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Book criticises NICE pelvic floor guidance

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The NHS is failing to properly implement advice on pelvic floor muscles, wasting resources and failing women, according to a new book.

The Kegel Legacy claims a review of post-natal rehabilitation care is needed to prevent discomfort and frustration for at least 5,000 new mothers each week who it says are affected by ineffective advice.

Millions of women suffer long-term problems, the book claims, in what it sees as a modern health scandal.

Author Barry Fowler accuses the medical profession of ignoring a major clinical trial that set out a Gold Standard for treating weak and damaged pelvic floor muscles and the related conditions, such as prolapse, stress incontinence or problems with sex. Fowler claims a third to a half of all women across the full age-span may be affected.

He says that despite Arnold Kegel’s exercises having been shown to cure 85% of problems in two weeks, doctors and physiotherapists are failing to follow the proper principles and procedures of the approach when issuing advice.

“If the exercises you are told to do by your doctor or physiotherapist were at all effective then we would not have seven million women in the UK with stress incontinence, millions suffering prolapse and a multi-billion industry supplying designer incontinence pads,” Fowler argues, adding: “Millions of women are wasting their time for many months with ‘exercises’ that will never deliver any real improvement.”

He accuses NICE of failing to adequately emphasise the Kegel approach, resulting in cash being spent on often-ineffective surgical and pharmaceutical interventions.

“It is impossible to put a cost on the impact that this is having on the lives of millions of women. And on the waste of resources and budgets,” the author complains.

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Readers' comments (1)

  • what about this evidence from the Cochrane review?

    Pelvic floor muscle training versus no treatment for urinary incontinence in women.
    Dumoulin C, Hay-Smith J.
    Published Online: January 20, 2010.
    Stress incontinence is the involuntary leakage of urine with a physical activity such as coughing or sneezing and can happen if the pelvic floor muscles are weak. Urge leakage occurs with a strong need to urinate, but the person cannot make it to the toilet in time and is caused by an involuntary contraction of the bladder muscle. A combination of stress and urge leakage is called mixed incontinence. The review of trials found that pelvic floor muscle training (muscle-clenching exercises) helps women with all types of incontinence although women with stress incontinence who exercise for three months or more benefit most.
    ....- See more at:

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