title: Prospective Outcomes of a Pelvic Floor Rehabilitation Program Including Vaginal Electrogalvanic Stimulation for Urinary, Defecatory, and Pelvic Pain Symptoms.
abstract: This study evaluated our experience after implementing a pelvic floor rehabilitation program including behavioral modification, biofeedback, and vaginal electrogalvanic stimulation (EGS).
  
  
  
  This prospective cohort study evaluated outcomes of patients with pelvic floor dysfunction (urinary or defecatory dysfunction, pelvic pain/dyspareunia) who underwent pelvic floor rehabilitation. Patients received 4 to 7 sessions (1 every 2 weeks) including biofeedback and concluded with 30 minutes of vaginal EGS. Surveys assessed subjective changes in symptoms; success was evaluated using a 10-point visual analog scale (VAS) at the final session (10 = most successful). Paired comparisons of responses at baseline and final treatment were evaluated.
  
  
  
  Ninety-four patients were followed up through therapy completion. Treatment indications included urinary (89.4%), defecatory (33.0%), and pelvic pain or dyspareunia (30.9%); 44.7% of patients had a combination of indications. Among women with urinary symptoms, the percentage reporting leakage decreased from 92.9% to 79.3% (P = 0.001), leakage at least daily decreased from 69.0% to 39.5% (P < 0.001), daily urgency with leakage decreased from 42.7% to 19.5% (P = 0.001), daily urgency without leakage decreased from 41.5% to 18.3% (P < 0.001), and median VAS rating (0 = not at all, 10 = a great deal) of daily life interference decreased from 5 to 1.5 (P < 0.001). The median success ratings were 8, 8, and 7 for treatment of urinary symptoms, pelvic pain/dyspareunia, and bowel symptoms, respectively.
  
  
  
  An aggressive pelvic rehabilitation program including biofeedback with vaginal EGS had a high rate of self-reported subjective success and satisfaction and should be considered a nonsurgical treatment option in patients with pelvic floor dysfunction.
authors.affiliation: From the Divisions of *Gynecologic Surgery and †Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Schmitt
authors.forename: Ruchira
authors.initials: R
authors.lastname: Singh
authors.forename: Amy L
authors.initials: AL
authors.lastname: Weaver
authors.forename: Kristin C
authors.initials: KC
authors.lastname: Mara
authors.forename: Randina R
authors.initials: RR
authors.lastname: Harvey-Springer
authors.forename: Felecia R
authors.initials: FR
authors.lastname: Fick
authors.forename: John A
authors.initials: JA
authors.lastname: Occhino
mesh_terms: D001521:Behavior Therapy / Q000379:methods; D001676:Biofeedback, Psychology / Q000379:methods; D003131:Combined Modality Therapy / Q000379:methods; D004414:Dyspareunia / Q000534:rehabilitation; D004599:Electric Stimulation Therapy / Q000379:methods; D005081:Exercise Therapy / Q000379:methods; D005242:Fecal Incontinence / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D059952:Pelvic Floor Disorders / Q000534:rehabilitation*; D017699:Pelvic Pain / Q000534:rehabilitation; D011446:Prospective Studies; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000534:rehabilitation; D014621:Vagina