About Biofeedback

Dietary Irritants to the Bladder

Biofeedback

Pelvic Floor Muscle Training

Biofeedback training is a relatively new treatment for urinary incontinence; however its origin can be traced to 1940 when Dr. Arnold Kegel described an exercise program to help strengthen the pelvic floor.  Dr. Kegel felt these exercises could be used to treat urinary incontinence and pelvic floor problems.  Multiple research studies have subsequently proven Dr. Kegel to be correct and validated that pelvic floor exercises or rehabilitation can be extremely effective in the areas of incontinence and pelvic prolapse.  Unfortunately, many women do not perform pelvic floor exercises correctly, or don’t understand how to do them at all, hence the need for training.  Biofeedback is a painless, effective modality for teaching patients how to control and exercise their pelvic muscles, under the direction of a trained technician.

How do I know if my pelvic floor is weak?
Pelvic floor weakness can be diagnosed at physical exam.  You probably have a weak pelvic floor if you have ever been told that you have a "cystocele" (dropped bladder) or a "rectocele" (dropped rectum).  These ‘bulges’ are actually hernias of the bladder, rectum, or both, into the vagina.  Symptoms can include pressure, difficulty with emptying the bladder or rectum, or a feeling that “things are falling down”.  Many women report a mass protruding from the vagina that is actually the bladder or rectum ‘ballooning’ out of the vaginal opening.

How does Biofeedback work?
Biofeedback helps to isolate the muscle groups in the pelvis similar to the machines used to isolate arm and leg muscles at the local gyms. It is well known that the most rapid effect on the strength and size of muscles can be obtained when these muscles are isolated and exercised regularly with periods of rest in between. Biofeedback training helps by providing visual and audio feedback in response to the activity of your pelvic muscles.  Much like an athlete uses special equipment to train; you can use biofeedback equipment to reach a new level of strength in the pelvic muscles.

How is it done?
Biofeedback sessions are done privately in the office by a trained technician. A small sensor is placed either in the vagina, or on the skin of the outside of the vagina. Once in place, the patient can stay fully clothed for the remainder of the session. Additional sensors (similar to the pads placed for EKG’s) are place on the abdomen or buttocks.   These sensors measure the electrical signals that all muscles produce when they contract. The sensors are connected to a computer that displays them on a screen.  The patient can therefore see immediately when she is contracting the proper set of muscles and doing the exercise correctly. The computer can also measure the strength of the muscle and follow the progress as the pelvic floor gets stronger with each session.  Subsequent sessions will also involve the computer painlessly causing the pelvic muscles to contract, to show you which muscles are involved, for future ‘pelvic workouts’ at home.

Why do I need biofeedback if I already do "Kegel" exercises?
Biofeedback is just a tool to make sure that you are doing the exercise correctly.  Unfortunately, many women do not do "kegels" correctly and contract other muscles along with the pelvic floor muscles, especially the abdominal muscles. When a pelvic floor contraction is done correctly, the pelvic floor moves up and into the pelvis. However, the most common problem for patients that we see is that they will accidentally contract the abdominal muscles at the same time as the pelvic muscles. When this occurs, the abdominal muscles (which are bigger and stronger) push down on the pelvic floor and can actually make the problem worse.

What is involved?
Typically, there are weekly 30-45 minute sessions in the office for a total of 6 weeks. The first session may be a little longer for an initial evaluation. You will then be given specific exercises customized for you to do at home.

Are these treatments covered by my insurance?
Most insurance companies cover the cost of this treatment option. However, we obtain prior approval when necessary.

What if I need surgery?
Biofeedback in no way would cause a problem if surgery is done. Biofeedback training will only make the pelvic floor stronger and can be used either before or after corrective surgery.

How do I start?

Please call the office of Bayside Gynecology at 485-5700 and speak with our staff.  Weekly appointments for therapy will be planned that are convenient to your schedule.

Dietary Irritants To The Urinary Tract

ACIDIC FOODS TO BE AVOIDED

For bladder symptoms related to dietary factors, strict adherence to a diet which eliminates the above food products should bring significant relief in ten days. The proof is resuming your old dietary habits followed by the return of symptoms. Once you are feeling better, you can begin to add some of these things back into your diet, one item at a time. This way, if something does cause your symptoms, you will be able to identify what it is and eliminate it.  Avoidance of caffeine, citric acid, and spicy foods can alleviate many symptoms for some patients.

SUBSTITUTIONS

LOW ACID FRUITS - Pears, Apricots, Papaya and Watermelon

FOR COFFEE DRINKERS - KAVA (Low Acid Instant) Cold Brew from Starbucks

FOR TEA DRINKERS - Non-Citrus Herbal Sun Brewed Tea

VITAMIN C SUBSTITUTE - Calcium Carbonate Co-buffered with Calcium Ascorbate