Biofeedback

Biofeedback therapy uses an electronic device to help individuals having difficulty identifying the levator ani muscles. Biofeedback therapy is recommended for treatment of stress incontinence, urge incontinence, and mixed incontinence. Biofeedback therapy uses a computer and electronic instruments to let you know when the pelvic muscles are contracting.

Biofeedback is intensive therapy, with weekly sessions performed in an office or a hospital by a trained professional, and it often is followed by pelvic floor muscle exercises at home. During biofeedback therapy, a special tampon-shaped sensor is inserted in the vagina or rectum and a second sensor is placed on the abdomen. These sensors detect electrical signals from the pelvic floor muscles. You will contract and relax the pelvic floor muscles when the specialist tells you. The electric signals from the pelvic floor muscles are displayed on a computer screen.

With biofeedback, you know that you are strengthening the pelvic muscles that need rehabilitation. The benefit of biofeedback therapy is that it provides minute-by-minute feedback on the quality and intensity of your pelvic floor contraction.

Studies on biofeedback combined with pelvic floor exercises show a 54-87% improvement with incontinence. Biofeedback also has been used successfully in the treatment of men with urge incontinence and intermittent stress incontinence after prostate surgery.

Medical studies have demonstrated significant improvement in urinary incontinence in women with neurologic disease and in the older population when a combination of biofeedback and bladder training is used.

Female urinary incontinence is reduced more with biofeedback than with pelvic muscle exercises alone.

Electrical Stimulation

Electrical stimulation is a more sophisticated form of biofeedback used for pelvic floor muscle rehabilitation. This treatment involves stimulation of levator ani muscles using painless electric currents. When the pelvic floor muscles are stimulated with these small electrical currents, the levator ani muscles and urinary sphincter contract and bladder contraction is inhibited. Similar to biofeedback, electrical stimulation can be performed at the office or at home. Electrical stimulation can be used with biofeedback or pelvic floor muscle exercises.

Electrical stimulation therapy requires a similar type of tampon-like probe and equipment as those used for biofeedback. This form of muscle rehabilitation is similar to the biofeedback therapy, except small electric currents are used to directly stimulate the pelvic floor muscles.

As in biofeedback, pelvic floor muscle electrical stimulation has been shown to be effective in treating female stress incontinence, as well as urge and mixed incontinence. Electrical stimulation may be the most beneficial in women with stress incontinence and very weak or damaged pelvic floor muscles. A program of electrical stimulation helps these weakened pelvic muscles contract so they can become stronger. For women with urge incontinence, electrical stimulation may help the bladder relax and prevent it from contracting involuntarily.

Research indicates that pelvic floor electrical stimulation can reduce urinary incontinence significantly in women with stress incontinence and may be effective in men and women with urge and mixed incontinence. Urge incontinence that is caused by neurologic diseases may be decreased with this therapy. Electrical stimulation appears to be the most effective when combined with pelvic floor exercises. The rate of cure or improvement with electrical stimulation ranges from 54-77%; however, significant benefit occurs after a minimum of four weeks, and you must continue pelvic floor exercises after the treatment.