Biofeedback for Incontinence

I perform kegel exercises daily.

On 3/3/2009 I started 12 weeks of biofeedback, designed to curb the incontinence. The session is divided into 2 parts:(1) alternating kegels (holding for 5 sec. each) with rest periods (15 sec. each), for a total of 6 min.; (2) the same pattern of kegels and rest periods, but with electrical stimulation applied during each kegel (total of 12 min.). The level of electrial stimulation is determined solely by my pain threshhold. It is raised until I say that it hurts, then it is backed down.  I tolerate this procedure because, according to articles that I have read, the theory is provide sufficient electrical stimulation to cause a pelvic muscle response. Theoretically, this leads to a "reawakening" or reactivation of the pelvic floor muscles.

My question is directed to anyone who has undergone biofeedback sessions combined with electrical stimulation.  Has anyone had an adverse reaction to an overuse or over-application of the electrical stimulation?  Are there any risk factors known or explained to you of which I should be aware? What specifically have you done in the biofeedback sessions, or in addition to the biofeedback sessions, that have improved your results?

Thanks in advance for your replies.

RHC

    RHC,  I did have biofeedback but I did not have electrical stimulation of the pelvic floor muscles.  I was showing very small gains in muscle tone but no change in the leaking.  I finally gave in and went the AUS route and have not regreted the decision.  I hope you regain control but do not get down if you don't.  There are ways to take care of it. 

    Good Luck,  KW

KW and JerseyCity:

Thanks to both of you for responding.

BTW, I have had 2 sessions already, so I am familiar with my format. Two sensors are applied externally to the lower abdominal area. A third sensor is inserted rectally. That sensor also supplies the electrical stimulation.  The two-part session itself is I previously described.

Prior to my first 2 sessions, I only had seen studies showing indefinite conclusions about biofeedback with electrical stimulation. So, I was skeptical, and my cooperation mirrored my skepticism. Lately, I have seen additional and more recent studies concluding that biofeedback, combined with electrical stimulation, is helpful in speeding up continence. This has changed my attitude, and I now wish to do whatever is required to make each session the best that it can be.  My principal concern focused on the amount (amplitude) of the electrical stimulation. The study from Prysberterian Hosp. in NYC talked about a "mild" electrical stimulation. Other studies have talked about a more substantial electrical stimulation, with the theory being that sufficient voltage must be applied to cause a reflexive response in the pelvic floor muscles. So, in my session tomorrow, I guess that I'll go with the concept of ramping up the voltage until it hurts, and then backing it down to a more tolerable level. I'll first discuss it with the therapist (I am not comfortable with the scope of her knowledge - but she does try). I'll give that procedure 2 to 4 sessions, and then see what happens. At the halfway mark (6 sessions), I'll try to touch base with my operating surgeon (or with his partner who performed the biopsy), and discuss with him/them the details of my status.

BTW, as to the kegels at home, I have done them, and continue to do them, religiously.

JerseyCity - I am aware, as you may have found, that the mere passage of time may present the cure. Just as you, and others, have done, I will try to make the most of each opportunity  --- and if it's just the passage of time, so be it.

RHC

Interested Observers:

Today I completed 12 weeks of biofeedback therapy, coupled with electrical stimulation.  The sessions went as described in my first posting under this thread, except that kegels are not performed while receiving the electrical stimulation. Just lay back and feel the low dosage voltage.  As suggested, I did have the operator ramp up the voltage from time to time to a point just before pain. Shaving was not necessary.

Based upon what I can see, there have been no improvements in my condition. I remain totally incontinent, meaning that I still have no ability to control urinary leakage.  My immediate conclusion: it was just a waste of time. However, it is possible that there are things that I don't see or of which I haven't felt the impact (such as additional muscle fibers growing as a result of the electrical stimulation). So, for anyone in my postion who is just grabbing at anything to improve the condition, it is a possibility.  Have very low expectations, and be grateful for any positive results.  If treatment is not covered by insurance (as was mine), you may wish to think twice.

RHC Jr.