2026 Urogynecology for the Advanced Practice Provider-Concurrent Session 1

Video Transcription

Video Summary

This video features a detailed medical lecture on pelvic floor dysfunction, vulvodynia, and the role of pelvic floor physical therapy in treating chronic pelvic pain and sexual health concerns in women. Dr. Pope introduces herself through a humorous story about misplacing her passport, then explains that pelvic floor dysfunction is an umbrella term covering myofascial pelvic pain, hypertonic or hypotonic pelvic floor muscles, vaginismus, and penetration disorders.<br /><br />She emphasizes careful history-taking, trauma-informed care, and physical examination, including the cotton swab/Q-tip test and assessment of pelvic floor muscle tone. Common symptoms include pain with tampon use, penetration, pelvic exams, urinary leakage, constipation, and sensations of “hitting a wall” during intercourse. She explains that many cases are linked to tight pelvic floor muscles, hormonal factors, or conditions such as endometriosis, interstitial cystitis, menopause-related GSM, and vulvodynia.<br /><br />Treatment options discussed include pelvic floor physical therapy, dilators, vaginal diazepam, trigger point injections, Botox, hormonal creams, vaginal estrogen, and lubricants. Dr. Pope also highlights the importance of addressing anxiety, sexual pain, and social determinants of health.<br /><br />The second speaker, Kristen, a pelvic floor PT, expands on anatomy, evaluation, and therapy techniques. She describes how the pelvis connects to the abdomen, spine, hips, jaw, and nervous system, and demonstrates relaxation strategies, nerve glides, biofeedback, manual therapy, and vagus nerve techniques. A case study shows significant improvement in a young woman with endometriosis-related pelvic pain through coordinated physical therapy and medical management.<br /><br />Overall, the talk stresses that pelvic pain is complex but highly treatable when clinicians listen carefully, examine thoughtfully, and collaborate with pelvic floor specialists.

Asset Subtitle

1. Pelvic Floor Dysfunction

Speaker: Rachel Pope, MD

Learning Objectives:

Define pelvic floor dysfunctionand differentiate between overactive, underactive, and incoordination disorders.
Identify common clinical presentations, including pelvic pain, urinary incontinence, fecal incontinence, pelvic organ prolapse, and sexual dysfunction.
Discuss evidence-based management options, including pelvic floor physical therapy, behavioral strategies, medications, and procedural/surgical approaches.

2. Vulvodynia: When You Cannot See the Pain

Speaker Rachel Pope, MD

Learning Objectives:

Define vulvodyniaand distinguish between provoked, spontaneous, generalized, and localized subtypes.
Describe the diagnostic evaluation, including history-taking focused on pain characteristics, sexual function, psychosexual contributors, and exclusion of dermatologic and infectious causes.
Identify key exam components, including cotton-swab testing, visual inspection, pelvic floor assessment, and vulvar dermatoses evaluation.

3. Pelvic Pain from a PT Perspective

Speaker: Kristen Cook, PT, DPT

Learning Objectives:

Review relevant anatomy of the pelvis pertaining to pelvic pain etiologies
Describe evaluation techniques to help differentiate underlying etiologies and their contributions
Discuss the variety of treatment options for pelvic pain conditions of urological, gynecological, and neurological origins

Keywords

pelvic floor dysfunction

vulvodynia

chronic pelvic pain

pelvic floor physical therapy

myofascial pelvic pain

vaginismus

trauma-informed care

Q-tip test

endometriosis

interstitial cystitis

biofeedback

vaginal estrogen