Pelvic Organ Prolapse: The Silent Epidemic. Sherrie Palm. New York, NY: Eloquent Books; 2009. Soft cover, 148 pp, $23.50.
Sherrie Palm begins her introduction with a theme that is evident throughout her book "knowledge is always the key." Her book is intended to open dialogue among women about pelvic organ prolapse (POP). She also wishes to bring information about POP to young women during routine gynecological examinations so that POP can be prevented or minimized.
As a layperson writing about a very difficult medical condition, Ms Palm does an admirable job. She has had surgical intervention for several POPs and writes candidly about her experience and offers some wonderful, practical tips on how to cope with the postoperative experience. The book is easy reading and starts with information about the causes and types of POP. She describes the various symptoms that might indicate a POP. She discusses when to seek medical evaluation, what to expect during an evaluation, and various treatment options. Ms Palm writes very briefly about how physical therapy may help with POP and also discusses the use of pessaries.
One of the most important chapters is on preventing POP. For women who do need surgical intervention, she lists possible questions to ask the physician and what to expect in POP surgery; suggestions from preoperative meal preparation to comfort measures after, especially since hospital stays are usually kept to a minimum. Ms Palm provides a list of Web sites for further information, mentions 4 articles, and includes a brief (too brief) glossary and product information.
This is a patient education book and is not referenced. There is also usage of incorrect terminology ("electric stimulus" instead of electric stimulation). This book does not explain the physical therapy for POP well.
This book should be mandatory reading for childbirth educators. For therapists who are working with patients with pelvic floor dysfunction, it would be a good reference for the practical tips that may help clients with other pelvic floor problems. Physical therapists may also recommend this book for selected patients who may be dealing with POP problems.
Elaine Pomerantz, PT, MSPH
South Orange, NJ
Female Sexual Pain Disorders. Evaluation and Management. Edited by Andrew T. Goldstein, Caroline F. Pukall, and Irwin Goldstein. Hoboken, NJ: Wiley-Blackwell; 2009. Hard cover, 270 pp, $149.95.
This book is an inclusive reference covering the relationship between sexuality and pain. This book includes history, prevalence, and relevance of dyspareunia. It is coauthored by many experts including epidemiologists, infectious disease specialists, physical therapists, lay patient advocates, neurologists, psychiatrists, and dermatologists. The coeditors of the book are Andrew Goldstein, MD, gynecologist; Caroline Pukall, PhD, psychologist; and Irwin Goldstein, MD, urologist. Each chapter has its own set of references, which are generally from recent, peer-reviewed journals and textbooks.
This book covers history, prevalence, and relevance of dyspareunia. The authors describe the physiological pain and interpersonal problems dyspareunia can cause. Other diagnoses that can contribute to dyspareunia are discussed. These diagnoses include provoked vestibulodynia, generalized vulvodynia, interstitial cystitis, endometriosis, pelvic inflammatory disease, irritable bowel syndrome, POP, and postpartum dyspareunia among others. Medical conditions that can contribute to dyspareunia, including dermatological conditions, hidradenitis suppurativa, sexually transmitted diseases, vulvovaginitis, noninfectious vaginitis, and pudendal neuralgia, are discussed. Medical management as well as cognitive and behavioral therapies, including physical therapy, is described.
Two chapters are coauthored by physical therapists. Talli Y. Rosenbaum authored the chapter on physical therapy evaluation. She includes a section on pelvic anatomy including a concise description of the pelvic floor muscles. She describes the physical therapy evaluation as including medical history, general observation and posture, musculoskeletal examination, pelvic and genital examination, pelvic floor examination, and electromyographic assessment of the pelvic floor. Amy Stein and Dee Hartmann coauthor the chapter regarding physical therapy treatment of pelvic floor dysfunction. They include descriptions of manual therapy techniques such as myofascial and trigger point release and visceral, neural, and joint mobilizations. Therapeutic exercise, behavioral therapies, and additional modalities are also explained. Physical therapy and its use of surface biofeedback are also included in a chapter discussing alternative treatments. All descriptions of physical therapy are well-written accounts of interventions and evaluation techniques useful for treating patients with dyspareunia. Therapists with training in pelvic floor management will already be familiar with this information.
Overall, this is a valuable text covering a wide variety of topics related to dyspareunia. It will be a useful reference in the clinic as well as helpful for physicians, insurance carriers, and patient education.
Bobbie Stergar, PT, CLT
Dunlap, IL
You Go Girl But Only When You Want to: Key Tips, Topics, and Exercises for a Healthy, Passionate, Excited You. Missy D. Lavendar and Dorothy B. Smith. Chicago, IL: Women's Health Foundation; 2007. http://www.totalcontrolprogram.com. Soft bound, 141 pp, $14.95.
Missy D. Lavendar is the Executive Director of the Women's Health Foundation, which she founded in 2004 after experiencing postpartum urinary incontinence and finding little help available. The foundation's mission is to "improve pelvic health and fitness of women through education, research, and innovative programs." Dorothy B. Smith, MS, RN, is a nurse who has worked with patients experiencing incontinence in a variety of settings. She has authored more than 125 publications related to her field and currently works for DesChutes Medical Products, Inc.
You Go Girl is a very good, comprehensive overview of urinary incontinence including anatomy and physiology involved, risks and causes, how and why to exercise for bladder health, lifestyle and behavioral modifications, medical interventions, alternative interventions, and special topics. Women of all ages and demographics can learn something from this book that may help steer them toward an appropriate intervention or prevent a future problem. Individuals having no prior knowledge about urinary incontinence may encounter difficultly in knowing how to begin treatment for the control of their urinary condition solely by reading this book. Working with a women's health physical therapist or other professional may be helpful in giving specific recommendations for an appropriate approach. This book is written for women and does not address the male bladder health although many of the topics apply equally to both genders. There is a "References and Resources" section at the end of this book, which includes lists of articles, books, online resources, and even pharmaceutical and medical equipment companies. In addition, a glossary provides easy access to terms used throughout the book.
I would recommend this book specifically to women who want a global understanding of how the bladder works and types of urinary incontinence management techniques. It may also be helpful to beginning women's health physical therapists in developing teaching strategies for patients.
Meghan Swenck, PT, DPT
Richmond, VA
Total Control Pelvic Pyramid Workout DVD. Chicago, IL: Women's Health Foundation. http://www.totalcontrolprogram.com. $19.99.
The Women's Health Foundation is a nonprofit organization formed in 2004 with a mission to "improve pelvic health and fitness of women through education, research, and innovative programs." A comprehensive Web site http://www.womenshealthfoundation.org supplies a wealth of information, links, publications, and products.
The Total Control Pelvic Pyramid Workout DVD specifically addresses the multifidi, pelvic floor, and transverse abdominus muscle groups and how they work together to help promote trunk and pelvic stability as well as continence. It is accompanied by a brief booklet on bladder anatomy and physiology, introduces the pelvic floor muscles, defines urinary incontinence and some treatments, and introduces the pelvic pyramid. The DVD begins with an easy-to-follow introduction with instructions on correctly engaging the pelvic pyramid muscles individually. The duration of the workout is 60 minutes broken into four 15-minute sections: Pelvic Pyramid, Mat, Standing/Ball, and Ball. Each section includes a series of exercises with verbal instructions and reminders to engage the pelvic pyramid as a unit. Most exercises have beginner and advanced positioning, both of which are demonstrated. You will need a 6-in lightweight ball, stability ball to sit on, and a small towel. The verbal instructions are correct and thorough; however, verbal instructions alone may not be sufficient for a patient to perform a Kegel exercise program correctly. This DVD might be best used with an internal vaginal examination by a trained professional to enhance results.
The Women's Health Foundation partnered with Dr Linda Brubaker of Loyola University to conduct 2 studies to support the Total Control program. The Web site has a brief description of the research; the study design, validity and reliability measures used, and the use of control subjects are not clear from the Web site description, and therefore it is difficult to determine the efficacy of the Total Control program. The research is mentioned briefly on the DVD introduction, but no details are discussed. Based on their research, this program recommends performing the DVD routine 2 times per week for 7 weeks and provides charting for the first 4 weeks of training. Individuals may need instruction in more challenging exercises after that time to continue to improve and progress.
This DVD workout would be an excellent adjunct for a woman needing a structured transition out of physical therapy and into a home exercise program for urinary incontinence and related diagnoses.
Meghan Swenck, PT, DPT
Richmond, VA
Pelvic Floor Disorders DVD (for PC and Mac). London, United Kingdom: Primal Pictures Ltd. http://www.primalpictures.com. $275.00.
Rhonda Kotarinos and Allison Ariail, along with Primal Pictures, have produced a DVD that is a comprehensive clinical tool for physical therapists and other medical practitioners, as well as a tremendous teaching tool for students and patients. Anyone familiar with Primal Pictures knows how valuable their 3-dimensional interactive series DVDs are for learning the anatomy and function of parts of the human body. In the case of this DVD, titled "Pelvic Floor Disorders," they have created a masterful teaching and learning tool. After a tutorial for how to navigate the DVD, individuals can start with the bones of the pelvis and then build the layers of ligaments; muscles; and reproductive, urinary, digestive, nervous, and circulatory systems. Throughout this process, one can click on a structure to identify what it is and rotate the 3-dimensional model to get a total view of the structure. There are also anatomical slides illustrating several coronal section views of the female pelvis and clinical animations showing contraction of the pelvic floor muscles.
The DVD also includes detailed instructive text for clinicians on the topics of POP, fecal and urinary incontinence, chronic pelvic pain syndromes (dyspareunia, interstitial cystitis, levator ani syndrome, coccygodynia, anismus, proctalgia fugax, pelvic floor tension myalgia, pelvic floor damage, and treatment). For each topic, the authors have included information on pathogenesis, diagnosis, and management that is well-grounded in current literature.
The authors have also provided excellent teaching handouts that can be printed for patients for each of the pelvic floor disorders. The illustrations are clear and the text is easily understood. Another very useful piece of this software is the ability to copy and paste the pictures into other electronic programs, including Microsoft PowerPoint.
Anyone involved in the treatment of pelvic floor disorders would benefit from having this DVD in her or his library. Primal Pictures has changed the way in which practitioners can study anatomy and function, and this will enhance the teaching we provide to students, patients, and clients.
Nancy C. Rich, PhD, PT
Bridgton, ME