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The Center for Pelvic Floor Diseases of the Western Pennsylvania Hospital
Pelvic floor diseases, although common, are not a part of the aging
process. Individuals over the ages of 40 experience pelvic floor disorders
most frequently, with incontinence of urine or stool and pelvic pain.
Although pelvic floor diseases are sometimes caused by nerve conditions or
spinal cord trauma, most often, they result from stresses on the pelvic
floor muscles secondary to aging, vaginal childbirth and other conditions.
Pelvic floor diseases can devastate a person’s quality of life creating
discomfort and embarrassment. Indeed, fecal incontinence has made many
people captives in their own home. However, following an initial
evaluation, many conditions can be treated painlessly in an outpatient
setting through the use of medications, biofeedback, pelvic floor
exercises, and behavioral modification. In some cases, surgery is needed
to repair muscles located between the rectum, vaginal canal and urethra or
to treat underlying conditions.
The Center helps patients suffering from a variety of pelvic floor
diseases, such as fecal or urinary incontinence, pelvic pain, cystocele,
rectal prolapse, rectocele and enterocele as well as bladder incontinence
or uterine prolapse. Th state-of-the-art facility offers testing
unavailable at other sites such as anal electromyography, transanal/transrectal
ultrasound, biofeedback, anorectal manometry, Pudendal Nerve Terminal
Motor Latency and endoscopy.
The Center combines the most technologically advanced and effective
treatments for pelvic floor diseases with the utmost in compassion and
care to individually improve the quality of life for each patient. The
biofeedback center is the most advanced in the region.
1. Electromyography (EMG)
-EMG is a painless procedure that utilizes two small surface electrodes
that measure strength and electrical activity of muscles. It allows
physicians to determine whether the nerves that are within an individual’s
sphincter muscle are intact.
2. Pudendal Nerve Terminal Motor Latency Testing
-Pudendal Nerve terminal testing is a way to test function of a nerve
involved in having a bowel movement. It measures the electrical activity
of the nerves within an individual’s sphincter muscle.
3. Biofeedback
-Biofeedback is an important component of treating pelvic floor
syndromes and urinary or fecal incontinence, providing patients with
specific information regarding pelvic floor muscles. By placing a small
sensor on the muscle being monitored, biofeedback devices can detect the
electrical activity of the pelvic muscles. Once the sensor is in place, it
is connected to a computer which changes the electrical activity of the
muscles into a signal that can be seen or heard on the computer screen.
A trained physician assistant directs the biofeedback session.
4. Transanal/Transrectal ultrasound
-Transanal/transrectal ultrasound is a painless procedure that utilizes
an ultrasound probe to evaluate the pelvic floor muscles. It uses high
frequency sound waves to create images of tissue layers beneath the
surface. The procedure is used to stage cancer or other lesions or to aid
in the treatment of an abscess or fistula.
5. Flexible Sigmoidscopy
-The Flexible sigmoidoscopy is a procedure that enables the physician
to examine the lining of the rectum and colon by inserting a flexible tube
and advancing it through the lower part of the colon. Biopsies or
treatments may be conducted at the initial screening.
6. Anorectal Manometry
-Anorectal manometry is a painless procedure that measures the overall
strength of the pelvic floor muscles and rectal reflexes. The test is
performed by placing a thin catheter, perfused by water, into the anus.
Pressure monitors inside the catheter transmit the muscle impulses to a
graph similar to an electrocardiogram. This is a painless procedure that
takes approximately ten minutes to perform.
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