A Nonsurgical Treatment for Pelvic Pain

By Jane Farrell

Experts say that a nonsurgical option can be as good as medicine or sugery for women suffering from pelvic floor dysfunction, which includes bladder and bowel probems as well as pelvic pain.

 “Pelvic floor rehabilitation is effective in helping women overcome pelvic floor problems with little or no medication,” said Julie Starr, a doctoral student in the Sinclair School of Nursing and a family nurse practitioner at the University of Missouri Women’s Health Center. “The treatment involves muscle strengthening for improved bladder control and muscle relaxation for those with symptoms of constipation and pelvic pain.”

In their study, published in Female Pelvic Medicine & Reconstructive Surgery, Starr and other MU researchers analyzed data from nearly 800 women with symptoms of pelvic floor dysfunction who underwent the treatment. Patients who completed at least five comprehensive pelvic floor rehabilitation therapy sessions reported an average of 80 percent improvement in urinary incontinence, defecatory dysfunction and pelvic pain.

“We attribute the success of our program to patients’ regular contact with health care providers who provide biofeedback and vaginal electrogalvanic (e-stim) therapy as well as advice on behavior modification,” Starr said.

“The e-stim therapy, a painless treatment in which a stimulator is used to send electrical pulses to relax pelvic muscles, improves symptoms of bladder and bowel incontinence as well as pelvic pain and pain with intercourse. We rarely prescribe medications for these complaints; in fact, many women are able to stop taking their medications for bladder control and pain after therapy…A nurse practitioner who provides pelvic floor therapy will focus on decreasing all of the patients’ unpleasant pelvic symptoms instead of referring them to multiple providers.”

Many women take medicine to alleviate symptoms and don’t know that other treatment methods are available. Starr emphasized though, that “medication and surgical management are options that always will be available if pelvic floor rehabilitation does not provide the desired relief.”