Acupuncture for Pelvic Floor Dysfunction

Acupuncture is an important mainstay of traditional Chinese medicine (TCM). Empirically derived by thousands of years of observation, Chinese medical doctors recorded their treatments almost 2000 years ago in the then modern text, Yellow Emperor's Book of Internal Medicine. Although the physiologic reasoning may seem bizarre to modern allopathic physicians, accepting and understanding the basic tenets does then provide a logical choice of therapy that has withstood the test of time,longer than...

Neurologic Evaluation of the Pelvic Floor

Pudendal Electromyography

Several elegant methods of neurophysiologic assessment of the anal and urethral sphincters exist. Their purpose is to help localize the site of neurologic pathology leading to the disturbance of bowel and bladder continence and evacuation. Although the clinical neurologic examination may sufficiently determine if the lesion involves the muscle or the nerve control to the muscle, a quantitative assessment of the disturbance by neurophysiologic means is often needed for clinical monitoring and...

Bowel Retraining for Constipation

The surgeon's first priority when faced with a patient complaining of constipation is to eliminate mechanical obstruction as the cause of the constipation. A complete history and physical examination should be performed. The history needs to focus on multiple factors, but specific attention should be given to the patient's medications as well as their diet and exercise regimen. If mechanical obstruction has not been ruled out before evaluation of the patient, this should be done either by...