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Biofeedback: Incontinence Treatment Without Surgery
Medically Reviewed by Taylor Holmes, DPT, STAR-C
Surgery is the gold standard for pelvic repair to “cure” urinary leakage or stress incontinence. However, following the diagnosis, nearly every gynecologist will start with a series of non-surgical options.
Modifying behavior and the way a woman reacts to her body’s signals has been the focus of clinical attention in the US for several decades. One of these – biofeedback – can be used in conjunction with Pelvic Muscle Exercises – also known as kegels.
Biofeedback uses technology to offer information about body systems, such as muscle contractions, that are usually regulated automatically by the body.
When used with urinary incontinence, biofeedback can help people train and, with Kegels, strengthen their muscles to produce a contraction.
HOW IT WORKS
Electrical leads are placed on the skin or a small probe is inserted in the vagina. When a woman attempts to control her pelvic muscles, the apparatus reads the success and displays it on a meter. By trying different techniques, the woman can find the best way to contract her muscles, eliminating accidental urine leakage.
The training starts under the care of a physician, nurse or physical therapist and can be continued at home. Biofeedback is also a safe way to help a person train their rear (anal) muscles to control accidental defecation (fecal incontinence).
After about 4-8 weeks of physical therapy treatment sessions occurring 1-2 times per week, a woman will most likely see improvement but it won’t be permanent without continued exercise at home.
The combination of pelvic floor training and biofeedback can improve stress incontinence by 50-85%.
In some cases, biofeedback can be used for urge incontinence by educating muscles around the pelvis and bladder to relax, reducing the feeling of a need to urinate.
One study included more than 400 women, each of whom had been incontinent for years. It used biofeedback combined with pelvic floor muscle strengthening. Electrical stimulation was for women whose muscle contractions were initially too weak for training. More than 70% of the women reported long-term improvement in their stress incontinence.
Final Thought. In addition to your gynecologist and urologist, your family medicine physician can order an assessment by the physical therapist to determine if biofeedback is a non-surgical option for your unique condition and needs. However, an examination by your gynecologist is needed before any treatment plan is decided. Incontinence may be a symptom of other health issues, such as diabetes or cystitis.
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Sources: McLeod Health, National Institutes of Health, Netdoctor.co.uk, American Journal of Physical and Medical Rehabilitation, National Health Service UK, National Association for Continence, Agency for Healthcare Policy and Research, American Urogynecologic Society Foundation