Petros Peter - Unlocking the Female Pelvic Floor: A Guide for Symptom Relief With Illustrative Patient Stories

Ulysses or Mountain Blue Butterfly is found only in Northern Queensland.

It symbolizes the freedom which the women described in this book experienced when their burden of pain and incontinence was lifted by application of the Integral System method, the substance of this book.

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Copyright Peter Petros, Joan McCredie, Patricia Skilling

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Contents

A CONSPIRACY OF SILENCE

I write from my own personal experience as a woman who had the problem of severe chronic pelvic pain and incontinence and who had to face the fact that I needed to seek professional advice. Later, as a staff member of the first clinic in the world based on the methods outlined in this book, I had the opportunity to observe and discuss with other women, how their bladder, bowel and pain problems had affected not only their quality of life but also, the very essence of their being.

What I heard, confirmed the opinion I had formed, that the subject of incontinence has been hidden away by generations of women, a passive conspiracy of silence. During my time at the clinic, I realized that there is no age group that is untouched. It occurs even in children, in younger women during sport, during pregnancy and after childbirth. But incontinence is about much more than just the mechanics of bladder and bowel function which are described in this book. For the individual sufferer, it is a powerfully emotive issue. It causes acute embarrassment, erosion of self-confidence and self-esteem. Even the least fastidious woman knows that an odour could be perceptible to others in her company. This leads to a reluctance to socialize, which in turn further depletes her self-image. She has to cope with a high level of constant anxiety, such as having to be aware of the location of toilets. Some addressed their fate with resignation, others with bitterness.

Many patients who came to our clinic had already exhausted all standard avenues of treatment. They were recommended because it offered them hope of cure for conditions which had been considered incurable.

We have written this book for the woman who needs to understand how her pelvic organs work and how and why the methods so successfully applied by physicians who follow the new system promise to be a major step in finally lifting the veil of this conspiracy of silence.

Joan McCredie

About the authors

Professor Peter Petros, DSc DS (UWA) PhD (Uppsala) MB BS MD (Syd) FRCOG (Lond) FRANZCOG CU is a highly experienced pelvic floor reconstructive surgeon. He is internationally recognized as a leader in the field of incontinence and prolapse both in basic science and surgery. In the early 1990s, he and the late Professor Ulf Ulmsten from the University of Uppsala, Sweden, invented the midurethral sling operation for cure of urinary stress incontinence. It is based on their Integral System, a revolutionary method, which forms the foundation of this book. At least 1.5 million of these operations have been performed worldwide since the year 2000. Professor Petros has authored more than170 original scientific articles on incontinence and prolapse and he has Professorships in Medicine at the University of NSW Sydney, Case Western Reserve University, Cleveland Ohio and in Engineering at the University of Western Australia. He has written a major medical textbook on The Female Pelvic Floor now in its 3rd edition, which has been translated into 8 languages. He now lives and works in Sydney.

Dr Patricia M Skilling MB ChB (St Andrews) studied with Professor Petros. As Director of Pelvic Floor Rehabilitation (PFR) at the Kvinno Centre, she initiated the Integral System for PFR, the first new system of treatment since Dr Kegels 1948 method. Her work has been published in leading scientific journals. The new system is time efficient and improves many symptoms not addressed by the Kegel method, for example, urgency, nocturia, pelvic pain and emptying symptoms, as well as stress incontinence.

Joan McCredie has a 25 year experience with incontinence and Palliative Care patients. As an advocate, she has lectured widely to womens groups and civic organizations. She has worked closely with Professor Petros and Dr Skilling as a counsellor at the clinic. Her empathy, understanding and special interest in the profound psychological effects which incontinence and pain can wreak in womens lives has been invaluable for our patients and this work.

Foreword What is different about this book?

By Dr Bernhard Liedl, President, ICOPF (International Collaboration of Pelvic Floor Surgeons) Munich, Germany.

It is based on a major scientific discovery, the Integral System, by Professor Petros (Australia) and Professor Ulmsten (Sweden) who proposed that bowel and bladder problems originate mainly from a damaged vagina or the ligaments which support it and not from the organs themselves. One application, the midurethral sling operation, also invented by Petros & Ulmsten, has changed the lives of millions of women since the year 2000, converting a painful operation involving a12 day hospital stay with indwelling urinary catheters, to a fairly painless day-care operation.

The experience of myself and other surgeons confirms cure or major improvement of other symptoms, urgency, nocturia, pelvic pain and bowel incontinence, following similar day-care repair of other ligaments.

It takes many years for such a radical change in thinking to become widely known. This book is timely. It informs women how damaged vaginal ligaments can cause specific problem and how such problems can be cured or improved with a time-efficient pelvic floor regime, or with minimally invasive surgery.

In this 2nd Edition, Dr Darren Gold has added a valuable chapter on the colorectal manifestations of loose ligaments, constipation, fecal incontinence, haemorrhoids, anal fissures and other bowel conditions.

Liedl B Abteilung fr Urogenitale Chirurgie und Urologie, Beckenbodenzentrum Mnchen, Denningerstrasse 44, D-81679 Mnchen, Germany, President International Collaboration of Pelvic Floor Surgeons, President International Society for Pelviperineology.

The Key Messages of the Book

Though symptoms seem to come from the bladder and bowel, the actual cause is looseness in the ligaments which support them. Using actual patient stories, we show how a wide variety of symptoms and prolapse can be improved or cured by strengthening the damaged ligaments either with day-care surgery, or in less severe cases, simple pelvic floor exercises.