Conference 2017 The colorectal pelvic floor: a multidisciplinary team approach
The management of functional pelvic floor disease is challenging. Complex, multisystem interactions demand the integration of expertise from different specialties in order to allow the multidisciplinary team (MDT) to work together and achieve optimal results. Careful history taking and clinical assessment, tailored treatment escalation with physiotherapy as the first-line approach in the majority of cases, skilled radiology when necessary, and MDT-based discussion prior to offering operations by surgeons with a sub-speciality interest are all key. This paper reviews the evolution of this practice in a busy UK acute general hospital. Lessons from history and the experience of other specialties paved the way for a management pathway that has been implemented and run successfully. The management of joint physiotherapy and surgery clinics, and the way in which the MDT functions are discussed from the perspectives of both a specialist physiotherapist and a surgeon. This model of care has been endorsed as best practice by The Pelvic Floor Society.
Keywords: best practice, colorectal pelvic floor, management pathway, multidisciplinary team.