E-Stim Handout

Pelvic Floor Therapy/Electronic Impulse & Biofeedback

You have been referred for electronic pelvic floor therapy at Swor Women’s Care. This new treatment program was modeled after urogynecology protocols at the Mayo Clinic. We use computer planning and electronic impulse stimulation to strengthen and train the pelvic floor muscles. The treatments are non-surgical and painless, and provided in our private clinic by our expert professional staff.

Following your first one hour orientation visit, subsequent sessions typically last about 45 minutes. Typical pelvic floor rehabilitation plans require between 5 and 10 visits, usually on a weekly schedule. It is important to maintain regular continuity to your visits, as gaps in therapy will delay your response. An office visit is recommended with your practitioner after the 5th session to assess progress.

E-stim and biofeedback for the pelvic floor muscles is a safe, non-invasive, and effective means to treat bladder control problems, chronic pelvic pain and other pelvic floor disorders, including Intersitial Cystitis, Vulvadynia (vulvar vestibulitis), Levator Ani Syndrome and Vaginissmus (vaginal muscle spasm). It has also been successfully used in the treatment of irritative voiding symptoms: urinary frequency, urgency, dysuria, urge incontinence as well as genuine stress urinary incontinence (SUI). Biofeedback therapy has been recommended as a first line treatment for these urinary conditions by the Agency for Health Care Policy and Research (AHCPR), of the U.S. Department of Health and Human Services. Many patients can avoid the need for drug therapy and surgery with successful outcomes from E-stim.

Biofeedback uses computer-generated signals to “train” patients to improve their body function and strength. Biofeedback techniques are often used in connection with special pelvic floor exercises to teach E-stim patients to strengthen the muscles of their pelvic floor. In women who suffer urinary leakage from stress incontinence, this muscle strengthening improves the support of the bladder, minimizing leakage from cough, sneeze, exercise, etc. Biofeedback-based continence training has also proven effective in the treatment of urge incontinence (inability to reach the toilet in time) as well as overflow incontinence (related to incomplete emptying of the bladder).

Biofeedback can also be used to learn to relax the pelvic floor muscles in certain cases of pelvic floor dysfunction and spasm. Similar to “muscle-contraction” headaches, excess tension in the pelvic floor muscles can result in painful intercourse, frequent urination, difficulty initiating and completing urination, and constant pelvic, rectal or vaginal pain. Biofeedback is used in this setting to “train” patients to find, relax, and ultimately control these spastic muscle groups through specialized exercises taught during the biofeedback session and then regularly practiced at home.

In a biofeedback session, and electronic EMG sensor, about the size of a tampon is placed into the vagina. A smaller probe is placed in the anal canal. The sensors measure muscle activity and connect to the biofeedback computerized monitoring device, which produces a measurement and graph of the muscle activity.

Once the patient has learned to recognize and properly exercise the correct muscle groups, the biofeedback monitor is no longer necessary. The patient is instructed to continue the exercise therapy at home on a daily basis.