Physical Therapy
Treatment of the pelvic floor is a specialized aspect of physical and occupational therapy. There are a wide range of issues that can arise from weakness in the muscles of the pelvic floor or around the organs inside the pelvis such as urinary frequency, urgency or problems with incontinence and interstitial cystitis.
Patients typically attend in-office appointments 2-3 times per week for a duration of 12 weeks. Treatment requires manual digital manipulation of the external and internal tissues of the pelvis, vagina and/or rectum. This type of therapy is fairly intimate and can be uncomfortable for some patients.
Therapists will often utilize bladder training, biofeedback, pelvic floor muscle exercises and electrical muscle stimulation.
Bulking Agents
Another way to prevent leakage from stress incontinence is to inject synthetic bulking agents into the tissues around the urethra boosting the size of the urethra lining and creates resistance against the flow of urine from the bladder.
Injections must be repeated every 12 to 18 months and are only helpful against stress incontinence. Potential side effects include pain at injection site and or damage to the urethra.
Note: Bulking Agents treat Stress Urinary Incontinence only and do nothing to strengthen the pelvic floor muscles.
Neurotoxin Injection (Botox)
Neurotoxin (Botox®) is used for urge incontinence. Toxin is injected into the detrusor muscle (the muscle that surrounds the bladder) to limit the muscle’s ability to contract, thus diminishing the symptoms of urgency for a period of time. Injections must be completed with regularity, as the effects of the injection diminish.
Common side effects:
- Urinary retention (not being able to empty the bladder completely) which may require catheterization
- Urinary tract infection
- Hematuria (blood in the urine)
- Fatigue (extreme tiredness)
- Insomnia (difficulty getting to sleep and or staying asleep)
Note: Does not treat Stress Urinary Incontinence, no strengthening of the pelvic floor muscles.
