The Tribune

By JEFFARAH GIBSON

Tribune Features Writer

jgibson@tribunemedia.net

WITH the help of her team, a local physiotherapist is seeking to bring greater awareness to pelvic floor dysfunction, a common problem many people shy away from addressing.

Dr Christina Messarra is blazing a trail as the only physiotherapist in the Bahamas with a special focus on treating pelvic floor dysfunction.

“I wanted to stay fresh and relevant in my practice,” she told Tribune Health. “So I explored different areas of physiotherapy and it became apparent that there were physiotherapists offering pelvic health service but no one had truly specialised in it.

“Physiotherapists were doing a good job, but they were not focusing on a highly specialised area of care and I decided to investigate that areas because I feel it was a great fit for my personality. I like deeper interpersonal relationships with my patients and do enjoy that opportunity to sit down and talk with them. The pelvic health area lends itself to a more caring, focused practice,” she said.
Dr Messarra has been a physiotherapist for 24 years and operates an out-patient clinic called the VIP Institute.

The VIP Institute uses a multifocal approach to treating disorders of the pelvic floor, including counselling to manage the emotional distress and embarrassment often associated with a pelvic floor disorder.

Pelvic conditions are diagnosed and medically managed by urologist Dr Robin Roberts,using the latest in sophisticated diagnostic medical technology, while Dr Messarra applies the latest therapeutic medical technology in combination with internal and external “hands-on” techniques to treat, cure or manage the condition.

Dr Messarra told Tribune Health that although not life-threatening, people should know that there is treatment available locally for issues surrounding the pelvic muscle.
“The pelvic floor muscles are like a hammock or a sling that support the bladder, uterus and bowel. Pregnancy, childbirth, obesity, surgery, disease and the straining of chronic constipation can weaken the pelvic floor in both men and women causing voiding dysfunction, stress incontinence and pelvic pain,” Dr Messarra said.

The pelvic floor muscles also function as a sphincter to prevent urinary and faecal leakage; a core stabiliser for the back and pelvic girdle, a sexual enhancer for sexual satisfaction/orgasm; support for the internal organs, and assists the lymphatic system and veins to bring blood back to the torso.

Pelvic floor dysfunction has a myriad of causes, including neurological injury or disease, menopause, prostate surgery, muscle damage, obesity and more.

“The more embarrassing issues surrounding pelvic floor includes urinary incontinence, which is a loss of bladder control, and voiding dysfunction. which is the inability to control bowel movements,” she said.

“We tend to think of the pelvic floor in very narrow terms as a private area or sexual area, but we cannot ignore that it is intimately concerned with defecation and urination,” she said.

“Is it a cruel joke that God put our pleasure centres right by our garbage can? Maybe it is. But it is what it is but we need to face it and accept it. These functions may not be vital to life but they are vital to quality of life because you may leak urine or you may leak faeces, or you may not be able to engage in sexual function or you may live with pelvic pain. You are not going to die because it is not life-threatening, but it will affect your quality of life. We have advanced and in medicine today; it is not just about saving lives, but making the life we have much better and more comfortable,” she said.

Both Dr Roberts and Dr Messarra are tasked with diagnosing the problems and treating the problem. In their pursuit to create more awareness, a public symposium was recently held to share information about pelvic issues.

“I want people to know that help is available for people to improve their quality of life where they do not have to be calculating where the toilet is; where they do not have to be wearing underwear pads seven days a week, 365 days a year; where they do not have sexual dysfunction as a normal part of the aging process. There is help and treatment available that will significantly improve quality of life,” she said.

Dr Messarra recently became qualified in the assessment and treatment of voiding dysfunction, leaking urine and pelvic pain through the University of Saint Augustine for Health Sciences and the Cleveland Clinic in Fort Lauderdale, Florida.

Dr Messarra said she not only provides intervention that may treat the underlying causes of pelvic floor dysfunction, but also provides patients with education in symptom management and support in lifting some of the stigma surrounding this issue.