The information provided by Advanced Healthcare for Women and E. Daniel Biggerstaff, III, M.D. is for informational purposes only. As each woman is unique, do not rely on this information for diagnosis and treatment. We cannot guarantee the accuracy of the content and advise that you see a qualified Health Care Professional for individual needs and care.

Urinary incontinence is the involuntary loss of urine (see Urinary Incontinence in Patient Health Information). Biofeedback is a painless, non-surgical method used to try to improve both genuine stress incontinence (GSI) and detrusor instability (DI or irritable bladder). Biofeedback is frequently used in combination with electrical bio-stimulation.

Biofeedback assists in re-training the bladder floor (1) by teaching you which muscles to contract, which muscles to avoid contracting, and (2) by reinforcing the exercise with visual input (you actually see how strong your contractions are on the computer screen). Each practice session is recorded on a computer disc and is available for retrieval and comparison for subsequent therapy.

Pelvic floor electrical bio-stimulation uses weak electrical pulses to help you identify the appropriate muscles to contract, to improve muscle strength, and to treat overactive nerve impulses in the bladder (as seen in urge incontinence). The settings for the treatment are individually adjusted until you feel weak muscular contractions.

How are muscle contractions measured? And what about this electrical bio-stimulation? A probe that is slightly larger than a tampon is gently inserted into the vagina. Also, several wires are also connected to the abdomen with sticky patches, similar to the ones used when taking an EKG (electro-cardiogram). The vaginal probe and abdominal wires are attached to sophisticated equipment that measures and records the muscle contractions and shows these contractions on a computer screen. The vaginal probe works in two ways: (1) by sensing electrical activity in the pelvic floor muscles as you cause them to contract and (2) by actually causing mild contractions in these muscles. Again, this is painless.

How long does the treatment take? In a typical session, you will contract your pelvic floor muscles for 15-30 minutes, and the probe will cause your muscles to contract for 15-30 minutes. On an average the total time is about 45 minutes. A common problem when exercising the pelvic floor muscles is contraction of the abdominal wall muscles more than the pelvic floor muscles. The system monitors both groups of muscles and shows you graphically (on the computer screen) which muscles are being contracted and how strong your contractions are.

The majority of patients require between six to eight sessions of therapy using the pelvic biofeedback/pelvic floor stimulation. You are encouraged to do daily pelvic floor exercises (Kegel’s) between sessions and after finishing the program. You should also avoid bladder irritants in addition to some other precautions to improve your results (see Urinary Incontinence in Patient Health Information).

How effective is the program? Studies show this form of therapy can reduce the need for surgery for genuine stress incontinence (GSI) by 40-50%. Since 50% of women over 50 years of age have some degree of incontinence, many unnecessary surgeries could be avoided. As noted above, this form of therapy is also used to treat urge incontinence, which should not be treated surgically. The long-term success of the program depends largely whether you continue the exercises at home and whether you keep up with the other measures suggested to reduce incontinence.