Pelvic floor
rehabilitation is a term that describes a systematic approach to improving the
strength and function of the muscles which support the bladder, urethra and
other organs contained within the bony pelvis.
A group of muscles,
called the levator ani, stretch from the pubic bone (symphysis pubis) to the
tail bone (coccyx) creating the "floor" of the pelvis. The levator ani (also called
pelvic floor muscles or PFM) help maintain pressure within the urethra, which in
turn prevents urine leakage at inappropriate times. Strong muscles also may
reduce or alleviate the involuntary bladder contractions associated with
overactive bladder, and help to keep the bladder, uterus and rectum in their
proper position within the pelvis. These muscles may become damaged or lose
strength and tone due to aging, childbirth, surgery, illness or other condition.
Pelvic floor
rehabilitation uses the principles of physical therapy to provide a structured
program for muscle reconditioning.
Pelvic Floor
Rehabilitation is used to help people learn how to better control their
bladder symptoms. This treatment usually consists of a combination of
tests which reveal how strong or weak the pelvic floor muscle is, how
well the nerves 'talk' to the muscle, and stimulation of the nerves and
muscles in the pelvis to improve coordination and strength and calm the
bladder muscle. A nurse performs the therapy under the supervision of a
doctor, generally over the course of 4 visits, and can include any of
the following:
Electomyography
A small, tampon-like device is inserted into the vagina (or rectum in men), and special electrodes along the sides of the device measure the electrical activity generated, in the muscle while exercising. Abdominal EMG will also be monitored to be sure you are performing the exercises correctly.
Stimulation
The EMG sensor is also used to stimulate the pelvic floor muscles and nerves with mild, intermittent bursts of electricity. This therapy helps you learn better control and coordination of this part of your body and acts to calm the bladder muscle to ease urgency.
Anal Manometry
A small, soft, air-filled balloon pressure monitor is inserted into the rectum (the pelvic floor muscle is strongest at the anus), and strength and endurance are measured while you practice your exercises.
Biofeedback
This therapy is an extenuation of pelvic floor rehabilitation, available for those patients who need extra help in learning to control their symptoms, and involves practicing your exercises while watching a computer screen for visual and auditory rewards when they are performed correctly.
None of these procedures are painful, and we will make every effort to help you feel comfortable during the visit. Initial visits usually last 1 hour and subsequent visits 30 minutes. Many patients are glad to learn there is something they can do themselves to improve on their bladder control problems, and often comment on the confidence they gain over the course of treatment.
