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Unread 11-01-2002, 12:01 PM
Pelvic PT

For anyone who might be wondering about this topic -

I had my 6th visit for pt yesterday. First visit was 100% evaluation, a very detailed pelvic exam. Helped diagnose areas that I needed improvement in, and there were many. Tests like how fast can you do repeated Kegals, how long can you hold a Kegal, how tightly you can hold a Kegal, what can you feel (is the touch to the top, bottom, right or left). Very eye opening experience. If nothing else, the therapist made me more aware of what I was feeling and WHY and how everything works together. Just a completely different viewpoint on the body than anyone had ever presented to me in 41 years.

The next five visits, one a week, involve demostrating how well you have been practicing a variety of exercises, discussion of symptoms and/or any improvement, and electric stimulation of the pelvic floor. (Some people don't need this, but I did). This can happen by placing/taping electrodes externally to the perineal area or by using an internal tampon-like electrode. The pt said she felt the internal was better, so that's what I opted for. Pulses of electricity are used in 7 second intervals (in my case anyway) to help the muscles contract - seven seconds on, seven seconds off for 20 minutes. How much electricity varies by what an individual can tolerate, and after a few minutes at one level I tend to have the amount raised. You try to contract with the current. While each person is different, if I do NOT try to contract with the pulse it can really sting.

There is also bio feedback if needed, sensors can let you know how well you are holding a Kegal. I have had a few problems in this area, doesn't always feel like I'm accomplishing anything.

Big question is does this work? An acquaintance went thru weeks of pt and was doing great while she went. Her issue was stress incontinence. But when she stopped she went right back to dribbling. It is obvious that my muscles are much stronger, and I have worked very hard outside of my pt visits to try to end pt sooner. But my rectocele isn't going to go away just because of pt, because fascia is involuntary muscle that you can't consciously exercise. A hernia is a hernia is a hernia, and they don't just "go away". My bladder seems a little better. It had shifted a little, but not enough to cause incontinence.

I have not noticed any "difference" with intercourse, and I had really hoped for improvement. Maybe the rectocele (an occassional ouch factor) is masking any improvement there. I still get a pulling sensation if I pick up anything (gallon of milk for instance) that is definitely the rectocele.

I have an appointment with a prolapse specialist in about ten weeks. I think I need the opinion of an expert who deals with this stuff everyday. The pt agrees with me. No negatives toward my normal gyn, but I want resolution and I don't care if its a pessary, or a cream, or even surgery at this point.

I hope this has been informative and/or helpful to someone.
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Unread 11-01-2002, 04:07 PM
Pelvic PT

thank you for this very detailed description of these sessions. I had a recurrence of my stress incontinence and my doctor discussed that very kind of therapy with me. I was truly curious about what it'd be like. Doing Kegels on my own, and just getting fitter and healing, helped tremendously, but I think that down the road, I would be very interested in having sessions like yours to improve my muscles. I'd do anything to avoid further surgery. My doc did say that you have to do them all the time, so that it becomes almost unconscious.

I think it's great that your doctor had you try these, although I understand that you're frustrated. But I was complaining of stress incontinence for years to my former Gyn and my PCP and they'd both just shrug their shoulders.

thanks again for writing.

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