Pelvic Floor Training, Biofeedback & E-Stimulation: Major Benefit from One-on-One Guided Sessions

Yosaira Brioso RMA & Andrew Siegel MD   2/12/2022

Last week’s entry reviewed the anatomy and function of the pelvic floor muscles and the means of using pelvic floor muscle exercises to improve pelvic health.  Today’s entry segues to the use of biofeedback and electrical stimulation done under the guidance of a skilled and experienced pelvic personal trainer to optimally hone one’s ability to identify and isolate the pelvic floor muscles and increase their strength and endurance. 

The goal is to improve urinary, bowel and sexual function and to gain control and confidence in everyday activities. This can benefit both females and males and can specifically help stress urinary incontinence, overactive bladder and urge incontinence, bowel urgency and incontinence, pelvic prolapse, and sexual dysfunction. Furthermore, the training can help decrease pelvic floor muscle tension and spasm and normalize pelvic floor muscle function in those suffering with pelvic pain syndromes due to tight pelvic floor muscles.

It is one thing to pursue pelvic floor muscle training independently, but another dimension entirely when you have the advantage of an experienced pelvic coach to provide one-on-one guidance to help the process and teach you how to become a master of your pelvic domain.  The pelvic training is done by superb personal pelvic trainer, Yosaira Brioso, who also runs our centralized urodynamic laboratory and does the percutaneous tibial nerve stimulation procedures for overactive bladder and whom I have worked with since 2009.  She has done an amazing job and our office has received a flood of compliments from patients about how positive their experience was.

New Jersey Urology offers this program in our Saddle Brook office (160 Pehle Avenue, Suite 103, Saddle Brook, NJ 07663). The system that is used is the Laborie Urostym (Stimulation and Biofeedback). The training is highly individualized and nuanced to address the specific problem and clinical scenario that the patient is experiencing.

Laborie Urostym

The training involves a 30–45-minute session that is done weekly for 6 weeks. The first part of the session is biofeedback, an adjunct to pelvic floor muscle training in which special sensors (EMG patches and leads on the abdomen), a vaginal probe sensor in females, and a short anal probe sensor in males, are used to relay auditory and visual feedback information about the quality and magnitude of one’s pelvic floor muscle contraction and relaxation. The intent of biofeedback is to enhance awareness of the pelvic floor muscles, ensure focus on and contraction of the proper muscles, and to optimize control over pelvic muscle function.  The biofeedback helps evaluate the contraction strength, endurance, and relaxation of the pelvic muscles during the cycles of contraction and relaxation.  This promotes using the proper muscles and decreases the use of accessory muscles including the abdominal muscles, gluteals, and thigh muscles. Ultimately, biofeedback facilitates patients in the process of strengthening, relaxing, and controlling the proper muscle groups.  The biofeedback allows patients to objectively monitor their improvement over the course of the six sessions.

The second part of the session is electrical stimulation. Electrical stimulation of the pudendal nerve via the vaginal probe in females and short anal probe sensor in males produces a reflex contraction of the pelvic floor muscles.  This helps increase awareness, identification, isolation, and strengthening of the proper muscles. E-stimulation guided contraction of the pelvic muscles reflexively inhibits involuntary bladder contractions, helping to improve bladder function, decrease pelvic floor muscle spasms and normalize pelvic floor relaxation.  

Bottom Line: Pelvic floor muscle one-on-one training, biofeedback, and electrical stimulation are a safe and conservative first-line approach to many pelvic floor issues. One of my practice principles has always been to try simple solutions before complex and aggressive ones– “Simple is good”–and this program embodies that philosophy. Patients have been delighted with the excellent outcomes that many have experienced after completing this program. Happy patients lead to pleased and gratified physicians.

Wishing you the best of health,

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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro AreaInside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community. He is a urologist at New Jersey Urology, the largest urology practice in the United States.  He is the co-founder of PelvicRx and Private Gym.  His latest book is Prostate Cancer 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families. 

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Video trailer for Prostate Cancer 20/20

Preview of Prostate Cancer 20/20

Andrew Siegel MD Amazon author page

PROSTATE CANCER 20/20 is now available at Audible, iTunes and Amazon as an audiobook read by the author (just over 6 hours). 

Dr. Siegel’s other books:

THE KEGEL FIX: Recharging Female Pelvic, Sexual, and Urinary Health

Video on THE KEGEL FIX

MALE PELVIC FITNESS: Optimizing Sexual and Urinary Health

PROMISCUOUS EATING— Understanding and Ending Our Self-Destructive Relationship with Food

FINDING YOUR OWN FOUNTAIN OF YOUTH: The Essential Guide to Maximizing Health, Wellness, Fitness and Longevity

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