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Bladder and bowel (pelvic floor) rehabilitation

Overview

The bladder and bowel (pelvic floor) rehabilitation services at the Centre for Rehabilitation Medicine provide comprehensive therapy to individuals with dysfunction in muscles related to bladder and bowel functions (pelvic floor muscles). Often, for reasons apart from ageing, the pelvic floor muscles tend to tighten, be weakened, or cause pain. Such issues often begin with pregnancy and childbirth in women and prostate-related problems in men and commonly affect young athletes.

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  • Conditions we treat
  • Urinary and/or faecal incontinence
  • Urgency, retention, hesitation, and frequency of urine and faeces
  • Pelvic organ prolapse (when one or more pelvic organs drop from their position)
  • Pain during urination or defecation
  • Dyspareunia (painful intercourse)
  • Neurogenic bladder
  • Chronic pelvic pain syndrome
  • Constipation

Our Programmes

Manual therapy for pelvic floor problems aims to lengthen, mobilise, and relax the pelvic floor, and ultimately, provide relief from pain. Manual therapies often include internal vaginal or rectal techniques and/or extrinsic techniques to relax ligaments, tendons, muscles, fascia, joints, and nerves.

Based on each patient’s specific needs, we use many manual techniques, such as deep-tissue massages, myofascial release, soft-tissue/urogenital/joint/nerve mobilisations, muscle energy techniques, trigger point pressure, and connective tissue manipulation.

Bladder and bowel retraining allows patients to:

  • Understanding bladder and bowel function
  • Using techniques for strengthening bladder and bowel control
  • Dissemination of advice regarding diet and fluid intake
  • Using bladder and bowel diaries

Biofeedback is a highly beneficial technique that can help improve the connection between the muscles of the bladder and bowel and their function. It is also useful for retraining weak or overactive muscles to improve muscle control and activation during functional activities. Biofeedback treatment may be provided with the help of a machine or manually depending on the case.

Muscle electrostimulation can enhance muscle awareness, improve the function of weak pelvic floor muscles, and assist muscle strengthening. Other electrotherapy modalities used for treating an overactive bladder and relieving pain include transcutaneous electrical stimulation and ultrasonography.

The patients and their families are taught progressive exercises that are monitored and customised at frequent intervals by the physiotherapist.  

Goals of therapy  

  • To relieve the symptoms related to bladder and bowel dysfunction, improve functionality, and decrease pain  
  • To help the patient achieve optimal independence, restore function, and prevent disability  
  • To help the patient live the most active lifestyle possible, including returning to work activities and resuming their normal home and recreational routines

We offer comprehensive information to the patients and their families’ education regarding the condition. This includes guidance regarding specific lifestyle changes, avoiding exposure to irritants, dietary/fluid modifications, and other methods for behavioural changes.

Rehabilitation Team

Our multi-speciality healthcare team combines their expertise to create the best possible treatment programmes. Our team consists of the following personnel:

  • Physicians
  • Physical therapists
  • Speech and language therapists
  • Biomechanists (researchers who study the structure, function, and motion of biological systems)
  • Rehabilitation psychologists
  • Rehabilitation nurses
  • Pain management specialists
  • Nutritionists
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