Empowering YOU to be in control

This months pessary lesson is the Shaatz Pessary.

For whom is the Shaatz pessary suitable for ?

The Shaatz pessary is ideally recommended for women who have a first or second degree prolapse (mild – moderate) which has complications of a mild cystocele.

I can’t retain a ring pessary so will this help?

Possibly, as the Shaatz is ideal for the patient that has a shallow pubic notch.

How does this work with someone that has very little pubic notch to support a pessary?

The Shaatz uses the levator muscles to hold it in place, so good pelvic muscle structure is a great help in this case.

Can I build up muscle structure?

Through regular kegel exercises and physiotherapy, women have built up a good pelvic floor muscle strength leading to good structure.

I have pressure sores on the pubic notch can I use the Shaatz?

Yes it is designed to alleviate pessary pressure on the pubic notch.

What are the holes in the pessary for?

The holes in the pessary allow for drainage of any vaginal fluids.

How do I know what size to use?

Your doctor or women’s health physiotherapist will be able to measure you. The width of the vaginal vault helps determine the size of the Shaatz needed. The Shaatz requires a roomy vaginal vault.

With my uterine prolapse, will the cervix push out the Shaatz?

No, if the shaatz is positioned correctly then there shouldn’t be any movement of this pessary as the cervix rests behind the disc of the pessary.

Can the Shaatz restrict bowel movements?

It is possible if the shaatz is the wrong size or in the wrong position. But it could also restrict if you have a rectocele regardless.

How do I remove the Shaatz pessary?

Insert one finger into the large hole to bring the pessary down toward the introitus (opening of the vagina) . Turn the pessary so that the rim is almost parallel to the introitus. With one or two fingers of the other hand, press down on the perineum and slide the pessary out.

What about cleaning the Shaatz?

Its like any other pessary, wash under clean water, you can boil it, autoclave it but its just as easy to wash well. If you use soap remember to remove ALL soap residue before re-inserting. Do not towel dry as tiny fibres can get stuck to the silicone and may cause infection. Just air dry or even reinsert when wet.


Shaatz for prolapse and cystocele     Shaats pessary for prolapse and cystocele


Diagram credit to www.louisedouse.com

Diagram credit to http://www.louisedouse.com


Bowel dysfunction has many causes. Thanks Sue Croft Physiotherapist for this great blog

Originally posted on sue croft physiotherapist blog:

slice of apple pie       apple pie with slice missing

When you think about a pelvic floor physiotherapist, the first thing most people think of is that WH physios teach pelvic floor exercisesand quite often, even amongst a few doctors, that’s ALL we teach patients. But as you have read from many of my blogs, the treatment strategies involved for stress urinary incontinence, the overactive bladder, vaginal or rectal prolapse, bowel dysfunction, persistent pelvic pain and other conditions involve quite a number of different treatment strategiesand each of them – and the sum of all of them – are what contribute to a solution for each of these problems.

That’s what is going wrong for women when they lament that they are doing their pelvic floor exercises but they are still leaking/ soiling/suffering frequency and urgency/feeling a vaginal bulge/ getting pelvic pain/having sexual dysfunction and so on. If the only piece of advice they have been given is to “Do your pelvic floor exercises” then…

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Zerreau is a revolutionary towel off shampoo that cleans hair effectively without water. Just apply the foam to your hair and towel off.

So you have heard lots about Zerreau but still not convinced?
Let us show you why it is different and how it works…

Zerreau’s predecessor is Nilaqua the original towel off liquid shampoo that has been used in NHS hospitals and care settings to wash people effectively without water for years! We are different to anything currently on the market as the dirt and grease is lifted into the towel leaving you with soft clean hair.
Sounds good but not sure how to use it?

Apply the foam directly to the roots and massage, this will allow the foam to combine with the dirt and grease, then to remove this you must towel dry thoroughly. Dirt and grease is then transferred to the towel. After this process is complete you can then style as normal. i.e. plait, straighten etc..
What else should you know?

    It is alcohol and paraben free
    Smells divine
    Cleans hair properly
    Easy to use

Is Zerreau a dry shampoo?

No it is not a powder
Is Zerreau a brush through shampoo?

No as you towel it off
Is Zerreau a leave in shampoo?

No it removes dirt and grease
Is Zerreau a towel off shampoo?

YES towel away the dirt!
We guarantee Zerreau will effectively clean your hair or we will give you your money back!

For more information Zerreau




The T Pessary

pTreatment The T pessaryis successful in treating a 1-3 degree cystocele accompanied by a rectocele. It can also be used to manage stress incontinence (SUI) The T pessary can be left in the body continuously for up to 30 days, but it is advisable to remove daily to give the body a rest and to […]/p

via The T Pessary.

Originally posted on :

A common scenario: You have constipation, but the cause is unknown (and may have several underlying factors). There are a variety of tests for constipation. What if your physician orders a “DEFECOGRAM?”

This is actually quite a common test, but if you search the internet, it will likely leave you with questions and fears. Dr. Vikas Shah, guest blogger and UK consultant radiologist specializing in gastrointestinal and colorectal imaging, shares information to dispel to the myths about defecograms.

* Google Image

* Google Image

 What is a defecogram:

A defecating proctogram, also known as a defecography or a defagram, is used for functional imaging of the muscles and tubular structures used in defecation. It is a study commonly used to demonstrate the functional problem in a person with pelvic floor dysfunction, or a rectocele.  These symptoms can be constipation, incomplete evacuation, incontinence, mucous discharge, or perineal pain

By Dr.Shah



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#pelvicmafia. Go girls you are simply the best

Originally posted on :

Would you like an official #pelvicmafia shirt?

Are you looking for a fun way to start a conversation about pelvic health and the pelvic floor? Do you want to share a common mission with many pelvic health professionals and supporters from all over the globe? Would you like strange and inquisitive looks and questions from strangers? (ha).

Many of you asked and I have an answer for you!


Here’s the link: Ts for Vs 

Info from the website:

“An ambitious bid (by an impassioned & frustrated pelvic/women’s health physical therapist) to ratchet up the visibility of sensitive pelvic health concerns internationally and to fund the projects supporting those concerns. Because believe it or not, it is ironically not sexy to fund humanitarian organizations addressing sexual health (and pelvic pain, and poo, and pee…). Buying from Ts for Vs gets these necessary conversations going.

Proceeds from Ts for Vs supports The…

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Originally posted on Sexual Healing:

Photo courtesy of Gabby Carroll

Photo courtesy of Gabby Carroll

As usual when you have any kind of pelvic pain or sexual disorder, absolutely nothing that has to do with your lady parts or derrière is simple. You even have to be concerned with the way you dress it. As annoying as this fact may be, selecting the right kind of underwear for your pain is essential for your day-to-day comfort.

Before I was afflicted with my pelvic pain, jaunting on over to Victoria’s Secret and picking out sexy underwear was a favorite activity of mine. I was relatively young, just beginning to explore my sexuality, and was thrilled that someone actually found me attractive, that I could dress up this new, womanly body (I loved me some cheeky cut undies). Of course, that all changed when I began feeling the pain and especially after I was diagnosed.

When you have pelvic pain, suddenly choosing what kind of…

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