Pelvic Floor Stimulation
Pelvic Floor Stimulation
Pelvic floor muscle stimulation to treat urinary incontinence (loss of bladder control) has been used for more than 25 years. Pelvic floor stimulation (PFS) is based on the principles of treating nerves which supply the pelvic floor muscles. When a muscle is weak, regular treatment with an external stimulus may make the muscle contract, helping to build both strength and endurance and aiding in bladder control.
The pelvic floor is a group of muscles that stretch from the pubic bone to the tail bone (Diagram 1). These muscles support the bladder, urethra, and other internal organs. The support of these muscles is very important for bladder control.
Pelvic floor stimulation (PFS) is the controlled delivery of small amounts of stimulation to the nerves and muscles of the pelvic floor and bladder. The stimulation is generated through a tampon-like sensor that is placed in the vagina or rectum or by surface electropdes that are placed around the anus. The sensor, or electrode, is attached by a cable to a small battery operated device or a larger clinical device in a doctor or therapist’s office. Sometimes pelvic floor stimulation is called electrical stimulation or E-Stim (Diagram 2).
Pelvic floor stimulation is not painful. Some people describe a tightening or lifting of the pelvic floor muscles. Others feel nothing or sometimes a light tapping or mild tingling sensation.
Pelvic floor stimulation works in two ways for urinary incontinence.
In stress incontinence — leakage of urine with coughing, laughing, etc. — it may be difficult for the person to contract the correct muscles because of muscle weakness (See diagram 3). Stimulation may help strengthen the pelvic floor muscles and ensure that the correct muscles are being contracted. Over time, this treatment builds muscle strength for support of the bladder.
In urge incontinence — leakage of urine with a very strong urge to urinate — stimulation is used to stop the urge to urinate by acting on the nerves to the bladder that cause unwanted contractions. Over time, it is believed that stimulation helps relax the bladder muscle and reduce the urgency and leakage.
Many people have both stress and urge incontinence, also known as mixed incontinence. This means that they leak when they cough or sneeze or exert pressure on their abdominal muscles; but they also feel the urgent need to go to the toilet and may not make it in time. Stimulation has been used successfully in this condition too. Pelvic floor stimulation may also help men or women with chronic bladder pain and frequent or uncomfortable urination because of an inability to relax pelvic floor muscles.
Therapy for urinary incontinence may be more successful when combined with some life-style changes including weight loss, decreased caffeine, regular bowel movements, hormone replacement, medications, stopping smoking, and drinking 6-8 glasses of water a day. It may be used with active muscle exercise, hormone replacement therapy in women, medication, biofeedback, or other treatments.
Speak to your healthcare professional. If he or she is not familiar with stimulation for bladder control, look for a physical therapist, nurse specialist, or physician who is knowledgeable about urinary incontinence. Treatments are usually combined with clinic and home exercises. An average program is three to six months and varies depending on the person’s needs and progress.