In pediatric pelvic health, sensory processing is not often considered as a significant factor. The current gold standard for addressing bowel and bladder dysfunction is urotherapy and medication. Urotherapy encompasses education regarding the anatomy and function, behavior modifications including fluid intake, removing or managing bowel and bladder irritants, diet changes, timed or scheduled voids, toilet postures and avoidance of holding maneuvers, manual therapy, and biofeedback. These forms of treatment have shown a roughly 50% success rate six months to several years after treatment is concluded (Pijpers et al., 2010 and Noordhoff et al., 2018). While the previously mentioned treatment methods are often necessary and appropriate, they fail to consider the central role that sensory processing, sensory integration, and emotional regulation play in basic biological functions and homeostasis. This doctoral project involved the creation and piloting of the Sensory Modulation – Bowel and Bladder Questionnaire (SM-BBQ) questionnaire to help diagnose children who have bowel or bladder dysfunction due to sensory under-responsivity. Results demonstrated a strong positive correlation between children who leaked both urine and stool and demonstrated hypo-responsiveness on the Sensory Processing Measure -2 (SPM-2) and their SM-BBQ scores. Significant findings were also noted between the SPM-2 scale scores and scores on both the SM-BBQ. In contemplating how these findings fit with Ayres Sensory Integration theory, perception and threshold may be more relevant than responsivity, as most participants were noted to be hypo- and hyper- responsive to input. A larger scale follow-up study will need to be conducted to ensure that the SM-BBQ is a reliable and valid measure for identifying children with toileting dysfunction related to sensory perception and helping those families to find appropriate services. / 2025-05-08T00:00:00Z

Bladder dysfunction is seen as a public health problem with a strongly increasing incidence in older men. Despite this, the man's experience of bladder dysfunction is a topic that has not been researched in the empirical field as much as women’s experiences. Not highlighting the man's experience leads to suffering and constitutes an obstacle to equal care. The aim of this study was to illustrate the man's experience of living with bladder dysfunction. This study is intended to illustrate experiences, therefore it was well suited to make an integrative compilation of qualitative research – inspired by meta-synthesis. Nine qualitative articles that described the man's experiences were analysed schematically and resulted in three themes and six sub-themes. Experiences that were noticed in the man were the impact of the environment in bladder dysfunction which included environmental and health care responses. Emotional impact in bladder dysfunction, which highlighted the experiences that arose in connection with bladder dysfunction. The life adaptations in bladder dysfunction was an experience which described the changes the man made to achieve a normality in everyday life as well as changes to hide the condition. The man used a range of strategies to maintain normality in life and to keep his condition a secret from those around him. This is seen because of the stigmatization that emerged through this study. Healthcare failed to care for the man with bladder dysfunction and was seen as partially responsible for the stigmatization the man experienced.

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Purpose To evaluate the pelvic floor health knowledge base and presence of pelvic floor dysfunction (PFD) in women working in an office environment, and whether this knowledge significantly increases following a pelvic floor health education session and a re-education session. To assess whether this knowledge-acquisition leads to significant decrease in PFD. Participants Female volunteers (N=161), ages 18-69 years, were randomly allocated to Groups A, B or C. Methods Online surveys were completed by all groups on three occasions and included validated tools (Prolapse and Incontinence Knowledge Quiz, Pelvic Floor Distress Inventory-20, Pelvic Floor Impact Questionnaire-7) plus sexual function and pelvic floor muscle (PFM) exercise items. On completion of the baseline survey, an education session was given to Groups A and B only (Group C represented the controls). Following this, all participants completed the second survey. Two months later, to allow time for efficacy for the PFM exercises, a re-education presentation was given to Group A only, followed by the final survey administered to all. Analysis Of the 161 volunteers, 16 failed to complete all study requirements, leaving 145 questionnaires (Groups A and B n=48, Group C n=49) available for analysis using ANOVA and Descriptive Analysis. Results The knowledge base of the participants receiving the education showed highly significant improvement compared to the control group, and again for those receiving the re-education session. Although only 14% stated that they had PFD, the surveys revealed that 96% of the participants had PFD. The groups receiving the PFM exercise education and strategies to encourage healthier bladder and bowel habits showed significant decrease in PFD symptoms and increase in QoL. Education was successful in producing highly significant increases in knowledge, importance and commitment toward PFM exercise. Conclusion This study is unique as it evaluated pelvic floor health knowledge and presence of PFD of presumably healthy women within an office setting in contrast to patients seeking PFD medical attention. While further research is required, it is clear that low pelvic floor health knowledge was associated with high prevalence of PFD. Further, as knowledge/awareness significantly increased following education, so did QoL, while PFD significantly decreased.

Purpose To evaluate the pelvic floor health knowledge base and presence of pelvic floor dysfunction (PFD) in women working in an office environment, and whether this knowledge significantly increases following a pelvic floor health education session and a re-education session. To assess whether this knowledge-acquisition leads to significant decrease in PFD. Participants Female volunteers (N=161), ages 18-69 years, were randomly allocated to Groups A, B or C. Methods Online surveys were completed by all groups on three occasions and included validated tools (Prolapse and Incontinence Knowledge Quiz, Pelvic Floor Distress Inventory-20, Pelvic Floor Impact Questionnaire-7) plus sexual function and pelvic floor muscle (PFM) exercise items. On completion of the baseline survey, an education session was given to Groups A and B only (Group C represented the controls). Following this, all participants completed the second survey. Two months later, to allow time for efficacy for the PFM exercises, a re-education presentation was given to Group A only, followed by the final survey administered to all. Analysis Of the 161 volunteers, 16 failed to complete all study requirements, leaving 145 questionnaires (Groups A and B n=48, Group C n=49) available for analysis using ANOVA and Descriptive Analysis. Results The knowledge base of the participants receiving the education showed highly significant improvement compared to the control group, and again for those receiving the re-education session. Although only 14% stated that they had PFD, the surveys revealed that 96% of the participants had PFD. The groups receiving the PFM exercise education and strategies to encourage healthier bladder and bowel habits showed significant decrease in PFD symptoms and increase in QoL. Education was successful in producing highly significant increases in knowledge, importance and commitment toward PFM exercise. Conclusion This study is unique as it evaluated pelvic floor health knowledge and presence of PFD of presumably healthy women within an office setting in contrast to patients seeking PFD medical attention. While further research is required, it is clear that low pelvic floor health knowledge was associated with high prevalence of PFD. Further, as knowledge/awareness significantly increased following education, so did QoL, while PFD significantly decreased.