The pelvic health clinical reasoning model – a structured approach to clinical reasoning for the complexity of pelvic health clinical practice

Key Points

1. Central, regional, and local mechanisms all play relative roles in clinical symptoms and program development.

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BACKGROUND & OBJECTIVE

Pelvic health conditions need to be addressed with clinical reasoning models that include the organs and the autonomic nervous system influences. Available clinical reasoning models are designed for the musculoskeletal system and do not also include pelvic health conditions such as urinary and faecal function, prolapse, or sexual dysfunction (1-3).

The authors of this paper present a clinical reasoning model based on the existing models that includes pelvic health conditions (4). The pelvic health clinical reasoning model (PHCRM) takes into account the multiple influences on pelvic health.

Pelvic health conditions need to be addressed with clinical reasoning models that include the organs and the autonomic nervous system influences.

The pelvic health clinical reasoning model may allow for more optimal pelvic health screening to shorten the time from symptom onset to resolution.

COMPONENTS OF THE CLINICAL REASONING MODEL

Central mechanisms: includes psychological, emotional, immune, inflammatory, and endocrine activity that modulates the sensitivity of the central nervous system. In pelvic conditions this can include beliefs and expectations about bowel, bladder, and sexual function, and if sexual assault or trauma

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