfunction.

Each patient is individually assessed prior to treatment where possible and a detailed plan of treatment is designed that is unique to each patient. This can involve pelvic floor muscle exercises, bladder training and whole-body exercise prescription.

Ingress Healthcare

Pelvic Floor Physiotherapy for Women

Women’s health physiotherapy is the therapeutic treatment of all disorders affecting the pelvis and pelvic floor. From incontinence to prolapse, pelvic pain or constipation, there is growing evidence that physiotherapy can alleviate, and in many cases cure these symptoms. Corina Avni is experienced in treating women through pregnancy, post-natally, through menopause and beyond!

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Introduction to Pelvic Health

  • Men and women of all ages can experience pelvic floor problems such as incontinence, particularly after childbirth, during the menopause and after pelvic surgery such as prostatectomy.
  • The most common problems are leaking with coughing and sneezing (known as ‘stress’ incontinence), leaking before you can reach a toilet (‘urge’ incontinence) and pelvic organ prolapse.
  • Our specialist Physiotherapist Corina Avni offers a holistic assessment of lifestyle and pelvic floor function, including a physical assessment.
  • Available treatments include:
    • Functional pelvic floor muscle retraining
    • Bladder retraining
    • Advice on lifestyle modification
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Telehealth consultations

We offer telehealth/video appointments to maximize patient experience and efficiency. We recognize during this heightened alert about COVID-19, that this convenient service is extremely helpful with reducing your potential risk of exposure. Used for both new and existing patients, these appointments may be made for most visit types. We appreciate your understanding that some conditions require a physical examination in the office. However, we are encouraging telehealth visits to start the conversation about patients’ symptoms and determine next steps.

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Women’s Health

Women can experience a range of pelvic disorders. Due to our anatomy and the demands on the female pelvis, we are particularly vulnerable to bladder, bowel and sexual dysfunction. Most times, this vulnerability is assumed to be because we are too ‘lax, loose and long’ often as a consequence of pregnancy and childbirth. However, we are just as likely to experience pain and dysfunction as a consequence of being too short and tight, be it due to ‘holding’ of the muscles in the area or restriction/scarring. Both extremes can and do present with pelvic organ dysfunction. 

Of course, it’s not only the pelvic floor muscles that concern us but the complex three-dimensional nature of pelvic function and activity, including the role of the nervous system – stress and anxiety impact on pelvic function!

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Pregnancy and the postpartum period

Pregnancy and the postpartum period are times of extreme change.

The three trimesters of pregnancy all have their own specific problems based on what’s happening in the body at that time, and the fourth trimester comes with its own special challenges.

Whether you are an athlete concerned about your first delivery, or a seasoned mum on a fifth pregnancy, we focus on issues relevant to your specific case and presentation.

 

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Women’s Health Treatments

We provide thorough assessments, treatment plans and rehabilitation programs to ensure your health concerns are dealt with efficiently and effectively, to maximise your recovery in the shortest possible time frame.

• Comprehensive assessment 
• Self-management 
• Therapist led interventions
• Community rehabilitation

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Comprehensive assessment-

Including history taking; questionnaires (optional); postural assessment; abdominal assessment (including core activation, diastasis); internal pelvic assessment (including pelvic floor muscle assessment, pelvic organ prolapse assessment); biomechanical assessment (pelvic girdle pain and other musculoskeletal pain); connective tissue assessment (pudendal neuralgia and other autonomic dysregulation); breathing assessment; real-time ultrasound assessment of abdominal and pelvic function; electromyography.

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Self-management –

Bladder training (calming an overactive bladder) and voiding facilitation (waking up an underactive bladder); how to poo (defecatory dynamics) and calling the poo (colonic considerations); pelvic organ prolapse management; breathing program

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Therapist led interventions –

Advice and education; abdominopelvic synergy (core) retraining; diastasis rehabilitation; pelvic girdle balancing for pelvic girdle pain; pelvic floor muscle retraining; internal pelvic release and facilitation; visceral manipulations; connective tissue manipulation including skin rolling; scar management; biofeedback for rehabilitation including real-time ultrasound and electromyography; neuromuscular stimulation

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Community rehabilitation-

Return to sport, ongoing maintenance is encouraged in your community e.g. Yoga, Pilates, Gyro, pole dancing

Women's Pelvic Health Conditions

Pregnancy

• Education regarding safe exercise in pregnancy
• Pregnancy-related pelvic girdle pain (PGP) including pubic, groin, buttock, sacrum, low back and perineal pain
• Aches and pains of pregnancy e.g. carpal tunnel, rib pain, mid back pain
• Urinary incontinence
• Constipation and faecal incontinence
• Pelvic organ prolapse
• Dyspareunia (pain with intercourse)
• Preparation for labour
• Abdominopelvic synergy

Pregnancy - Fourth Trimester

• Education regarding return to exercise postpartum
• Diastasis abdominis rectalis (separated tummy muscles)
• Abdominopelvic rehabilitation
• Pelvic floor muscle rehabilitation including internal examination, ultrasound, electromyography, neuromuscular stimulation
• Obstetric anal sphincter injury
• Scar release e.g. episiotomy, caesarean section
• Urinary incontinence
• Constipation and faecal incontinence
• Pelvic organ prolapse
• Dyspareunia (pain with intercourse)
• Persistent pelvic girdle pain including pubic, groin, buttock, sacrum, low back and perineal pain
• Postural imbalances

Bladder dysfunction

• Urinary incontinence, including stress, urge, post micturition dribble
• Urinary frequency/urgency
• Nocturia (waking at night to empty the bladder)
• Hesitancy
• Retention
• Recurrent urinary tract infections
• Post-surgical rehabilitation
• Urinary pain symptoms and syndromes e.g. dysuria (painful voiding), interstitial cystitis/bladder pain syndrome, urethral syndrome

Bowel dysfunction

• Faecal incontinence, including with sensation before a bowel motion, without sensation after a bowel motion
• Faecal urgency
• Constipation
• Incomplete evacuation/obstructed defecation
• Haemorrhoids and fissures
• Post-surgical rehabilitation including post stoma reversal
• Anorectal pain symptoms and syndromes e.g. dyschezia (painful evacuation), anal pain and proctalgia fugax, the symptom of a foreign object in the rectum
• Irritable bowel syndrome (IBS)

Sexual function and dysfunction

• Dyspareunia (painful intercourse)
• Sexual pain and penetration disorders e.g. vaginismus, vestibulodynia
• Anorgasmia
• Urinary incontinence associated with sexual activity
• Post-surgical rehabilitation

Pelvic Organ Prolapse

• Defects in the anterior wall (urethrocele, cystocele)
• Lack of superior support (uterovaginal prolapse, vaginal vault prolapse)
• Defects in posterior wall (rectocele, enterocele)
• Post-surgical rehabilitation

Pelvic Pain General

• Chronic pelvic pain, chronic pelvic pain syndrome, pelvic floor muscle syndrome
• Pelvic girdle pain e.g. pubic pain, buttock pain, groin pain, hip pain, sacral pain
• Low back pain
• Pudendal neuralgia
• Post-surgical pain
• Abdominal pain
• Interstitial cystitis/bladder pain syndrome, urethral syndrome
• Anorectal pain
• Coccydynia (coccyx pain)
• Fibromyalgia
• History of adverse childhood experiences/trauma/abuse
• Post-traumatic stress disorder (PTSD)

Pelvic Pain Female

• Endometriosis
• Vulvodynia/vestibulodynia
• Clitoral pain
• Persistent genital hyperarousal disorder
• Dyspareunia (painful intercourse)
• Post mesh (prolapse) surgery pelvic pain

Transgender Pelvic Health

• Urinary dysfunction
• Scar tissue release
• Pain with intercourse

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What pelvic health conditions do I treat in children?

In reality, it is common (yet not normal) for children to deal with challenges like bedwetting, constipation, or incontinence. As a result, they can experience humiliation, shame, social consequences, and confusion. Parents can become frustrated and often do not know how to help their child. It can be emotionally draining on the whole family, especially if problems persist as the years go on.

However, rest assured that your child can overcome these challenges with a bit of education, individualized treatment, and practice. Just like adults, it really is possible to teach children to take control of their bowel and bladder function using the tools and strategies provided through pelvic health physiotherapy

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Pelvic Floor Physiotherapy can help your child address issues with:

• Urinary incontinence (day time leaking due to sneezing, laughing, giggling, holding pee too long, and more)
• Urinary frequency or urgency
• Nighttime bedwetting
• Constipation or stool retention
• Fecal incontinence
• Under-active bladder or urinary retention
• Painful bowel or bladder movements
• Pain in the perineal or rectal region

Ingress Healthcare

Men's Health

Physiotherapy is very beneficial to the treatment of issues such as urinary incontinence, prostatitis, chronic pelvic pain [pudendal neuralgia], overactive bladder and erectile dysfunction.

Each patient is individually assessed prior to treatment where possible and a detailed plan of treatment is designed that is unique to each patient. This can involve pelvic floor muscle exercises, bladder training and whole-body exercise prescription.

Men's Pelvic Health Conditions

Bladder dysfunction

•  Urinary incontinence, including stress, urge, post micturition dribble
• Post prostatectomy incontinence
• Urinary frequency/urgency
• Nocturia (waking at night to empty the bladder)
• Hesitancy
• Retention
• Recurrent urinary tract infections
• Urinary pain symptoms and syndromes e.g. dysuria (painful voiding), i·nterstitial cystitis/bladder pain syndrome, urethral syndrome

Bowel dysfunction

• Faecal incontinence, including with sensation before a bowel motion, without sensation after a bowel motion
• Faecal urgency
• Constipation
• Incomplete evacuation/obstructed defaecation
• Haemorrhoids and fissures
• Post surgical rehabilitation including post stoma reversal
• Anorectal pain symptoms and syndromes e.g. dyschezia (painful evacuation), anal pain and proctalgia fugax, symptom of a forgein object in rectum
• Irritable bowel syndrome (IBS)

Sexual function and dysfunction

• Erectile dysfunction
• Post prostatectomy erectile dysfunction
• Peyronie's disease
• Hard: flaccid syndrome
• Anorgasmia
• Urinary incontinence associated with sexual activity

Pelvic Pain General

• Chronic pelvic pain, chronic pelvic pain syndrome, pelvic floor muscle syndrome
• Pelvic girdle pain e.g. pubic pain, buttock pain, groin pain, hip pain, sacral pain
• Low back pain
• Pudendal neuralgia
• Post surgical pain
• Abdominal pain
• Interstitial cystitis/bladder pain syndrome, urethral syndrome
• Anorectal pain
• Coccydynia (coccyx pain)
• Fibromyalgia
• History of adverse childhood experiences/trauma/abuse
• Post-traumatic stress disorder (PTSD)

Pelvic Pain Male

• Penile pain
• Scrotal Pain, testicular pain
• Ejaculatory and post-ejaculatory pain
• Post mesh (hernia) surgery pelvic pain
• Chronic non-bacterial prostatitis
• Cyclists syndrome

Corina Avni

Ms Corina Avni

Physiotherapist
M.Physio (SUN SA), Accreditation in Women’s Health Physio (Bradford UK), B.Physio

Biography

Corina graduated from UCT in 1997 with a B.Sc.Physiotherapy, and joined the brain-drain to the UK where she became involved in pelvic health. She returned to South Africa after completing a post graduate qualification in Women’s Health, and has been based at the Kingsbury Hospital ever since.

In 2016 she completed her Masters in Physiotherapy through Stellenbosch University with original research into pelvic floor muscle function during gait. She sees all pelvic patients – Women’s Health, Men’s Health and paediatric bladder bowel dysfunction.

The majority of her caseload involves chronic pain with multiple co-morbidity – everything going wrong all at once. Special interests include anxiety and its impact on function, and anything to do with gait (human locomotion).

She was a founding member of the Pelvic and Women’s Health Physiotherapy Group post graduate training courses, and lectures extensively both nationally and internationally.

Ms Corina Avni's calendar

Ms Corina Avni
Ms Corina Avni
M.Physio (SUN SA),
Accreditation in Women’s Health Physio (Bradford UK),
B.Physio
Physiotherapist
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Room 100, Fairfield Suites, Kingsbury Hospital
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Room 100, Fairfield Suites, Kingsbury Hospital
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Room 100, Fairfield Suites, Kingsbury Hospital
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Room 100, Fairfield Suites, Kingsbury Hospital
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Ms Corina Avni
Ms Corina Avni
M.Physio (SUN SA), Accreditation in Women’s Health Physio (Bradford UK), B.Physio
Physiotherapist

Biography

Corina graduated from UCT in 1997 with a B.Sc.Physiotherapy, and joined the brain-drain to the UK where she became involved in pelvic health. She returned to South Africa after completing a post graduate qualification in Women’s Health, and has been based at the Kingsbury Hospital ever since.

In 2016 she completed her Masters in Physiotherapy through Stellenbosch University with original research into pelvic floor muscle function during gait. She sees all pelvic patients – Women’s Health, Men’s Health and paediatric bladder bowel dysfunction.

The majority of her caseload involves chronic pain with multiple co-morbidity – everything going wrong all at once. Special interests include anxiety and its impact on function, and anything to do with gait (human locomotion).

She was a founding member of the Pelvic and Women’s Health Physiotherapy Group post graduate training courses, and lectures extensively both nationally and internationally.

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Practice number PR0052205
HPCSA number PT0063541
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