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The Max K. Willscher Urology Center employs physical therapists with advanced training in the evaluation and treatment of muscular causes of urinary incontinence and various pelvic pain syndromes. Referrals are made to the physical therapist by physicians who have diagnosed the problem and determined that non-surgical management would be helpful. During a physical therapy evaluation the muscles which control urine flow are assessed for strength. These muscles, commonly known as the pelvic floor are located inside the vagina and rectum. Weakness here from childbirth, chronic straining or physical injury allows the bladder to drop and urine is easily expelled during coughing, sneezing, laughing, lifting and jumping. Physical therapy treatment generally involves instruction in proper strengthening technique followed by a specific exercise prescription of Kegel exercises to be done at home. If weakness is significant, biofeedback may be prescribed. During biofeedback a sensor is placed near the pelvic floor muscles which will pick up the electrical activity that the muscle generates when it is squeezed. This information is displayed on a computer screen so that the patient is able to better perceive the force of contraction of this hidden muscle group. If the patient is actually unable to generate any force from the muscle, electrical stimulation is used. A tampon-like probe is placed in the vagina or rectum and comfortably "jump starts" the muscle. This can also be used to teach the bladder to hold larger amounts of urine before signaling the urge to go. This will decrease the number of time one needs to go to the bathroom and will also decrease episodes of large accidents. |
