2006 Brookwood Medical Center Drive, Ste. 405
Birmingham, AL 35209

Pelvic Floor Muscle Rehabilitation

Healthy pelvic floor muscles protect women from incontinence and prolapse.  Many times these muscles become weak with time or injury such as after childbirth.  Pelvic floor muscle strengthening and retraining can improve bladder and bowel control as well as decrease symptoms of prolapse such as pressure and bulging with early stages of prolapse.

Many women will try Kegel exercises but become frustrated when they either do not improve the bothersome symptoms or women feel like they are not doing them correctly.  Kegels or pelvic floor exercises are challenging to do correctly which is why Pelvic Floor Rehab can be beneficial.

Women undergo guided pelvic floor muscle retraining using a special set of sensors. During this training, women learn how to correctly use their Pelvic Floor Muscles to improve symptoms associated with various pelvic floor disorders.  

This guided pelvic floor muscle training helps women learn to use their pelvic floor muscles in a meaningful way to treat urinary incontinence, fecal incontinence and early stages of pelvic organ prolapse.  It can also help reduce the risk of progression or recurrence of pelvic organ prolapse.  During this training, women learn to isolate their “Kegel” muscle and strengthen it to improve pelvic floor symptoms.  

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Medical Treatment

Urge urinary incontinence includes bladder leaking associated with urinary urgency.  Many women experience a sense of needing to rush to the restroom for fear they may lose a small amount of urine or even flooding before safely making it to the toilet.  Primary treatment includes lifestyle modifications such as timed voiding, bladder retraining and avoiding irritative substances such as caffeinated beverages, carbonated beverages, coffees, teas and alcohol.  If these approaches do not improve bladder control, then many women will move toward medication to help.  Many medications are used to treat urgency incontinence.  Medical management is also individualized to the patient and her unique needs.

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Posterior Tibial Neuromodulation

This therapy is available for women who have tried conservative treatment options and medication without improvement in their urinary urgency incontinence or overactive bladder symptoms.  Women who choose this therapy will be scheduled for 6 weekly sessions at first, to see if the therapy works.  The nerve is stimulated at the ankle and uses a small accupunture needle. The therapy lasts for 30 minutes and is generally very well tolerated with minimal discomfort.

After women have tried first line therapy (lifestyle modifications) and second line therapy (medication) without adequate improvement, third line treatment options are available for the treatment of urgency incontinence or Overactive Bladder (OAB).  Posterior tibial neuromodulation offers a safe and effective in office therapy designed to improve urinary urgency, frequency and urge urinary incontinence or loss of urine.  For many women, this therapy will help improve urinary symptoms without medication or surgery.


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Sacroneuromodulation with InterStim

This third line treatment option for women who have tried and failed lifestyle modifications and medical management, provides relief for many women who urge urinary incontinence, urinary retetention and fecal incontinence.  During this two step procedure, women undergo a trial period for approximately a week during which time we are able to see if the therapy will adequately improve bladder or bowel symptoms.  If the test period is successful, we then move to placing a permanent neurostimulator.  This therapy has been available in the United States since 1996 and continues to safely and effectively provide many women relief from their bladder or bowel symptoms.

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