To be given an opportunity to speak at the inaugural pelvic health forum hosted by the World Federation of Incontinence Patients (WFIP) on the 3rd June was a dream come true. The conference took place in the beautiful venue of Hospital de Sant Pau, Barcelona. This is what we at EVB Sport worked tirelessly at for the last 6 years, to get an opportunity to share the views of our community on a global stage.

WFIP MISSION

For people living with incontinence and pelvic floor dysfunction, WFIP’s mission is to:

• Be the patient’s voice
• Be heard in society and by policy-makers
• Be a global umbrella for national organizations
• Encourage an open public debate and break stigma and taboos

WFIP Vision

The vision of WFIP is to create a world where people living with all forms of pelvic floor dysfunction(s) can enjoy a high quality of life, play an active role in society and have access to appropriate treatments.

Conference

Attending the conference were patient organisations from all over Europe. Patient reps from Austria, Hungary, Germany, Spain, Ireland, UK, and many practitioners from all over Europe.
The conference heard from experts in birth trauma, menopause, burden of incontinence, conservative measures to treat pelvic issues and chronic bladder pain. See the full programme for the event.

Personally I was very taken aback by the quality of all the presentations and in particular Dr Oriol Porta Head of Gynaecology in Hospital de Sant Pau. Pelvic floor modelling was discussed and the images of the degree of stretching that take place during labour were incredible. There were discussions around the URCHOICE algorithm which assesses the risk to a mum of injury in childbirth. This is an excellent tool derived by Prof Wilson and Scientists in Mayo Clinic. On a side note we recently listened to Lori Forner’s Pelvic Health Podcast where she talks to Professor Wilson, Dr Kellie Tathem OBGYN and Physiotherapist Natalie McConochie explaining the algorithm around the pelvic floor disorder risk calculator and the benefits of this tool . It is definitely worth a listen.

Key take aways I took from the Presentations

1. In a recent study the prevalence of anxiety and depression in a cohort of pelvic floor dysfunction patients was found to be 31% and 20% respectively. A multidisciplinary approach containing psychometric assessment for PFDs in order to obtain better diagnostic results and personalized treatment options should be considered. Physiotherapist Stephanie Kauffmann.
2. Genitourinary syndrome of menopause (GSM) previously known as vulvovaginal atrophy, atrophic vaginitis or urogenital atrophy is a chronic, progressive vulvovaginal sexual and lower urinary tract condition. The prevalence of this condition is 15% premenopausal and 40-50% postmenopausal women. Moisturisers and lubricants are very important for this condition and reference was made to the North American Menopause Society for further information . Dr Antonio Cano.
3. Stress urinary incontinence is the most common UI type worldwide (2018) because of it’s high prevalence in women. World wide numbers expected to increase to 167 million by 2018. Urge incontinence was expected to increase to 60 million in 2018. Numbers effected by urge are estimated to be similar in men and women. Mixed urinary incontinence is expected to increase to 66 million in 2018 with more women affected than men. Dr Virginia Martinez Barea.
4. Recent study in the UK found a prevalence of chronic pelvic pain of 14.8% in women over 25 yrs. Difficult to diagnose, difficult to treat and difficult to cure. Dr Stavros Charalampous.
5. The prevalence of fecal incontinence can be between 2.2% to 19.5%, increases with age and increases with coexistence with other pelvic floor disorders. The key message is to seek help. Dr Arantxa Munoz.
6. Main variables related to obstetric anal sphincter injuries (OASI) can be seen in the equation below. The type of delivery is the only variable that can be modified therefore obstetric attitudes can impact women’s well-being either in the short and in the long term. Dr Oriol Porta.
   Parity + Type of delivery + NN Weight = OASI variables

EVB Sport Community participation

To close the conference a very interactive session took place and the audience were asked for suggestions on how to move forward. This is where we got a chance to put some of our communities points of view across. Before we left for Barcelona we reached out to 1000 customers and asked them what they would like us to put forward for discussion.We were delighted with the response to our online survey. We would have loved the chance to bring every response to the forum however we were given the opportunity to highlight 3 of the main issues during our presentation, the round table panel discussion and the workshop session on the 4th June with the WFIP Board . We have listed the 3 items below with examples from our customer survey.

1. Education platform for patients and medical practicioners alike.

Better communication all round. A platform to be formed for patients and practitioners alike to refer to. A one stop shop for information, knowledge and support. There is so much information in various platforms that there is a need for a Gold Standard Platform for patients when it comes to all aspects of pelvic health. A place where practitioners can guide their patients to, where fitness professionals can direct their customers to and a place where those affected to any degree can refer to for support and advice.

EVB Sport Community Survey Response

” Awareness of continence issues affecting so many women and men. Ageing population Everyone will be wet sometime! Hidden disabilities need better research. Need to find ways to improve surgeries and support needs. Complacency is not acceptable. See NHS England excellence in continence care 2018 and NICE clinical guidance 171 (2019). Also http://www.appgcontinence.org.uk/ also https://www.nice.org.uk/guidance/ng123 “

EVB Sport Community Survey Response

‘Information is power. Women should be informed about the risks of vaginal delivery especially instrumental delivery to allow them to better look after their bodies in post partum period’.

2. GP Awareness

More awareness amoungst GP’s to flag pelvic issues early and know who to refer to. The need for GP’s to be aware of the care path for all aspects of pelvic health. The need for GP’s and those in primary care to be asking early about signs of pelvic floor dysfunction. GP’s need to be educated on the work of a pelvic health physiotherapist. This was also discussed at the UGUS conference in April where Pelvic Health Physiotherapist Grainne Donnelly from the Western Health Trust and Absolute Physio carried out her own survey with doctors which reflects this lack of awareness among GP’s of the work of a pelvic health physio. You can read about this here.

‘GPs are not equipped with the information they need to help us, nor is there a significant amount of research into solving a problem that affects so many more women than we even know. The more we talk about it, the more options we’ll have in the future. ‘

EVB Sport Community Survey response sample

‘ Incontinence should not be something that is considered normal. Women should receive ongoing checks from doctors in case symptoms develop. There doesn’t seem to be a focus on women taking care of their pelvic floor after birth. Don’t automatically assume they have had a physical exam at 6 week check to make sure everything is OK’

EVB Sport Community Survey response sample

‘ I believe that if I had discovered EVB for pelvic support earlier, then I would not have the problems with a prolapse and other issues that I have now. I am facing into 3 general anesthetics and two ops at this point that most professionals I have seen agree could have been avoided if my condition had been understood and acted on earlier. Early pelvic support could have changed the situation. Every menopausal woman should be told that such aids exist. My pain levels have improved, exercise has been made a less painful option and although my situation is too late to resolve without surgery, I am telling anyone I can about this other option if caught early enough. My daughter wears EVB’s too and is aware of the necessity for good pelvic health before, during and after childbirth in a way that my generation wasn’t. Educate! Educate! Educate! ‘

EVB Sport Community Survey response sample:

3. Early Education

Education early on about good pelvic health, education at sports clubs, coaches, PE teachers etc. The importance for women to know their own bodies as they journey through the different life stages. Education at an early stage is of paramount importance.

‘I am 23 and the message I would bring is that it doesn’t just affect older people and I have had the issue for years so this has affected me from much younger. ‘

EVB Sport Community Survey Response Sample

‘National physical activity and sports policies need to acknowledge and educate fitness and health practitioners about incontinence in women’.

EVB Sport Community Survey Response Sample

World Incontinence Week

The event was extremely well organised and we came home energised and full of ideas and information to share to our community. We were reminded by the organisation to spread the awareness about World Continence week which is taking place between 17th – 23rd June and toolkit to help share the message is available here to down load free

Driving change for Women’s Health

Our mission at EVB Sport is to drive change for women’s health and in particular bring awareness to pelvic health and help prevent pelvic floor dysfunction. We were delighted to get the chance to share the views of our community on this global platform. Thank you to all our customers who answered the survey to enable us to bring real information to the forum. We look forward to working more closely with the WFIP organisation in the future to help drive change for pelvic health world wide.