Non-Surgical Alternatives for Prolapse, Incontinence, & OAB

There are many types of pessaries available. They can be used to treat both prolapse and / or stress urinary incontinence. The pessary is the mainstay of non-surgical management
of pelvic prolapse. A Pessary is a silicone vaginal insert that holds prolapse in place. Certain types of pessaries are designed to obstruct the urethra during activity thereby
treating stress incontinence. Pessaries are available in many sizes and shapes. It is typically inserted and removed by the patient.

Pelvic Floor Physical Therapy and Behavioral Modification

Pelvic floor Physical Therapy and Behavioral Modification is often used in the treatment of a wide variety of Prolapse and Incontinence Conditions.

Behavioral Modification is habit training aimed to decrease symptoms related to a specific condition. Examples include:

• Timed Voids for urinary urgency and urge incontinence
• Dietary modification for chronic constipation
• Activity Modification for Pelvic Floor Dysfunction

Depending on the condition, Manual Therapy Techniques may be used including soft tissue mobilization, muscle energy techniques, myofascial release, trigger point manipulation, connective tissue manipulation and deep tissue massage.

Examples include:

• Pelvic floor strengthening to control Urinary Stress Incontinence.
• Strengthening the pelvic floor to alleviate the symptoms of pelvic organ prolapse.
• Myofascial release to decrease pelvic floor muscle tension.

Modalities include biofeedback, electrical stimulation, functional stimulation and ultrasound.

Treatment with a Physical Therapist is combined with a Home Exercise Program.