The Women’s Health Connection has developed an effective non-surgical alternative to simply “living with it”. Pelvic floor rehabilitation, a program which we refer to as “In-Control”, is an effective treatment for not only urinary leaking problems, but also urinary urgency and frequency, bladder pain, pelvic prolapse (pelvic organs “falling out” or “hanging out”), general pelvic pain, stool leaking and constipation.

The “In-Control” program begins with a detailed assessment of your problems by the medical provider, either physician or nurse practitioner. At that visit, they will ask you many questions about your specific problem, as well as your general health, family health and social situation. They will do a careful examination. They may order further tests to rule out abnormal growths or tumors, bladder stones, etc, and to further evaluate exactly what is causing your problem.

Once the cause of the problem has been figured out, we set about making it better. The “In Control” program is all about helping out the pelvic floor muscle. The pelvic floor muscle is a large muscle, shaped like a hammock which attaches to the pubic bone at the front and the tail bone at the back, and forms a kind of a sling that holds up and supports your pelvic organs, such as your bladder, your uterus and your rectum. It is in constant use and relaxes only when you urinate or pass stool.

Over time, it can get weak. When that happens, the bladder neck has no backboard to close against during a cough, and urine can leak. Pelvic organs can start to fall down as the muscle gets weak or develops tears. One of the goals of the “In Control” program is to strengthen this muscle.

This muscle can also go into spasm, and when this happens, you can develop problems such as not being able to empty your bladder properly, or empty your bowel properly. When the spasm is severe, it can cause pelvic pain. Another aim of the “In Control” program is to decrease the spasm in the muscle. The muscle functions much better when not in spasm.

After the medical provider has assessed you and determined that you’re a good candidate for this program, you will meet with one of our pelvic floor rehab nurses, who work under the direct supervision of the physician or advanced nurse practitioner. They will perform tests to measure the strength and endurance of the pelvic floor muscle and to measure its level of spasticity. They will also do muscle stimulations to increase the strength and decrease the spasm of the muscle. Based on the results of the tests, an exercise prescription will be written for you to exercise your pelvic floor muscle, similar to Kegal’s but with more detailed instructions as to the amount that’s right for you, the duration you should hold each contraction, the number of repetitions, the number of times a day to do these exercise sets, etc.

These detailed instructions are important because no two people’s pelvic muscle is exactly the same. Too much exercise can fatigue the muscle and make the problem worse; not enough means no improvement. The strength and endurance of the muscle is retesting every 1-2 weeks and your exercise prescription adjusted based on your progress. By about the third session, you will start to see improvement, and most people achieve maximal improvement around 7 or 8 sessions. You will be discharged from the program with detailed instructions on how best to maintain your new found control of your problem.

Seventy five to eight percent of women attain significant improvement through the “In Control Program. We carefully track our results. As with any treatment, there are some people who do not respond to non-surgical therapy. But in general, the success rate is high and many of our clients tell us we have given them their lifestyle back. Some women report that for the first time in years, they are able to sleep through the night without waking up with an urgent need to urinate. Some report that they no longer need to wear pads, or at least not as many. Some report that their disabling pain is much improved and they’re able to do more activity. For some women, staying dry means staying independent and out of nursing homes. For some, a decrease in the pelvic pain allows them to work and exercise again. Many report less constipation. Some report that they are able to stop medications they were taking for these problems or that they now need to take much less of these medications.

If you or someone you know could benefit from the “In Control” program, please call 465-8885 to set up your consultation. And yes, it is covered in whole or in part by Medicare and most major private insurances.