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The Methodist Center for Restorative Pelvic Medicine
6550 Fannin Street
Houston, TX 77030
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Electrical stimulation, or functional ES, is a method used by doctors to treat any number of ailments, including wound care and incontinence. Pelvic floor muscle electrical stimulation (PFES) uses electrical currents on pelvic floor muscles to make them contract. Combined with biofeedback therapy, these low-grade electrical currents help in performing pelvic floor exercises for weak pelvic muscles.
Essentially, this therapy produces a similar result as with patients who routinely perform Kegel exercises to strengthen pelvic floor muscles. PFES is used on the pudendal nerve, located inside the pelvic floor. This nerve is associated with the muscles of the pelvic floor. The pundendal nerve can also be strengthened to perform better with slightly higher frequencies. This electrical stimulation technique is proven to improve the function of both the bladder and the pelvic floor muscle groups. As previously mentioned, the use of biofeedback in conjunction with PFES can increase pelvic muscle contraction strength, decrease uninhibited detrusor muscle contraction or bladder spasms causing urgency and frequency symptoms and can assist in pelvic muscle relaxation.
Pessary (Vaginal Support Device)
Pessary instruments have been extremely useful for conditions resulting from pelvic floor prolapse (dropping of the pelvic floor), and can also be used to treat urinary incontinence. There is an array of pessary instruments available to meet the patient's specific condition and need. The Center for Restorative Pelvic Medicine hosts well-versed physicians who are familiar with the use of pessaries to manage various pelvic support defects.
Many conditions can be treated with pessary instruments, including:
- Stress urinary incontinence
- Vaginal vault prolapse
- Uterine prolapse
- Preoperative preparation
The goal of pelvic muscle exercises is to isolate the pelvic floor muscle and make it stronger, thus preventing prolapse or the dropping of the pelvic floor. One of the most common rehabilitation methods is the use of Kegel exercises developed by Dr. Arnold Kegel. Patients tighten and relax the pelvic floor muscles over and over again up to about 200 times a day to strength the pelvic muscle region. Studies conducted by The Cochrane Collaboration concluded that the use of these techniques actually reduces the severity of prolapse conditions compared to patients who did not do any kind of treatment at all.
Typical Kegel Exercise Routine:
- Contract the pelvic floor muscles
- Hold position for five seconds (keep breathing)
- Rest for three seconds
- Repeat 10 times
As the muscles become stronger, patients should be able to increase the holding time in small increments up to 10 seconds at a time. These short exercises can be done at any time of the day during everyday activity including at work, eating, watching television or even driving.
- Breathe deeply (do not hold your breath)
- Rest between contractions