Pelvic Floor Rehabilitation
What is the Pelvic Floor?
The pelvic floor muscles are a crucial layer of muscles located within the pelvis, responsible for controlling urination and defecation. Healthy contraction of these muscles ensures controlled retention of urine and stool, while healthy relaxation allows for their proper expulsion from the body. Beyond controlling urination and defecation, the pelvic floor muscles also support the bladder, bowels, and reproductive organs during physical activities, maintaining their anatomical positions like a hammock.
Pelvic floor rehabilitation is a program of therapies and exercises designed to prevent or treat pelvic floor dysfunction in children. Its goal is to strengthen the pelvic floor muscles, increase their flexibility, and improve overall function. Techniques include urotherapy education (healthy bladder and bowel training), behavioral modification, biofeedback‐guided pelvic floor exercises, manual therapy (massage), breathing exercises, electrotherapy (e.g., TENS, posterior tibial nerve stimulation), and various strengthening and stretching exercises. Each child’s rehabilitation plan and session content are individually tailored based on their needs.
Pelvic floor rehabilitation can benefit children whose pelvic floor muscle function is compromised by congenital anomalies, inappropriate toilet training habits, prolonged urine or stool holding, behavioral issues, insufficient or excessive physical activity, and other factors. It is indicated for children experiencing:
- Daytime urinary incontinence
- Nighttime bedwetting (enuresis)
- Constipation
- Fecal incontinence
- Frequent urination
- Urgency (sudden strong need to void)
- Vesicoureteral reflux (VUR)
- Recurrent urinary tract infections
- Pelvic pain
- Overactive bladder
- Underactive bladder
- Giggle incontinence
- Neurogenic bladder and bowel
- Anorectal malformations
- Hirschsprungʼs disease
Children with any of these issues may be referred by their specialist for pelvic floor rehabilitation with a trained therapist.
Several factors influence the success of pelvic floor rehabilitation, including the child’s motivation, readiness to participate, and the family’s adherence to bladder and bowel training and home exercise programs. The severity and duration of symptoms also affect outcomes.
In clinical practice, appropriately selected children often experience significant reductions in bladder and bowel symptoms, even when medication alone was insufficient. The average success rate is around 80%, though this can vary depending on the child’s age, symptom severity, clinical course, and treatment adherence.
Research indicates that effective pelvic floor rehabilitation typically requires between 10 and 20 sessions. The exact number depends on factors such as symptom severity, the child’s engagement, and the family’s commitment to the treatment plan. Your therapist will recommend the appropriate number of sessions based on the initial evaluation and ongoing progress.
