Firstly, the physiotherapist will take a thorough history asking personal questions about your sex health, bladder and bowel habits, menstruation and kind of delivery as well as the duration of the delivery. She may also ask you questions about your pain, when you notice it the most, how it affects your daily life and what your goals might be.
The more information you can give, the better the physical therapist can help determine the right course of treatment for you.

Education will be done on:
- Bladder and bowel function in relation of the pelvic floor muscle
- Bladder and bowel irritants
- Optimizing bladder and bowel habits
- Toilet posture
- Optimise breathing, core function and muscle condition around the pelvis
- Activation and relaxation of the pelvic floor
- Techniques and advice regarding dyspareunia (painful intercourse)


After a conversation, there will be an external and internal exam to assess range of motion and strength of different muscle groups.

External Examination:
- Soft-tissue structures of the abdomen, trunk, bony pelvis, and legs
- Skeletal structures of the pelvic ring and lumbar spine
- Scar mobility examination.
- Biomechanics/Motor Control evaluation

Skin inspection and internal examination


1.Skin inspection:
- Vulva skin colouring, atrophic or dermatologic changes, fissures
- This is important to determine if the patient needs a referral to a medical doctor.
- Internal pelvic floor muscle examination
- Healthy muscles do not hurt when they are palpated.
- A physical therapy internal examination also includes examination of the vulvar and peri-urethral connective tissue, palpation of all pudendal nerve branches, the pelvic floor muscle and a more involved investigation of a patient’s motor control, muscle length, and strength and endurance.

2.Physical Therapy Assessment and Treatment Plan

Following the history taking, the physical examination, and assessment a treatment plan will be formulated, discussing short and long-term goals. (2hour session during first consultation)
There after the sessions will be hands for an hour per week or second week for roughly for 3 months

BLADDER CONDITIONS:

• Urinary Incontinence: It is the involuntary leaking of urine
• Overactive bladder: Visiting the toilet more than 6-8 times per day with a strong urge to empty bladder but passing a small amount of urine
• Painful bladder or interstitial cystitis: It is often mistaken for urinary tract infection (UTI) but there is no infection when tested. Symptoms may include bladder- and pelvic pain, bladder pressure and a frequent urge to urinate.

Detrusor sphincter dyssynergia is the incoordination between the bladder muscle contraction and the relaxation of the bladder neck sphincter and the relaxation of the pelvic floor to urinate leading to the sensation of incomplete emptying of the bladder with small, interrupted flow of urine and pain during or after urination.