Pelvic Floor Biofeedback Therapy
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Introduction
Pelvic floor biofeedback therapy is a treatment intended to help patients learn to strengthen and relax their pelvic muscles in order to improve bladder function and decrease pelvic pain. Biofeedback uses electronic and mechanical instruments to accurately measure the action of the pelvic floor muscles, and provides ‘feedback’ information to the patient so that the patient can learn to better use the pelvic muscles. Patients can learn to use the pelvic floor muscles to decrease the sudden urge to urinate, decrease incontinence, and lessen certain types of pelvic pain. An important part of pelvic floor biofeedback therapy is consistent exercise of the pelvic muscles at home, and biofeedback therapy can help teach proper pelvic muscle exercise.
Pelvic floor biofeedback therapy has been used successfuly by many men and women for the past thirty years, and the 1992 & 1996 AHCPR (Agency for Health Care Policy and Research) Guideline on Urinary Incontinence listed biofeedback as a useful treatment option for reducing the symptoms of incontinence. More recently pelvic floor biofeedback therapy, along with pelvic floor muscle massage and "trigger point release" therapy, have been found to be helpful in men and women with chronic pelvic pain. Monterey Bay Urology Associates employ a pelvic therapy clinician, Kathy Cliff, who specializes in pelvic floor therapy in men and women. We have had excellent results with this type of treatment in patients with bothersome urinary incontinence and pelvic pain.
Goal of Biofeedback Therapy
The goal of biofeedback therapy in the treatment of incontinence is to strengthen the pelvic muscles that help to hold back the urine, and also to help teach the patient methods of pelvic floor muscle contraction that can improve bladder control. Contraction of the pelvic floor muscles, called "quick flicks", can sometimes make unwanted urges to urinate go away. Strengthening the pelvic floor muscles can also help to decrease leaking of urine that happens with cough, laughing, work, or exercise. Many women also find that pelvic floor therapy strengthens the vaginal muscles, which can benefit sexual relations. Patients with chronic pelvic pain may have pelvic floor muscle tightness, or spasm, that contributes to the pelvic pain. Pelvic floor biofeedback therapy can teach patients how to relax the pelvic floor muscles, which can help to reduce pelvic pain. Pelvic floor massage can also help to reduce pelvic pain.
How is Biofeedback Performed
Biofeedback therapy is done in the office on a weekly basis with a clinician who specializes in this type of therapy. Each session lasts one hour, and most patients have 6-8 sessions during their initial treatment. Some patients may have more treatments if they are effective, or if they have a relapse in the future. Biofeedback therapy uses computer graphs or lights as a teaching tool to help you identify and learn to control the correct muscles. Biofeedback helps you locate the pelvic muscles by changing the graph of light when you squeeze (tighten) the right muscle. A sensor is placed in the vagina in women and in the rectum in men to sense the contraction of the pelvic muscles. The system can also deliver a painless electical stimulation to the pelvic muscles which causes them to contract, and this stimulation both exercises the muscles and teaches the patient the sensation of pelvic muscle contraction.
Pelvic muscle massage, also called trigger point release, is performed in patients who have specific areas of the pelvic floor muscles that cause pain. The pelvic therapist can perform massage of these areas through the vagina or rectum at each weekly session.
You will be given “homework”. You will be asked to perform pelvic muscle exercises, and the routine will be specific to your problem. Most patients will come back to see the doctor after 6-8 weekly sessions.
Insurance Coverage
Biofeedback therapy for urinary incontinence or pelvic is covered by Medicare and some insurance plans. Most require that the doctor document that a woman has incontinence and has failed to improve with simple pelvic muscle exercises. Many private insurance plans will state that the treatment is a covered benefit, but then refuse to pay for the treatments. It is helpful for the patient to contact their insurance company and request that they pay for the treatments. Patients without insurance coverage for this therapy will be responsible for the cost of the treatment, and we do our best to make the treatments affordable and meet each patient's financial situation.