The role of the urotherapist in the care of patients with pelvic floor disorders

Background: To improve the management of healthcare requirements of pelvic floor disorders (PFDs) in adult patients, interprofessional collaborations are emerging. The aim of this study is to describe and evaluate the activities of a urotherapist in adult patients with PFDs. Methods: The prospective observational study was carried out at the Department of ObGyn at the Cantonal Hospital Winterthur/Switzerland, from July 2016 to June 2018. The activities of the urotherapist were assessed with respect to parameters such as, number of consultations, type of counselling, time frame of consultations and therapy as well patient satisfaction. Demographic and clinical data were collected by self-administered questionnaires and electronic medical data systems. Results: 1709 patients were examined by urogynecologists. Of these patients, 514 (30%) were subsequently referred to a urotherapist. 58% of the 514 patients were over 65 years old. The most common PFDs were complaints about increased bladder sensation such as an overactive bladder, recurrent urinary tract infections, chronic cystitis and pelvic pain syndrome in 221 patients (43%); the second most common was pelvic organ prolapse in 151 patients (29%). The average number of urotherapist consultations per patient was 3 . In the group with >5 consultations, 59% were patients with increased bladder sensation. The most common type of consultation was phone counselling (59% of all activities). Conclusions: Increased bladder sensation related complaints are chronic problems that result in the highest numbers of urotherapist consultations. Interprofessional collaborations between urotherapist, as a specialist nurse, and urogynecologist should be implemented in urogynecological units and further developed in the future.