Prolapse, Avulsions & Pessaries: Episode 103 with Dr Melissa Davidson

Hello & Welcome to today's episode, where I'm chatting with Dr Melissa Davidson about prolapse, avulsions and pessaries!

My guest today is a specialist physiotherapist in pelvic health, and we discussed her career journey, including her specialization in pelvic health in New Zealand, where she is the only registered specialist. She highlighted her expertise in advanced clinical practice, research, and leadership within the profession. Melissa also shared her experience conducting research in bioengineering at Auckland University, which revealed that physiotherapists' assessments of muscle tone and stiffness lack objective measurement methods, challenging traditional practices in the field...

We discussed the importance of evidence-based practice in pelvic health physiotherapy, particularly regarding prolapse and pain management. Melissa shared her experience conducting a PhD in bioengineering, which challenged many accepted beliefs in physiotherapy and highlighted the need to think outside traditional silos.

Melissa shared her experience developing and using a 3D model named Lily for patient education, discovering its effectiveness in helping patients understand complex medical concepts. She discussed her collaboration with bioengineers, noting that while the engineers were initially skeptical about her approach, they eventually recognized the value of her clinical perspective

We explored the diagnosis of levator avulsion and emphasized that a definitive diagnosis should not be made before 6-12 months postpartum, and we highlighted the importance of careful wording when communicating with patients about this condition, as the diagnosis can be devastating and there is currently no surgical fix.

Melissa discussed her approach to pessary management and training for physiotherapists, emphasizing the importance of medical clearance and speculum exams for assessing mucosal integrity. She explained the assessment process for avulsion injuries, including the use of a training model and peer-to-peer learning. Melissa also highlighted the need for informed decision-making during pregnancy regarding delivery options, advocating for patient autonomy and open discussions about birth plans.

We definitely agreed on the importance of using validated research and scientific terminology, rather than relying on subjective assessments or unproven treatments.

This was definitely a deep and rich conversation, that I really enjoyed...and I hope you will too!

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Until next time, Onwards & Upwards, Mx