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A new book claims that a core treatment recommended by the NHS is not fit for purpose leading to a shocking waste of scarce resources and failing millions of women who then suffer a lifetime of discomfort, frustration and embarrassment.

The Kegel Legacy (ebook gbp1.99, paperback gbp 6.99) calls for a fundamental review of post-natal rehabilitation and care quoting clinical studies showing that at least 5000 new mothers every week are developing serious health problems because of the inadequate and ineffective care and advice being offered by the NHS. These new mothers are joining millions of women who are already suffering long term problems in one of the biggest health scandals of the 21st Century.

According to author Barry Fowler, the problem has arisen because the medical profession has ignored the one large scale clinical trial that established a Gold Standard for the treatment of the most common post-natal conditions caused by weak and damaged pelvic floor muscles - conditions such as stress incontinence, prolapse and poor sex - that make life a misery for between a third and a half of all women of all ages.

Barry Fowler cannot hide his frustration that mothers are not getting good, timely advice and the treatment they deserve. He finds it impossible to believe that a treatment that was clinically proven to cure 85% of problems in two weeks could be just ignored:
“Women are told to do their ‘Kegel exercises’ but the techniques recommended by doctors, physiotherapists and the media are not fit for purpose because they are simply not rigorous enough and fall far short of the clinically proven exercises recommended by Arnold Kegel. They fail to follow his key principles in every respect.”

To prove the point he emphasises the stark evidence: “If the exercises you are told to do by your doctor or physiotherapist were at all effective then we would not have 7 million women in the UK with stress incontinence, millions suffering prolapse and a multi-billion industry supplying designer incontinence pads. Millions of women are wasting their time for many months with ‘exercises’ that will never deliver any real improvement.”

“Instead of effectively promoting a simple, lifestyle management approach, successive NICE Guidelines have failed to adequately acknowledge the one solution that addresses the problem. Instead, huge sums are being wasted on surgery and pharmaceutical intervention that are often unnecessary and largely ineffective at curing the root cause of the problem. It is impossible to put a cost on the impact that this is having on the lives of millions of women. And on the waste of resources and budgets.”

The Kegel Legacy highlights sources showing that that most women are totally unprepared for the distressing health consequences of childbirth caused by pelvic floor weakness and damage ie stress incontinence, prolapse and poor sex, and unaware that simple and effective treatments are available. They are also unaware that the problems may not always be immediately obvious and that, without treatment, they can, and often do, become much worse on reaching the menopause.

The Kegel Legacy reviews the clinical research and the development of treatments over the years, and tracks the history of ‘Kegel’ exercises from when they were eventually adopted, 30 years after the original clinical trials. The medical profession of the day paid lip service to the original clinical studies and adopted an unproductive set of exercises for purely arbitrary reasons. Nothing has changed over time and there has been no attempt to develop the exercises in the light of new technologies and experience, nor to test the efficacy of the current methods against the original Gold Standard. As a consequence, on the rare occasions when women are actually taught to use the NICE recommended treatment, the results are poor, compliance is low and most women give up in frustration.

The Kegel Legacy guides the reader towards simple, effective and non-invasive treatment options to treat the major problems and is intended to stimulate an informed debate on the whole subject of post-natal care that will hopefully lead to a more effective and pro-active approach to post-natal pelvic floor rehabilitation and the better use of lifestyle management approaches as alternatives to pharmaceutical and surgical intervention.

If you are a bona fide journalist or writer you can download a free pdf copy of The Kegel Legacy for review purposes by visiting
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