Conservative Treatment

Biofeedback

Biofeedback has been used to help people with pelvic floor dysfunction. However, biofeedback therapy is only one of several methods used in teaching pelvic muscle exercises. This form of therapy provides immediate auditory or visual information to the person about the status of the pelvic muscle function.

The goal of biofeedback therapy in the treatment of incontinence is to modify a person's behavior and train methods to help gain bladder control. Biofeedback therapy is a vital component of any behavioral program which deals with restoration of pelvic muscle dysfunction.

The main goals are: to improve awareness of pelvic floor musculature and to assist patients in the performance of pelvic floor muscle exercises.

A primary component is teaching patients how to identify and exercise pelvic floor muscles. Most important, is how to use them to prevent urine loss by aborting detrusor contractions and occluding the urethra during contractions that cannot be inhibited.

Biofeedback in conjunction with PME targets muscles skeletal muscles that are under voluntary control.

However, many patients have difficulty identifying, controlling, and coordinating the function of pelvic floor muscle group.

Biofeedback therapy uses computer graphs or lights as a teaching tool to help you identify and learn to control the correct muscles. Optimal biofeedback therapy includes visualization of both pelvic and abdominal muscle movement, thus a two channels system is preferable. Multi-channel systems can allow for both pressure and electromyographic channels.

Biofeedback, used along with specific exercises. An internal sensor (vaginal or rectal probe) is inserted in the vagina or rectum or external stick-on-electrodes placed on the perineum and/or sacrum can sense muscle activity, which can be seen on a computer screen or heard with an audio signal. These visual and audio “clues” allow the patient to learn to contract and, even more importantly, to relax the pelvic floor muscles.

Two small sensors mat be also placed with a sticky pad on either side of your anus, where the pelvic floor muscles are close to the skin. These can be placed under your loose clothing. Another set of sensors is placed across the abdomen. The sensors around the anus are connected to a computer screen and display a graph of your muscles as they are being exercised.

Becoming aware of these responses is the first step in learning to control them. Very important is the use of “The Knack”, technique or “Perineal blockage before stress” technique which is a voluntary contraction of the pelvic floor muscles before an increase in intra-abdominal pressure, as the entire muscle training program.