Pelvic Floor Pathway - Frequently Asked Questions
Why a Pathway?
The Pelvic Floor Pathway responds to patient and provider demand for faster access to effective treatment for incontinence and pelvic organ prolapse.
How was the Pathway developed?
The Pathway and the accompanying tools for patient and provider education were developed by a multidisciplinary Pelvic Floor Pathway Working Group, encompassing urologists, gynecologists, primary care physicians, pelvic health physical therapists, nurses, patients, and health care administrators.
What does the Pathway cover?
The Pelvic Floor Pathway is intended for women who suffer from persistent, uncomplicated urinary incontinence (leaking of urine), and vaginal prolapse (visible and noticeable bulge of vaginal tissue at the opening of the vagina). Direct services provided by the Pathway include patient education, assessment, decision support, and conservative management through multidisciplinary clinics in Saskatoon and Regina.
What is outside the Pathway?
The Pathway is not appropriate for patients with significant cognitive impairment, or for those with complex conditions such as hematuria, intractable UTIs, elevated post- void residual volume, pelvic mass, possible fistula, possible neurologic lesion, or pelvic pain. Practitioners who detect these red flags should refer directly to an appropriate specialist.
Should all patients with pelvic floor conditions go through the Pathway?
No. Many patients can be treated effectively in primary care, with interventions such as lifestyle change, medication, or pessary. Pelvic health physical therapy can also be accessed through private clinics. Local specialists may provide conservative options if wait times are not a barrier. Visit the Pathway website for information about other providers treating pelvic floor conditions.
Can I refer my patients to the Pathway when other interventions have failed?
Yes. Patients who have tried other treatment options are welcome in the Pathway, where they can receive additional assessment and treatment. Patients who have tried some conservative options may also benefit from referral to a local specialist, if available.
Can I still refer my patient directly to a surgeon?
Yes. Refer directly to a surgeon if you have already discussed/provided conservative options, or otherwise determined that the Pathway process will not benefit your patient.
Is there support for me to educate my patients about pelvic floor conditions?
Yes. The Pelvic Floor Pathway Working Group has produced a patient education booklet, video, and condition-specific information sheets. All are available on the Pathway website.
Is there support for me to provide conservative management?
Yes. The Pelvic Floor Pathway Working Group has produced a three-hour Continuing Medical Education presentation accredited for 3 Mainpro C Credits. “Practical Management of Female Incontinence and Pelvic Organ Prolapse” covers tips for examining and assessing patients, as well as advice for prescribing medication and fitting a pessary. If you are interested in hosting a session for your group, please email firstname.lastname@example.org.
How do my patients enter the Pathway clinics?
A Pathway-specific referral form is submitted directly to the Pelvic Floor Pathway Clinic in Regina or Saskatoon. Referral forms for each site can be found on your Accuro or Med Access EMR or the Pathway website. Referrals are accepted from physicians, nurse practitioners, and midwives.
Do my patients have to pay to use Pathway services?
Education, assessment, diagnostic tests, and therapies provided through the Pathway are covered by Saskatchewan Health. However, costs for travel, medications, or pessaries are the responsibility of the patient. Note: Private practice physical therapy clinics are fee for service and treatment is not covered by Saskatchewan Health. Patients with private supplementary health insurance may qualify for some reimbursements from their plan, depending on the kind of coverage.
What does the Pelvic Floor Pathway do for me and my patients?
- standardized educational resources and programs for patients
- tools and support for primary care providers to confidently manage incontinence and vaginal prolapse
- multidisciplinary clinic access for patients who need specialized assessment and follow up
- improved access to conservative options (such as self care advice, therapies, medication, and pessary).
Your feedback about the Pelvic Floor Pathway is always welcome by contacting the team in Regina or Saskatoon.
For more information, please visit: www.saskhealthauthority.ca/our-organization/quality-care-patient-safety/quality-improvement/stewardship-and-clinical-appropriateness/clinical-pathways/pelvic-floor-pathway