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New team of physios specialise in bladder and bowel issues



Patients with brain injury and other neuro conditions are being supported with pelvic, obstetric and gynaecological matters through a link-up between a clinic and specialist physiotherapist, believed to be the first of its kind.

Kirsten Barrett is part of the team at Neuro Physio Wales and supports its clients with issues including bladder and bowel issues and sexual dysfunction.

Access to such specialism is usually available via separate referral, but through Kirsten’s partnership with the clinic, patients are able to access the specialist support directly.

Kirsten, who has worked in pelvic, obstetric and gynaecological physiotherapy (POGP) for 15 years, is seeing a growing number of patients with neurological conditions, or who are living with a brain injury, spinal cord injury or stroke as part of her case load.

While most of her work is with women, and she continues to work widely in the NHS to give this support, Kirsten has also worked with men with bladder and bowel incontinence.

“We find that with many of our neuro patients in particular, they want to talk to someone they know, and it can really help that it’s a woman. If they come through Neuro Physio Wales, then there will already be that relationship in place, and me as part of the team can often be easier to speak to than going to their own GP,” she says.

“When you make a GP appointment you might not know who you’ll be seeing, but here, you know it will be me, and I think that’s quite reassuring.

“A trusting relationship is important in the kind of work we do, as we are talking about very sensitive subjects, and that’s what we really focus on building.”

While Kirsten’s work is able to help many patients, and revolves around giving advice and support, she will always refer elsewhere if she feels that will be of greater benefit.

“Sometimes, our patients just want some support, someone to talk to about what’s happening, and it may be a couple of appointments before they let me examine them,” says Kirsten, who has a Postgraduate Diploma in Physiotherapy (women’s health) and is currently on her way to completing a Postgraduate Diploma in Psychosexual Medicine.

“We have a lot of neuro patients with bladder and bowel problems, and we can help them in a variety of ways, from which pads will be best for them to use to showing them positioning for passing a bowel motion. Likewise with sexual dysfunction, which can also be common, we can explore issues around tightness of the pelvic floor.

“But if we feel there is something else going on, or if a patient comes in with something complex which isn’t just a physiotherapy need, we will always suggest they go and speak to their doctor. It’s really important they see a GP at the earliest stage possible, as many problems can be very treatable as long as you get them early.

“Sometimes, our patients don’t want to talk to their GP about very sensitive matters, such as discussing their bowel motions, but I will ask them if it’s OK for me to write to their GP and explain their situation. That can really help.”

Despite the challenges brought about by the COVID-19 lockdown – which Wales is currently experiencing for a second time – Kirsten continues to work, and keeps in touch with clients by email and telephone. The Neuro Physio Wales clinic remains open during the firebreak.

“It’s really important that people know you’re there to answer any questions, and I’m always just at the end of the phone. It can be that people get really stressed through their uncertainty, and this contributes to their existing problems, so by being there, that can play a big part,” adds Kirsten.