What is the role of pelvic floor physical therapy in continence care?

• A. Strengthen/coordinate pelvic floor muscles, improve urethral closure, reduce leakage; may include biofeedback
• B. Eliminate physical therapy completely
• C. Increase detrusor contraction
• D. Replace bladder training

Answer: (A)

Training and coordinating the pelvic floor muscles is the main way pelvic floor physical therapy improves continence. When these muscles are strong and can be activated at the right times, they help squeeze the urethra to keep urine in during activities that raise abdominal pressure, like coughing or sneezing, and they provide better support for the bladder neck. This combination reduces leakage and helps maintain contact of the urethra with its closing mechanism.

Biofeedback is often used because it helps you feel and see which muscles you’re contracting, ensuring you’re using the correct muscles and activating them with the right timing. This makes the exercises more effective and helps you translate them into everyday movements.

This approach is not about eliminating physical therapy, increasing detrusor (bladder muscle) contraction, or replacing bladder training. It’s about strengthening and coordinating the pelvic floor to support continence, often as part of a broader, multimodal plan that may include bladder training and behavioral strategies.