Questions People Ask Us

No. Not for us, and usually not for you by the end of the appointment.

You will be talking about your bladder, your bowel, your pain or your sex life with someone who talks about those things every working day and has done for more than a decade. There is no version of your situation that is going to raise an eyebrow here.

You do not need the right words. Plenty of people open with “I don’t really know how to say this”, and that is a fine place to start. If there is something you would rather leave until you know us better, leave it. It will keep.

No. Bladder, bowel, pelvic pain and sexual health problems are common in both men and women, and most people who have them have not told anyone. That is why it feels rare. It is not.

Common does not mean you have to live with it, and it does not mean nothing can be done. Both of those are worth finding out about properly rather than assuming.

No. In New Zealand you can book a physiotherapy appointment directly. You do not need to see your GP first, you do not need a letter from a specialist, and you do not need a referral to lodge an ACC claim.

If you already have a referral or a letter, bring it. It saves time. You do not need one to be seen.

Our fees are published in full on the Fees and ACC page, including what an initial assessment costs, what follow-ups cost, and what the payment options are. You will know the cost of any recommended plan before you agree to it.

Sometimes. ACC covers injury, not illness. Maternal birth injuries sustained on or after 1 October 2022 may be covered, as may an accidental injury such as a coccyx fracture from a fall. Erectile dysfunction, premature ejaculation, age-related bladder leakage, overactive bladder, prolapse from a birth before 1 October 2022, non-traumatic chronic pelvic pain and menopause symptoms are not covered.

The full position, including the covered birth injury list, is on the Fees and ACC page.

No. Everybody has a pelvic floor, and this practice sees men and women. Some concerns are common to both, some are specific to one. Men come in about bladder control, erections, ejaculation timing, pelvic pain and recovery after prostate surgery. Women come in about leakage, prolapse, pelvic pain, birth recovery and sexual comfort.

See Men’s Pelvic Health or Women’s Pelvic Health.

No. There is no upper age limit. Pelvic floor rehabilitation is muscle and nerve rehabilitation, and those systems respond at any age, although often more slowly than they would have at 40.

What changes with age is what a sensible goal looks like, not whether it is worth doing. If you want to get through a round of golf, a bus trip or a night’s sleep without planning around a toilet, that is a goal worth assessing.

No. Long-standing problems take longer and the picture is often more complicated, but a problem being old is not a reason not to assess it. Plenty of the people we see have had their symptoms for a decade or more before they said anything.

What we will not do is promise you an outcome before assessing you. After the assessment we will tell you honestly what we think is realistic.

Book a free 15-minute call. It is a confidential phone conversation, there is no charge, and there is no obligation to book anything afterwards. You describe what has been happening and we tell you honestly whether we are likely to be able to help. If we are not the right service, we will say so and point you somewhere better.

The whole appointment is set out step by step on Your First Appointment, including what to bring, what to wear, how long it takes and what you will be asked.

Not usually, and not at the first appointment unless you agree to it.

Whenever possible we use objective, non-invasive assessment. Real-time ultrasound is performed through your lower abdomen while you stay fully clothed. It shows the base of your bladder lifting when the pelvic floor contracts and descending when it releases, which tells us whether you can contract, hold and let go, and whether you are bearing down when you think you are lifting. It shows movement rather than muscle detail. Biofeedback measures activation, endurance and control. Between them these give a good picture of pelvic floor function for most people, without an internal examination.

There are things ultrasound cannot show: muscle strength graded directly, the type and degree of a prolapse, the exact location of tender or restricted tissue in pelvic pain, and scar tissue after a birth injury or surgery.

An internal (vaginal or rectal) assessment would only be suggested where the information would change what we recommend, or where it is part of the treatment itself, such as scar tissue work or trigger point release. If that applies, we will explain what it involves, why it is being suggested and what we would do differently with the information. Then we will ask.

Yes. Always, to any part of any assessment or treatment, at any point, for any reason, and you do not have to explain yourself.

You can decline and we will work with what we have. You can agree and change your mind halfway through, and it stops immediately. You can agree today and decline next week. None of it will offend anyone here and none of it will affect the care you get.

Under the Code of Health and Disability Services Consumers’ Rights you have the right to be treated with care, skill, dignity and respect, the right to have a family member, whānau, friend, caregiver or interpreter present, and the right to withdraw from treatment at any stage or to seek a second opinion. We can give you a full copy of the Code.

Yes, at any appointment, for any examination, without giving a reason.

At Kāpiti we have a trained chaperone on site. If you are a woman and an intimate examination is part of your appointment, we arrange the appointment so the chaperone can attend. That is for your protection and the clinician’s, and you do not have to ask for it.

Palmerston North does not have a chaperone on site. If an intimate examination would be useful there, you have two options: come to Kāpiti for that one appointment, or bring someone you trust with you, a partner, a family member or a friend. We will talk it through with you when we book, so nothing is decided in the room on the day.

You can also ask for a chaperone at any appointment at either clinic for any other reason. Ask when you book so it can be arranged.

Yes. Bring whoever you want, or nobody. Some people want their partner in the room throughout, some want them in for the conversation and out for the assessment, some would rather come alone. All of those are normal. You can change your mind mid-appointment.

It is the same kind of ultrasound used in pregnancy scanning, used differently. A probe is placed on your lower abdomen with gel, over or under clothing, and the image on the screen shows the bladder and the pelvic floor moving.

It does not involve needles, radiation or anything internal, and it does not hurt. You watch the screen with us, which is often the first time somebody has seen what their own pelvic floor is doing and realised why the exercises they have been doing for years were not working.

You may be asked to arrive with a comfortably full bladder, because the image needs some fluid in the bladder to be useful. If that applies we will tell you when you book.

Biofeedback measures what a muscle is doing and shows it to you on a screen in real time. Pelvic floor muscles are hard to feel and easy to get wrong, so working without feedback is guesswork. Seeing the trace makes it possible to learn to contract, hold and, just as importantly, fully let go.

An assessment should not be painful. Some parts may be uncomfortable, particularly if you are being seen for pelvic pain, where the point of the assessment is partly to find where it hurts.

Tell us if something hurts and we will stop. That is not being difficult, it is information we need. Working through pain is not how pelvic rehabilitation works.

For real-time ultrasound and biofeedback, no. Both are done through or under ordinary clothing, and you will not be asked to change into a gown.

If an internal assessment is agreed to, you will need to undress from the waist down, in private, with a sheet, and you will be covered throughout. Nothing about that happens without your consent first.

Sixty minutes. That is the same for every first pelvic health appointment, whatever you are coming in about, so you can plan around it.

Follow-up appointments are 30 minutes.

In most cases we will be able to tell you what we think is contributing to the problem and what we recommend doing about it, on the day. Sometimes the picture is not clear after one appointment, and we will say so rather than guessing.

If we think you need investigations or an opinion we cannot provide, we will tell you and write to your GP or specialist if you would like us to.

Yes. It is a group of muscles slung across the base of the pelvis, from the pubic bone at the front to the tailbone at the back. It holds the bladder and bowel closed until you decide otherwise, it contributes to the firmness of an erection and to the timing of ejaculation, and it works with your deep abdominal muscles, back muscles and diaphragm to stabilise your spine.

Erections can change with age, but persistent change is not something to simply accept as inevitable. An erection depends on blood flow, nerves, erectile tissue, pelvic floor muscles, hormones and general health working together, and when one or more of those is not working as well as it could, erections often become less reliable.

Which of those has changed is worth identifying, because it is what determines whether anything useful can be done. More detail on the erectile dysfunction page.

The pelvic floor muscles play a part in achieving and maintaining an erection. They help support blood flow within the penis and contribute to rigidity. In some men these muscles are weak. In others they are overactive and cannot let go, which causes different problems. That is why assessing what the muscles are actually doing matters more than assuming they need strengthening.

Psychological factors influence erectile function, but they are rarely the whole story. Stress, anxiety and performance pressure all have an effect. So do blood flow, erectile tissue health, pelvic floor function, medications, sleep and general health. Usually it is a combination rather than one cause.

Yes. Nathan Scott sees all men’s appointments, at both clinics.

Recovery varies between individuals and depends in part on whether nerve-sparing surgery was possible. Rehabilitation after prostate treatment is a recognised part of care, and starting it early, where medically appropriate, matters.

What is realistic for you depends on your surgery and your assessment, and it is a conversation to have properly rather than in an FAQ answer. See Prostate Recovery.

We would generally suggest understanding what is limiting your function before spending money on something aimed at it. The most appropriate option depends on your individual situation, and an assessment tells you which approaches are worth your money and which are not.

It is common. Common and normal are different things.

Leaking urine is very often a consequence of pelvic floor muscles that are weak, poorly coordinated or not working together with the rest of the system, and that is worth assessing rather than accepting. Whether much can change depends on what is causing it, which is what an assessment is for.

Sometimes, if you are doing them correctly and they are the right thing for your situation.

Two things go wrong. The first is technique: pelvic floor muscles are hard to feel, and a lot of people who believe they are contracting are not, or are pushing down instead of lifting. The second is that not every pelvic floor problem is a weakness problem. An overactive pelvic floor that cannot relax will often get worse with more squeezing.

Real-time ultrasound and biofeedback show which of those applies to you, which is why the assessment comes before the exercises rather than after.

Prolapse is when one or more of the pelvic organs, most commonly the bladder, the uterus or the rectum, drops down into the vaginal canal. It can cause a feeling of heaviness or dragging, a bulge, difficulty emptying the bladder or bowel, or discomfort during sex.

Prolapse is graded, and grade does not always match how much it bothers somebody. More on the prolapse page.

No. Pelvic floor rehabilitation is not time limited. What changes is that a long-standing problem often has more contributing factors, so the assessment matters more.

Note that ACC’s maternal birth injury cover only applies to births on or after 1 October 2022, so a birth before that date is not covered even if the symptoms are current. See Fees and ACC.

Yes. Pregnancy is one of the most common reasons people come to see us, and we see people at every stage of it.

What changes during pregnancy is which tools we use. PelviPower is not used in pregnancy. Assessment, real-time ultrasound, breathing and pelvic floor work, and help with back and pelvic girdle pain all are. We will tell you what we are using and why.

Yes. It makes no difference to a non-internal assessment. If an internal assessment had been planned and you would rather reschedule, ring us and we will move it without any fuss.

Pelvic health physiotherapy is available for women living with genitourinary symptoms around menopause, including bladder urgency, leakage, vaginal dryness and discomfort during sex. Whether it is the right starting point for you, and whether you also need to talk to your GP about other options, is part of what an assessment sorts out.

Menopause-related symptoms are not covered by ACC.

There is no single answer, and anyone who gives you one before assessing you is guessing. Some people need an assessment, an explanation and a home programme and that is the whole course. Others benefit from a structured programme over several weeks.

You will leave the first appointment knowing what we recommend, roughly how many appointments that involves and what it will cost in total. You can stop at any point.

It depends on what is contributing to the problem and what we end up doing about it. Muscle and nerve rehabilitation takes weeks rather than days, and changing a habit takes longer than changing a muscle.

We will not give you a number before assessing you, and we would be sceptical of anyone who does.

We review progress against the goals you set at the start. If something is not working we change it rather than repeating it harder, and if we do not think we can help you further we will say so and tell you what else might be worth trying.

You can stop at any time and you can ask for a second opinion at any time.

PelviPower is a chair that delivers repetitive magnetic stimulation to the pelvic floor and surrounding muscles. You sit on it fully clothed. There are no probes and nothing internal, and the muscles contract in response to the magnetic field rather than through your own effort.

It is one option among several and it is not right for everybody. Whether it forms part of your pathway is decided after your assessment. More on the PelviPower page.

Magnetic stimulation is not appropriate for everyone, and there are absolute contraindications. In general terms these include pregnancy, cardiac implantable electronic devices such as pacemakers and defibrillators, other implanted electronic devices such as neurostimulators and drug pumps, certain metal implants within or near the field, epilepsy and other seizure disorders, and some cardiac conditions. There are also situations where the chair is used only after a period of recovery or specific medical clearance, including after surgery or radiation therapy in the pelvic region.

Whether a particular implant or device rules the chair out depends on what it is and where it sits, so we work through it with you rather than asking you to work it out from a list. Intrauterine devices are one example: whether a specific IUD matters depends on the device, so tell us the make and type and we will check it.

The full list, and what we ask you before your first session, is set out on the PelviPower page. Anyone considering the chair has a screening conversation with us before a session is booked. Tell us about your medical history, any implanted device, any metal, any current or possible pregnancy and any medication when you book, and we will tell you whether the chair is an option for you.

These restrictions do not apply to the PelviPower biofeedback trainer, which involves no magnetic stimulation.

No. You stay in ordinary clothes. The magnetic field passes through clothing and there is nothing to insert or attach. People generally read or use their phone during a session.

Usually yes. Building awareness of the pelvic floor and using it in ordinary daily activities is part of making a change last, and a home programme is normally part of the plan. It is normally short. A programme you will actually do is worth more than a thorough one you will not.

MAPLe is a pelvic floor EMG system that measures the electrical activity of individual regions of the pelvic floor rather than the muscle group as a whole. It is used where a more detailed picture of pelvic floor function would change what we recommend, and it is discussed with you before it is used. More on the MAPLe page.

Pelvic floor rehabilitation is commonly used both before and after pelvic and prostate surgery, and we work alongside surgeons where that is useful. Whether it applies to your situation, and what it would involve, depends on the surgery and your assessment.

If you have a surgery date, tell us when you book. It changes what a sensible plan looks like.

It can. Fluid intake, caffeine, constipation and straining, how you lift, how you breathe, how much you sit, body weight and general fitness all influence pelvic floor function, sometimes considerably. We will go through the ones relevant to you and give you practical changes rather than a list of things to feel guilty about.

Yes, where it helps and where you want us to. We work alongside GPs, urologists, gynaecologists, midwives and surgeons. Nothing is sent to anybody without your agreement.

Two clinics.

Kāpiti: 2 Seaview Road, Paraparaumu Beach, Paraparaumu 5032. Directions and parking

Palmerston North: OraKinetics, The Pillars (next to Milson Pharmacy), 91 Milson Line, Palmerston North 4410. Directions and parking

Whichever is closer. Both offer the same pelvic health assessment and care. Kāpiti suits people coming from the Kāpiti Coast, Ōtaki, Porirua and Wellington. Palmerston North suits people from Palmerston North, Feilding, Ashhurst and the Manawatū. Levin sits between the two, so pick on the basis of which day suits.

Yes. There is plenty of street parking at Kāpiti, and street and off-street parking at Palmerston North. Full detail on each location page.

Kāpiti is open Monday, Wednesday and Friday, 8am to 5pm. Palmerston North is open Tuesday, 8am to 5pm. Nathan is on site on those days.

Ring 0800 267 346, email hello@coregood.co.nz, or send us a message through the form on the contact page and we will ring you back. Email is a perfectly good way to start, whether you want to ask something first or go straight to booking.

We do not have an online booking portal. Pelvic health appointments vary in what they need and how long they take, so we would rather have a short conversation and book you the right appointment than have you pick a slot that turns out to be wrong.

Ring as soon as you know. A fee will apply if you change your appointment within 24 hours. Full policy on Fees and ACC.

Payment is due at the time of your appointment. We do not invoice. Payment methods are listed on Fees and ACC.

Yes, in some circumstances, arranged with Nathan rather than booked as a standard appointment.

Video suits people who live a long way from either clinic, and it suits appointments that are mostly education: preparing for surgery, for example, or working through premature ejaculation. Some parts of an assessment need you in the room, particularly real-time ultrasound and biofeedback, so we will tell you honestly whether video is worthwhile for your situation before you pay for one.

An online video consultation is 60 minutes and costs $230, or $200 where ACC covers your claim. Ring 0800 267 346 or email hello@coregood.co.nz and ask.

Your notes are held by CoreGood under the Health Information Privacy Code 2020. They are not sent to your GP unless you ask or have agreed. They are not shared with your partner or family. If you have an ACC claim, ACC receives the clinical information relevant to that claim, and we will tell you what is being sent. You can ask to see your own notes at any time.

No. Nothing is sold from this website.

If something would help you, we will tell you what it is and where to get it, and we will tell you the price first. You are never obliged to buy anything from us.

Ring 0800 267 346, email hello@coregood.co.nz, or book a free 15-minute call and ask. Nothing you ask will be a surprise.