Women’s Health Service Consent & Information

After booking your appointment you will be directed to our website which has further information about your appointment.

At Pure Women’s Health we understand that talking about pelvic health issues can be daunting, we provide a safe and confidential space for you to discuss this at your own pace.

You should have been sent details of your appointment location, parking, and more, so you can plan your journey and for our post-natal patients so that you can plan if you need to bring your new baby or arrange childcare. Our pelvic health clinics are breastfeeding friendly and there is space to store your pushchair if you are visiting on foot.

On arrival, please report to the reception team who will advise you where to wait, you will then be welcomed into the clinic room by your physiotherapist.

The initial part of your appointment will be a thorough sit-down consultation. This is an opportunity for you to talk about the issues you are experiencing, how they are impacting you, and the concerns you have. Your pelvic health specialist physiotherapist will listen and ask questions to ensure we have all the information we need to help.

For the majority of pelvic health issues your physiotherapist is likely to recommend a physical examination, including an internal vaginal examination. This is something which helps the specialist physiotherapist to determine the problem to its full extent, in the same way we would assess any other physical problem. For example, if you had a problem with your neck we would want to take a look and feel your neck to examine it. To thoroughly assess your pelvic floor muscles, we need to take a look and a feel each of these muscles too, and because they are inside the pelvis, this means we need to do an internal vaginal examination. Your therapist will fully explain the process of the examination and ensure that you are happy and comfortable to go ahead. At any time on your say so we can stop, and you do not have to agree to an internal examination in the first place if you are not comfortable. We will ask you to formally consent to an internal examination, if recommended. See below for more information about consent.

Following the assessment, your physiotherapist will discuss the findings with you and together you will agree the next steps. You will be encouraged to ask any questions you have so that you feel fully informed of the diagnosis and understand the course of treatment.

Your physiotherapist will then discuss your rehabilitation plan for you to work on between visits to support your recovery, this will include demonstrations and you will be given your plan in the format that suits you best. If you need referral or signposting to other services and products this will be discussed.

Finally, your physiotherapist will review your condition and inform you of next steps for follow up treatment and potentially book this in for you. Following the appointment, you will leave with a clear plan of action and know what to do next, in time for your next appointment.

You may wish to bring someone with you to support you and help you to feel more comfortable during your appointment (an informal chaperone); based on safeguarding policy we strongly recommend this is not your partner. Please let us know prior to your appointment that you plan to bring someone. Please also be aware that at some point during the appointment we will ask to speak to you on your own.

You can also ask the physiotherapist if you would like a formal chaperone with you during your appointment.

You are more than welcome to bring your baby or child with you to your appointment and our facilities allow for this, however; to allow you to focus on your health during the appointment, we prefer if you can arrange childcare in advance – but we understand this is not always possible.

What are internal digital vaginal and rectal examinations (DVE and DRE)?

The pelvic floor is like any other muscle – it can be weak, inactive, tight or overloaded. Like other muscles, to determine if there are any problems, a physical examination to feel it and test strength and activity is recommended. Because it is situated internally, such assessment is best completed via an internal examination.

DVE and DRE are performed by a suitably trained specialist physiotherapist. A single lubricated gloved finger is inserted into the vagina (or rectum if vaginal examination is not appropriate) to assess the condition of the pelvic floor muscles. In some cases, the physiotherapist may start to treat your pain or problem directly during this examination. You can ask your physiotherapist to stop the procedure at any point and they will do so immediately.

Why would this be beneficial for me?

Because they aften involve the pelvic floor muscles, the following conditions may benefit from this kind of assessment (and associated treatment):

• Urinary Incontinence
• Urinary Retention
• Vaginal or Vulval Pain
• Pelvic Organ Prolapse
• Vaginismus or Dyspareunia
• Pregnancy-related Pelvic Girdle Pain (PGP)
• Low Back, Hip or Sacroiliac Joint (SIJ) Pain

Do I have to have an internal examination?

No. Whilst an internal examination is often the best way of accurately assessing your pelvic floor, there are other techniques that can be employed, for example, external palpation or the use of aids. These methods do not always give as accurate and extensive a picture as an internal examination.

What are the risks to me from this procedure?

All procedures carry risks. In this case, there are low risks of infection (urinary or vaginal), pain and bleeding. Every care is taken to minimise these risks through clear communication with you and the use of clean procedures and environment.