New approach helps patients regain strength and function
The pelvic floor muscles, located at the base of your pelvis, play a crucial role in bladder control, bowel function, posture stability and sexual health. But some cancers, and therapies for them, can affect the way your pelvic floor muscles support you, and lead to pain, incontinence, constipation, sexual dysfunction and other challenges that greatly impact quality of life.
“Many cancer types and their associated treatments, such as surgery, chemotherapy, radiation and hormone therapy, can lead to issues affecting the pelvic floor muscles, nerves and surrounding structures,” explains Dr. Renée Genereux, PT, DPT, PRPC, a certified Pelvic Rehabilitation Practitioner at Roswell Park Comprehensive Cancer Center.
“Pelvic floor therapy is a specialized form of physical and occupational therapy designed to improve strength, function, and coordination of your pelvic floor muscles. It’s beneficial for people of every gender and for many conditions beyond cancer. But at Roswell Park we are uniquely trained to address pelvic floor dysfunctions related to cancer and its treatments.”
Ultrasound — a rehabilitative approach
Rehabilitative ultrasound at Roswell Park
“Pelvic floor therapy is an essential rehabilitative approach for oncology patients, helping to alleviate pain, restore function and enhance quality of life,” reiterates Dr. Genereux. Roswell Park is one of few centers using ultrasound as part of therapy.
Ultrasound imaging has been used for decades as an effective diagnostic tool. Using the ultrasound during pelvic floor therapy provides both the patient and therapist with direct visual feedback of anatomical structures. It also enables them to see how the deep pelvic muscles contract and relax in real time, which they are unable to otherwise see with the naked eye.
“The imaging allows for objective and efficient treatment planning from the therapist side. From the patient side, being able to see muscles working that they would never be able to see otherwise is considered a biofeedback treatment. This visual just connects the dots for a lot of patients and, from that point forward, they have a better understanding of what is happening within their body that is contributing to their symptoms,” explains Dr. Genereux.
“Being able to directly view how the muscles are working, or not working optimally, can greatly accelerate the patient’s recovery.”
How it works
Ultrasound imaging used during pelvic floor therapy is non-invasive and completed during your physical or occupational therapy session within the rehabilitation patient clinic. You will lay on your back with only your abdomen exposed as your therapist applies cold ultrasound gel to your stomach and places the probe on various spots on your abdomen, depending on what muscles are being assessed. “The patient just lies on their back, relaxed, and can enjoy the image on the screen!” Dr. Genereaux says.
Patients benefit from gaining an awareness of their pelvic floor muscles and how they work and learning how to control them in a way they were not previously aware of. “Gaining awareness of how to control and manipulate something within your own body is very powerful and instills confidence very quickly,” says Dr. Genereaux.
“Sometimes the ultrasound treatment will be beneficial but others may need more hands-on manual treatment to improve their pelvic symptoms. For example, for someone whose main complaint was related to pain, the ultrasound machine could be less impactful,” Dr. Genereaux advises.
Rehabilitation services at Roswell Park
Our rehab team encompasses both inpatient and outpatient services to provide physical and occupational therapy, designed for cancer patients and survivors of all ages — before, during and after cancer treatment.
What pelvic floor therapy can do for you
After talking with you about your symptoms and therapy goals, you and your therapist will develop a care plan together. However, not every patient evaluated and treated for pelvic floor dysfunction will need to use the ultrasound system.
In addition to ultrasound imaging as a treatment method, your therapist can provide you with pelvic floor exercises and lifestyle modifications to improve bowel and bladder control, as well as education, reassurance and coping strategies to improve confidence and daily functioning. Overall, the benefits of pelvic floor therapy for oncology patients include:
- Post-surgical rehabilitation to help restore muscle strength, coordination and function that may result from post-surgical complications following surgeries such as prostatectomy, hysterectomy or colorectal cancer procedures
- Relief from radiation and chemotherapy effects related to treatment for prostate, cervical or colorectal cancer that results in fibrosis, pain and tissue changes; and from hormone therapy that may cause vaginal dryness, pain and genitourinary symptoms, such as urine frequency, urgency and leaking
- Management of incontinence and constipation with exercises, biofeedback and lifestyle modification, and techniques such as manual therapy and relaxation exercises
- Addressing sexual dysfunction that may result in pain during intercourse and dysfunction or decreased libido that may result from treatment
- Lymphedema management through manual lymphatic drainage and specialized exercises for patients who have undergone lymph node removal or radiation
Rehabilitative ultrasound at Roswell Park
“Pelvic floor therapy is an essential rehabilitative approach for oncology patients, helping to alleviate pain, restore function and enhance quality of life,” reiterates Dr. Genereux. Roswell Park, she adds, is one of only two pelvic rehabilitation clinics in Western New York with the technology for using the ultrasound system for pelvic floor therapy.
