Physiotherapists treating pelvic floor related dysfunctions have a different education around the world. Susan Slade et al. did a qualitative study in Australia interviewing twenty-eight physiotherapists with different levels of experience in treating pelvic floor dysfunctions. She asked them for instance about education, clinical reasoning and the transition from novice to expert. Do you want to compare this to your situation, please continue to read?


Issue 1: education


To become an expert continence clinician first of all post graduate education should be followed. There is some concern about colleagues practising women’s health without a postgraduate course. Post graduate education teaches research literacy skills. You also learn how to search databases for evidence and appraise the trustworthiness of articles. Participants thought that clinicians without the proper post graduate education are less competent.

Issue 2: clinical reasoning


Another attribute is clinical reasoning which develops from novice to expert. The more experienced clinician is able to digest more information quicker and can easier adapt/revise treatment plans if necessary. Mentorship can be used as a powerful tool in gaining knowledge and skills. Novices being mentored by more advanced clinicians, the more advanced by seniors etc.


Issue 3: reporting training programs


Have you noticed that effective pelvic floor muscle training programs are often not reproducible because of incomplete reporting? This issue was mentioned in the research as well. I really hope that this will improve because only then data can be compared properly and above all used in treating our patients more effectively.


Issue 4: informing the public


Informing men and women about treatment options for urinary incontinence remains an important goal. Too many people still think that urinary incontinence is a part of life, the respondents answered. As this research was done in Australia it is hard to generalize it to other countries. However, to my opinion this remains a key issue for everybody. So if you are already involved in providing information; keep up the good work. Otherwise you might give it a go as well!


My personal opinion and conclusion:

Good quality and effective care can only be given by qualified professionals. A patient who is looking for help should know that he or she is going to see a properly educated physiotherapist. In the Netherlands we have tackled this issue to a certain degree. In order to treat pelvic floor dysfunctions and be reimbursed by the insurance the patient has to be treated by a ‘registered pelvic physiotherapist’. You can only register when you have successfully followed a three year post graduate course ‘pelvic physiotherapy’. The course is based on the proficiency profile of the Dutch society for pelvic physiotherapy.  Besides working at least 8 hours a week as a pelvic physiotherapist, in order to remain registered you have to gain a certain number of credits every  five years by following accredited courses related to pelvic physiotherapy or visit specialised conferences.

This Dutch system might be a solution for other countries as well.


Feel free to leave your ideas and personal opinion below.

Slade SC, et al. Attributes of physiotherapy continence clinicians: a qualitative perspective. Physiotherapy (2019)

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