Biofeedback Physical Therapy

[Archives1]

I had my RALP in August 2022. Like most, I have been dealing with incontinence since but have seen improvement recently so I estimate I am 50-60% continent at this point (2-3 light pads in 24 hour period and one brief for security). I have received physical therapy since my RALP, the first couple of months without biofeedback followed by a new therapist who uses biofeedback.

For those not familiar with biofeedback, my simplistic description involves placing a small device either in the anus (males) or vagina (females) while doing the kegal exercises. Sometimes small adhesive sensor pads are placed on the perineum area and other locations on the body in place of using the internal sensor. The device, whether internal sensors or external pads, provides visual measurement of electrical impulses generated by contractions of the pelvic floor muscles, providing feedback as to how well the kegal exercises are being performed.

My experience with biofeedback has been mixed. I used both the external sensors and anus inserted sensor. The pads were totally ineffective and a waste of time. The internal sensor was better in showing muscle contractions but it was never clear to me whether the contractions were the correct (pelvic floor) muscles. Also, the internal sensor only provided a measurement when standing or laying down. The pressure created by sitting negated the accuracy of the anal sensor.

I am curious what others have experienced with biofeedback as part of their PT. What seemed to work for you and what did not? Did it help you improve your use of kegals and to achieve continence?

Thanks for responding.

 

[Archives1]

What is RALP? Yes, had Biofeedback as part of Pelvic floor therapy. However, the training was so brief -- just two sessions -- that I have forgotten the results! I would say that four sessions of biofeedback would be necessary in order to remember the results.

 

[Archives1]

I didn’t do biofeedback as part of my pelvic floor / Kegel PT.

 

[Archives1]

Two weeks before my RALP (Robot Assisted Laparoscopic Prostatectomy)I had an appointment with the Pelvic Floor therapist associated with the Urology Group doing my surgery. I had absolutely no idea what to expect and she had me read a summary of what the session would involve. I chuckled and said ok, let's go. I will give you the short version of the next 45 minutes. She had me drop my pants and underwear, bend over and receive an electronic probe in my rectum, then sit on a large absorbent pad on the chair next to me. The rectal probe was not uncomfortable at all. She proceeded to place two electrodes on my lower abdomen, and one on each of my upper thighs. She placed a drape over my exposed midsection, saying due to modesty concerns it was protocol. She attached all my electrodes to a TV monitor which she swiveled so I could see it easily. On the monitor was a split screen video game, the animal in the top half controlled by my rectum (pelvic floor muscles) and the animal in the bottom half controlled by the other four electrodes (not pelvic floor muscles). My next half hour was spent making the top animal jump and fall on command by contracting and releasing the correct muscles. If the bottom animal moved, I was using my stomach or leg muscles, which was bad. I got the hang of it, and gradually was able to do make the top animal move as asked, while the bottom animal stayed motionless. I mentioned that all my readings on kegels said it involved pulling my penis in towards my body to help with anticipated incontinence. She said that's what you've been doing. I asked if I could lose the drape, and she said sure. Once that was gone, she showed my that while I was making the rectal probe cause the top animal to move, my penis was also being pulled in towards my body. Protocols about male modesty almost denied me that visual connection to kegels. (Now when possible, I watch my penis withdraw when I do my kegels and I know I'm doing them correctly). She removed the probes; I cleaned up and the session was over. She gave me a folder full of information and exercises to practice before and after my surgery.

 

[Archives1]

Unfortunately, probe irritated anus too much so I stopped session. Already pull penis in and anus up when peeing or Kegeling. Real story about complete continence after RP, if it’s possible without AUS and replacements over the years, is Kegels forever. The better they’re done, the fewer the pads. Coming to acceptance is best route. Hard to accept, especially if one unfortunately has RP while young. I had surgery 5 years ago at 70yrs. and PSA remains <0.1, the most important thing in my opinion.