Medicare now pays for pelvic floor therapy for some elderly and disabled patients.

The policy change will help some of the 18 million men and women affected by urinary incontinence (UI), the sudden and involuntary loss of bladder control. Levels of reimbursement may vary and criteria must be met to qualify, according to the Centers for Medicare and Medicaid Services (CMS), the organization that administers Medicare, formerly named the Health Care Financing Administration. Previously uncovered therapies such as pelvic floor electrical stimulators (PFES) are now covered for the treatment of UI in patients that have failed a medically documented trial of pelvic muscle exercise (PME) training.

According to Hollister Inc., a PFES manufacturer based in Illinois, studies show that while 80 percent of UI patients can be cured or improved by techniques such as pelvic floor therapy, less than one-third of those afflicted are aware of treatment options other than drugs or surgery.

What is pelvic floor therapy?

The pelvic floor is composed of an overlapping series of muscles that form a sling that holds the pelvic organs in place. Frequently, these muscles are weakened by childbirth, hormonal changes prior to menopause, and being overweight. Signs of muscle weakness may be an uncomfortable feeling of pressure or heaviness in the bladder or the leaking of urine when coughing, laughing, sneezing, running, or exercising.

Pelvic floor therapy aims at strengthening the pelvic floor muscles and decreasing episodes of UI. They include:

• Biofeedback: Uses a small machine to measure muscle tone that offers a pitched, audible sound to help patients to identify and contract the proper muscle areas. This can eventually be done at home, after proper training.

• Pelvic muscle exercise (PME): Simple exercises that strengthen the perineal muscles located around the urinary tract opening.

• Pelvic floor electrical stimulator (PFES): Uses electrical stimulation and biofeedback to help patients who don't respond well to PME learn to isolate and exercise their pelvic floor muscles.