Urogenital Manipulation

This book completes the authors widely acclaimed four-volume exploration of the osteopathic implications of the dysfunctions of the internal viscera. The focus of this volume is on the pelvis, particularly of women. Women's disorders constitute a large percentage of his exceptionally busy practice in France.

In the introductory chapter, Barrel provides an overview of the relations of the pelvis and spine, and then describes how the concepts of mobility, motility and listening apply to the pelvis. These which are especially useful for pelvic disorders, including the genitohumeral and completed lasegues tests, are detailed. There is a brief description of the functional anatomy of this area, and an osteopathic view of the etiology of pelvic problems, important contraindications to manipulation of the pelvis are noted. Also included in this chapter are imaging studies that demonstrate the utility of the visceral manipulative approach to the pelvis. Chapter 2 focuses on the bladder, especially understanding and treating stress incontinence. The connections and physiology of this organ are discussed, as are the effects of the various systems of pressure on the lower pelvis. The role of bladder restrictions in low back pain, lower leg problems, and hip pain is explained. A variety of internal and external tests and treatment techniques for the bladder and its surrounding structures is provided. Chapter 3 discusses the uterus, focusing on the cervix. Barrel explains his understanding of uterine mechanics and restrictions. The reader will gain an appreciation for the osteopathic view of the importance of the different motions affecting the uterus, and how they can become dysfunctional. Different types of pain (including dysmenorrhea and dyspareunia) are depicted. There is also a full explanation of the ligaments connecting the uterus to the other structures of the pelvis. Evaluation and treatment of these structures is described. Chapter 4 completes the tour of the female pelvis with a look at the uterine tubes and ovaries. The complex movements of these structures, their interconnections with the pelvis, and their importance to fertility are explained. The holistic osteopathic viewpoint is typified by Barrel's presentation of the various elements that must work in harmony for fertilisation to occur.