Below is a description of Pelvic Floor Therapy and treatment:
What is Pelvic Floor Therapy?
Does Pelvic Floor Therapy work?
Why does it work?
How well does it work?
What is Pelvic Floor Therapy? Pelvic Floor Therapy uses pelvic muscle exercises in which the patient can monitor muscle response on a video screen. This greatly enhances the effectiveness of pelvic floor muscle exercise regimens. It is non-invasive and painless. In addition, painless low voltage muscle stimulation (e-stim) is sometimes needed.
Pelvic Floor Therapy involves 8 weekly sessions of 1 hour each. Treatment is generally covered by insurance and Medicare and is not very costly.
Does it work? Absolutely. Pelvic Floor Therapy can be helpful in:
- Chronic urinary frequency/urgency
- Urge incontinence
- Pelvic Pain
- Stress Urinary Incontinence (SUI)
- Frequency/urgency after Sling surgery for SUI
- Post Prostatectomy Incontinence
- Unobstructed retention
Pelvic Floor Therapy works best for overactive bladder symptoms such as frequency, urgency, urge incontinence -- with over 80% markedly improved or completely cured. We have also used Pelvic Floor Therapy to successfully treat patients with chronic pelvic pain, unobstructed urinary retention, stress urinary incontinence, and incontinence following radical prostatectomies. We have been very successful using pelvic floor therapy to treat Nocturnal Enuresis (bedwetting) in children and adults, especially cases that did not respond to other treatments. In all cases our results clearly are far superior to unmonitored pelvic exercises such as Kegals. In many cases the patients had failed more typical medications and treatments and had given up hope.
Why does it work? Pelvic floor muscle contraction causes the bladder to hold urine by two mechanisms:
- contraction of the external sphincter
- reflex inhibition of bladder contraction.
Many patients with voiding disorders, regardless of the cause, have pelvic floor muscle overactivity. This results in a sudden need to urinate when the pelvic floor suddenly relaxes. As you can imagine, constipation, pelvic pain and pain with intercourse are often coexisting complaints. This overactivity and sudden inappropriate relaxation is known as Pelvic Floor Muscle Dysfunction.
Patients with Stress Urinary Incontinence (SUI) have the opposite problem. The pelvic floor muscles are weak and the sphincter is underactive. Cough, sneeze, and abdominal straining causes urine to leak out without an urge.
With pelvic floor therapy, the patient is taught more appropriate pelvic muscle tone and relaxation, resulting in more normal bladder function.
Even when inflammation or other causes of overactive bladder symptoms (discussed in the Frequent Urination and Overactive Bladder section) have been treated, the symptoms may continue because the pelvic muscles are still working improperly. Thus pelvic floor therapy can be an important part of treatment, just as with chronic back pain in which physical therapy is a very important part of treatment even if the underlying disc disease is cured. And just as with back pain, the patient will need to continue self exercises at home for a long time, and may need a refresher treatment with pelvic floor therapy from time to time.
How well does it work?
Again, we have seen DRAMATIC improvements in over 80% of our patients who had severe frequency, urgency, urge incontinence, or pelvic pain. All of our patients had failed more typical medications and treatments for their various causes. Thus pelvic floor therapy is very important to consider, especially if other treatments are not working, and certainly before giving up or resorting to surgery or neurostimulator implants.
Pelvic Floor Therapy can also work well in Stress Urinary Incontinence. Again, here the problem is underactive or weak pelvic floor musculature. Milder cases of SUI respond better, but surgery is often more fruitful than pelvic floor therapy in more bothersome SUI.
Post Prostatectomy Incontinence can be due to bladder instability or weak sphincter or both. We have had tremendous success with pelvic floor therapy for incontinence after prostate cancer surgery when due to bladder instability.
Pelvic Floor Therapy works well in children with bedwetting and is successful when more traditional treatments have failed. All of our cases to date have shown cure or dramatic improvement in the number of dry nights. Since this is a painless physical therapy, children tolerate treatment very well.
Summary: Pelvic Floor Therapy refers to pelvic floor muscle physical therapy and is becoming a major component of treatment for frequency/urgency, urge incontinence, chronic pelvic pain, bedwetting, and constipation syndromes. Pelvic muscle spasticity often accompanies these types of symptoms and may not resolve even though the underlying disorder has been corrected. Just as physical therapy can be an important part of correcting back pain after a slipped disc is repaired, pelvic floor therapy can be an important part of treating overactive bladder and related symptoms.
Please keep in mind that the information provided on this website is for informational purposes only and should not be used for self diagnosis. You should always consult your physician if you feel that you have a medical ailment.