90912 Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when performed; initial 15 minutes of one-on-one physician or other qualified health care professional contact with the patient

Name of the Procedure:

Biofeedback Training, Perineal Muscles, Anorectal or Urethral Sphincter (including EMG and/or Manometry)

Summary

Biofeedback training for perineal muscles involves using electronic monitoring devices to help patients gain control over their anorectal or urethral sphincter muscles. This training helps individuals by providing real-time feedback on muscle activity. The initial session lasts for 15 minutes and involves direct contact with a physician or another qualified health care professional.

Purpose

Biofeedback training is used to improve muscle function and control in the anorectal or urethral area. The goals of the procedure include reducing symptoms such as incontinence, constipation, or pelvic pain and improving overall muscle strength and coordination.

Indications

• Urinary or fecal incontinence
• Chronic constipation
• Pelvic floor dysfunction
• Rectal pain
• Other urinary or bowel control issues

This procedure is appropriate for patients experiencing these symptoms who have not responded to more conservative treatments like lifestyle changes or medication.

Preparation

• Patients may be instructed to maintain a regular diet and hydration leading up to the procedure.
• Any necessary diagnostic tests, such as an initial physical exam, urodynamic studies, or manometry tests, should be completed beforehand.
• Patients should inform their healthcare provider of any medications they are taking, as adjustments may be required.

Procedure Description

1. The patient will be positioned comfortably, and sensors will be placed on the skin near the targeted muscles.
2. The procedure uses EMG sensors (electromyography) or manometry devices to measure muscle activity and tension.
3. The patient will be instructed to perform specific muscle contractions.
4. Feedback will be provided via a monitor, helping the patient understand how to modify muscle activity to achieve better control.
5. The healthcare professional will guide the patient through various exercises and techniques.

Duration

The initial session typically takes 15 minutes.

Setting

This procedure is usually performed in an outpatient clinic or a specialized medical facility equipped for biofeedback training.

Personnel

• Physician
• Qualified health care professionals such as physical therapists, nurses, or biofeedback specialists

Risks and Complications

• Minimal risks associated with the non-invasive nature of the procedure
• Minor skin irritation from sensor placement
• Anxiety or discomfort while learning to control muscles

Benefits

• Improvement in urinary and fecal incontinence symptoms
• Enhanced muscle strength and coordination
• Reduced pelvic pain and discomfort
• Improved quality of life, often visible within a few weeks of consistent practice

Recovery

• No significant recovery time required
• Patients may be advised to continue exercises at home for optimal results
• Follow-up appointments may be scheduled to monitor progress and adjust training as needed

Alternatives

• Medications for incontinence or bowel regulation
• Pelvic floor physical therapy without biofeedback
• Surgical options for severe cases
• Lifestyle changes including dietary adjustments and bladder training

Patient Experience

• The procedure is generally well-tolerated, with minimal discomfort.
• Patients may experience a slight learning curve as they adjust to controlling specific muscle groups.
• Any discomfort experienced can typically be managed with guidance from the healthcare provider.