The biofeedback benefit
Technology gives patients a close look at how they are functioning, which allows them to tailor their treatments
Anna Saunders thought she was “going to breeze through this woman thing,” as she put it. But she hadn’t counted on a prolapsed bladder.
“It felt like a heaviness, or like I was being pulled inside out,” Saunders said.
Her doctor sent her to a gynecologist. “He went through all the different options of what could be done,” she said. Some of those options included an apparatus that fits inside and holds up the bladder, a surgery that stitches the organ back in place ( with the side- effect of incontinence), and a hysterectomy.
“He thought physio would be the best choice. His comment was, ‘ And I love doing surgeries,’ ” Saunders said. “So I was very grateful when he said, ‘ Let’s try the lesser of all the evils.’”
Childbirth is the No. 1 reason for bladder prolapse. Saunders had her children at 27 and 30, and she’s now 56. “It didn’t help that I was doing some heavy lifting at work,” she said.
A part of the recommended physiotherapy for prolapsed bladder is supervised pelvic floor, or Kegel exercises ( named after the doctor who first studied their effects). Saunders chose the Dayan Physiotherapy and Pelvic Floor Clinic in Vancouver, which also offers biofeedback. “I’m not going to go to a physiotherapist for necks and arms and backs when I can go to one where all they do is pelvic floor.”
Biofeedback is a process in which a subject’s various functions, including brain and muscle activity, are monitored and relayed back to the subject, with the objective of him or her being able to control or manipulate the function. Registered physiotherapist Marcy Dayan, who runs the clinic, said “a physiotherapist can treat without biofeedback, but it is certainly a good tool to have.”
There are still some questions about which disorders can be helped using biofeedback. However, a 2008 review of the efficacy of the process for a number of conditions found that, for female urinary incontinence, biofeedback was “efficacious and specific.”
Saunders had tried biofeedback before, for a concussion. A prolapsed bladder, however, was a different matter.
“They make you feel so comfortable,” she said of the clinic’s therapists. “It’s kind of a sensitive subject. Not everybody wants to talk about their bladder coming out of their body,” she said.
At the clinic, hooked up to electrodes, Saunders was shown her insides on a computer screen as she performed her Kegels. “You get to watch your muscles working. When the therapist tells me to squeeze and hold for 10, I can actually watch my hold on my muscles at the count of seven lessening, I’m not holding as well, so now I know I have to tighten up to the count of 10.”
Saunders began her therapy with one trip to the clinic every two weeks, and now she goes every three weeks, for a 30- minute session. Mostly she performs the exercises on her own, 30 repetitions of 10, every day.
“The first session is basically an exam, then doing the exercises lying down and standing up to find what was better for me,” Saunders said.
The treatment has helped. “Ever since I’ve been doing my Kegels, I don’t have any pain,” Saunders said. “That’s not per se from biofeedback. What biofeedback enables me to do is see that I’m losing my grip and I have to tighten it back up. If they didn’t have this biofeedback, all you could go on is, ‘ Well, I hope I’m doing it properly.’ In fact I wasn’t, until I saw it on biofeedback. It’s brilliant.”
If the physio continues to work, Saunders may be able to avoid surgery or a full hysterectomy, which is fine with her. “It’s been so helpful, and not embarrassing,” she said of her treatment at the clinic. “We all have a bladder. Who would’ve guessed they fall out?”