What is incontinence?
Incontinence is a condition where involuntary loss of urine becomes a social or hygienic problem. A common variation, stress incontinence, involves loss of urine with physical exertion such as coughing, sneezing, sports, or exercise. Another variation, urge incontinence, involves loss of urine due to a strong desire to void almost instantly that may be brought on by stimuli such as running water.

What about biofeedback for incontinence?
Biofeedback for urinary incontinence involves the use of special computerized devices to teach squeezing and relaxing of the pelvic floor musculature. This technique is important in regaining and maintaining bladder control. The fist step in attempting pelvic muscle exercise is to learn the proper muscles to squeeze or relax. Biofeedback is a tool used to teach the patient proper control over these muscles.

Exactly how does it work?
Small sensors are placed in the vaginal opening. Once the sensory have been correctly placed, the therapist attaches them to a computer, which produces a signal that can be both seen and heard on the monitor. For incontinence patients, the biofeedback machine acts as a sixth sense which allows them to “see” and “hear” the activity of their pelvic floor muscles. The therapist then coaches the patients in the proper exercises using the signals on the computer to show the patient how to perform the technique properly. At first the goals are made easy by the therapist, but as the patient succeeds, the task is made more difficult. Ultimately the patient should become her own therapist, and eventually control the pelvic muscles without the use of instrumentation.

How many sessions will be needed?
A typical course of treatment may require 8 to 12 sessions until mastery of the pelvic muscles is achieved. Each session lasts 20 to 30 minutes.

What are the patient’s responsibilities?
Biofeedback is useful for patients who are willing and able to perform the home exercise as prescribed. Because particular muscles need to be strengthened, this can only be done by the patient. The role of the therapist is to teach the patient how to perform the exercises and guide the patient through the program.

What additional costs are involved?
Biofeedback patients are responsible for purchasing their own individual vaginal EMG sensor costing $100., which will be reused by the patient during the course of biofeedback training.

Is biofeedback effective in treating incontinence?
A 1999 study of 197 women found that behavioral techniques such as relaxation and muscle control achieved through biofeedback training worked better than medication in controlling female incontinence. Women who took the drug oxybutynin to control urination had a 69 percent reduction in the number of incontinence episodes, compared with an 81 percent reduction for women who controlled their symptoms with biofeedback and exercise.

Should you try biofeedback?
If you think you might benefit from biofeedback training, you should discuss it with your physician or therapist, who may wish to conduct other tests to make certain that your condition does not require other medical treatment first. A physician’s referral is required before biofeedback training can begin.