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Pelvic Floor Rehabilitation

Multimodal physical therapy approach combining biofeedback, electrical stimulation, manual therapy, and exercise for urinary incontinence, pelvic organ prolapse, dyspareunia, and chronic pelvic pain.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Fizik Tedavi ve Rehabilitasyon department. Book Appointment →

What is Pelvic Floor Rehabilitation?

Pelvic floor dysfunction (PFD) results from weakness or hypertonicity of pelvic floor muscles (levator ani, coccygeus). Conditions: 1) Stress urinary incontinence - exercise/cough/sneeze leak (50% of all UI); 2) Urge incontinence - involuntary detrusor contraction; 3) Mixed UI; 4) Pelvic organ prolapse (POP) - cystocele, rectocele, uterine prolapse; 5) Fecal incontinence; 6) Dyspareunia/vaginismus; 7) Chronic pelvic pain syndrome.

Assessment: 1) Anamnesis (ICIQ, PFDI-20 scoring); 2) Physical examination - external pelvis, internal vaginal/rectal exam (Modified Oxford Scale, 0-5/5 power); 3) Biofeedback (EMG/manometry baseline); 4) Real-time ultrasound (transabdominal/transperineal); 5) Bladder diary (3 days, frequency-volume); 6) Urodynamic study (resistant cases). Hypertonic vs hypotonic differentiation is critical.

Treatment protocol (12 weeks): 1) Education - anatomy, lifestyle modifications, fluid management; 2) Pelvic floor muscle training (PFMT/Kegel) - 8-12 contractions, 3 sets/day, contraction-relaxation balance; 3) Biofeedback - EMG/manometry visual feedback; 4) Electrical stimulation - 35-50 Hz, 200 microsec pulse (urge), 50-100 Hz (stress); 5) Manual therapy - trigger point release (hypertonic), connective tissue release; 6) Behavioral - bladder training, urge suppression, urge deferring techniques; 7) Functional integration - core, breathing pattern, ergonomics.

Symptoms

Stress urinary incontinence (cough/sneeze)
Urge urinary incontinence
Pelvic organ prolapse (sense of bulging)
Dyspareunia and vaginismus
Chronic pelvic pain
Fecal incontinence and difficult defecation

Risk Factors

Vaginal birth and trauma
Multiparity and high birth weight
Menopause (estrogen deficiency)
Obesity (BMI >25)
Chronic constipation
Pelvic surgery (prostatectomy, hysterectomy)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent urinary incontinence
  • Pelvic organ prolapse symptoms
  • Dyspareunia and chronic pelvic pain
  • Postpartum pelvic floor weakness
  • Post-prostatectomy incontinence
  • Pre-surgery conservative trial

Treatment Methods

01
Pelvic floor muscle training (PFMT/Kegel)
02
Biofeedback (EMG/manometry)
03
Electrical stimulation (e-stim)
04
Manual therapy (trigger point release)
05
Behavioral modification (bladder training)
06
12-week structured program (multimodal)

Which Department to Visit?

You can visit our Fizik Tedavi ve Rehabilitasyon department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Fizik Tedavi ve Rehabilitasyon Department

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.