2023-06-22 20:09:47
They note that women are more and more fearful of going under the knife to have a urine strip installed in particular.
Currently, we have an estimate of 140 women on our waiting list , summarizes physiotherapist Marie-Ève Bergeron.
A year ago, she set up an innovative form of consultation that consists of bringing together women who are experiencing the same problem rather than treating them individually. These group classes, which take place in an aquatic environment, reduce both costs and waiting times for patients looking for solutions to treat stress urinary incontinence or pain during sexual intercourse, for example.
Marie-Ève Bergeron, physiotherapist specializing in pelvic health
Photo: Radio-Canada / Yoann Dénécé
There was a study in older women that group classes might be as effective as one-on-one classes. So for efficiency and effectiveness in the public health system, it’s something that should be explored , explains the one who was one of the first to offer pelvic floor rehabilitation services in Mauricie in 2016.
The Quebec Association of Physiotherapy (AQP) urges the government to listen to these innovative practices. Physiotherapy in perineal and pelvic rehabilitation has proven its worth, its effectiveness has been supported by the literature and does not necessarily imply individual care, writes the president, Simon Dalle-Vedove.
Simon Dalle-Vedove regrets that the Quebec government does not [se soit] not yet commented on the INESSS report, a report dating from October 2022, in which there are clear, precise, realistic recommendations to this effect, he said.
Compete in originality to reach more women
Even in the private sector, we are overwhelmed , launches physiotherapist Joëlle Fortier-Soucy. She finds it absurd that women have to incur costs, sometimes significant if they do not have insurance, to afford services that she considers basic. There where [la demande] exploded, it was when my clientele realized that they might have done prevention.
Faced with this observation, the specialist also felt an urgent need to democratize access to care. She co-created the podcast Your healthy perineum which has so far garnered more than 20,000 listens.
Joëlle Fortier-Soucy, physiotherapist and co-creator of the podcast Your healthy perineum.
Photo: Radio-Canada / Yoann Dénécé
« What we realize when we go to consult in perineal rehabilitation is that it is not a subscription! »
— A quote from Joëlle Fortier-Soucy, physiotherapist
It’s a lot of education, it’s a lot of information and we focus on the autonomy of the person , she explains. Very often, she says, a problem is solved in the space of a few sessions. The less it’s been a long time that we have the symptom, the faster it can be , she summarizes.
Sometimes, 6 to 10 meetings will be necessary, explains Marie-Ève Bergeron, “depending on the case, and depending on whether we want to make a Ironman Also! »
For Caroline Arbour, whose book Inhabit our bodies came off the press a few weeks ago, we have to find ways to talk to more people, to reach more people so that there is some of the work that can be done.
« Everyone needs to learn these things. Women… and men too! »
— A quote from Caroline Arbour, physiotherapist
His book offers a reflection on the normalization of abdominal and pelvic pain.
At the moment, what we normalize is the suffering and then the pain. We don’t give hope [aux femmes]we don’t show them that there are plenty of things that can work… not enough in any case , she adds.
« I think it’s a culture change that needs to be made in women’s health. »
— A quote from Caroline Arbour, physiotherapist
The training programs in this very specialized branch of physiotherapy are still few in Quebec and very restricted. A graduate microprogram has been offered at the Université de Montréal since 2010. A 12th cohort completed the program last May.
The Quebec Association of Physiotherapy reacts
In reaction to the Radio-Canada report, which shows women struggling with irreversible pain following the removal of their urine dipstick, the Quebec Association of Physiotherapy reiterates that conservative options should always be tried as a first resort. “The question that must be asked is: is the operating procedure of inserting or removing the strip still the solution”, says President Simon Dalle-Vedove.
Physiotherapists specializing in perineal rehabilitation notice that their patients are increasingly looking for preventive rather than curative solutions to solve urinary leakage.
The AQP calls on the Government of Quebec to promote access to and reimbursement of physiotherapy treatment for the perineal and pelvic rehabilitation of urinary incontinence in women.
In Mauricie and Centre-du-Québec, a single physiotherapist offers pelvic rehabilitation services for the entire population. Access to it is by referral from a urologist and not from a general practitioner. The CIUSSS MCQ indicates that there is no waiting to consult the specialist, but specifies that the wait can be long for the urology consultation, which must necessarily be done beforehand.
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