Drips,
Leaks, and Low Spirits - A Woman's Guide to Bladder Control, Infections and
Depression, Andre Alexander Kulisz, Ph.D.
Coping With Bowel and Bladder Problems (Coping With Aging
Series); Barbara Doherty King, Judy Harke
Female Pelvic Floor Disorders: Investigation and
Management; J. Thomas Benson (Editor)
Overcoming Bladder Disorders: Compassionate,
Authoritative Medical and Self Help Solutions for Incontinence, Cystitis,
Interstitial Cystitis. Rebecca Chalker et al;
Staying Dry: A Practical Guide to Bladder Control;
Kathryn L. Burgio et al
Managing Urinary Incontinence in the Elderly; John F.
Schnelle;
Nursing for Continence; Katherine F. Jeter, et al;
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Treatment
of Vulvar Vestibulitis Syndrome with Electromyographic Biofeedback of Pelvic
Floor Musculature
Howard I. Glazer, Ph.D., Gae Rodke, M.D., Charles Swencionis, Ph.D., Ronny
Hertz, D.D.S., M.D., Alexander W. Young, M.D.
Abstract
Thirty-three women diagnosed as suffering from vulvar vestibulitis syndrome,
marked by a significant history of long-term moderate to severe chronic
introital dyspareunia and tenderness of the vulvar vestibule, were selected for
treatment. Patients were given a computerized electromyographic evaluation of
the pelvic floor muscles and were then provided with portable electromyographic
biofeedback instrumentation and instructions
on the conduct of daily, at-home, biofeedback-assisted pelvic floor muscle
rehabilitation exercises. They received intermittent evaluations of pelvic floor
muscles to ensure compliance and monitor their progress and symptom changes. The
results show that after an average of 16 weeks of practice, pelvic floor muscle
contractions increased 95.4%, resting tension levels decreased 68%, and the
instability of the muscle at rest decreased by 62%. Subjective reports of pain
decreased an average of 83%. Twenty-eight patients had abstained from
intercourse for an average of 13 months. Twenty-two of these 28 patients resumed
intercourse by the end of the treatment period. Six month follow-up indicated
maintenance of therapeutic benefits. (J Reprod Med 1995;40 283-290)
Keywords: vulvar diseases, electromyography, vulvar vestibulitis syndrome.
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How Effective Is EMG
Biofeedback in the Treatment of Incontinence?
John D. Perry, Ph.D., Leslie T. Hullett, M.S., R.N., & James R. Bollinger,
M.D.
Abstract
Although urinary and fecal incontinence have been successfully treated by
behavioral and biofeedback methods for over a decade, most projects report a
fixed number of therapy sessions and less than perfect success. In addition, the
use of home training instruments has been sporadic or undocumented. The present
project was based on a fee-for-service out-patient clinic population where all
patients were provided home trainers and all were treated until cured.
Forty-six patients were treated at either of two outpaitent fee-for-service
Continence Clinics in suburban Philadelphia. Average age was 56 years; 73% were
female. Subjects without a recent urological examination were required to have
one prior to treatment. Basic behavioral protocols established by the NIA
were followed. At each visit the patient's pelvic muscles were evaluated using
an EMG perineometer, and all subjects were afforded exercise practice
opportunity using a computerized program. An EMG home trainer was issued for
twice-daily at home practice. In addition, a telephone report line was installed
to increase compliance with exercise instructions.
Of the 46 patients who were admitted to the program and completed training, all
but two were cured of their incontinence in an average of 4.3 visits (for 36
Stress and Urge patients), or 8.7 visits (for 10 patients with other kinds). The
two "failures" achieved 99.5% reduction in symptom, however. These
results were better than previous projects using biofeedback methods.
Contributing factors may have been: (1) this project was the first to use
computerized software for diagnostic evauations, (2) the first to use EMG Home
trainers with every patient, and (3) the use of the patient report telephone
line to enhance compliance.
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*Selected patients with stress urinary incontinence and urinary retention
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