Pelvic floor dysfunction can be caused by problems with the muscles supporting the pelvic floor or impairment of the sacroiliac joint, low back, coccyx and/or hip joint. The muscles of the pelvic floor as well as abdominal and and back are related to pelvic floor dysfunction. These muscle groups are often overlooked and can go un-diagnosed or un-treated for many years.

Carla Czervenny, PT

Carla, a native of Brazil, graduated from the University of Marilia in 1995 with a degree in Physical Therapy. She completed specialty training from the University of Sao Paulo, Brazil in the areas of CardioThoracic Surgery and ICU patient care in 1997. Her passion for physical therapy and what it affords the patients has been primarily in acute care setting treating a variety of complex conditions. Upon given the opportunity, Carla has embraced the opportunity to serve on a team of specialists treating disorders related to pelvic floor dysfunction, which requires an intense post graduate training for certification in treatment of incontinence, pelvic pain and other related disorders. Her caring nature serves as a great asset to the team of specialists at our center. Carla has been with the UTMB family since 2008 and will continue to serve the in-patient population on the main campus as well as pelvic floor patients at Victory Lakes and the main campus.

Starr Stanich, PT, MS

A graduate from the University of Kansas Medical Center in 1975 with a B.S. in Physical Therapy, she later received a Master of Science in Higher Education in 1981 from the University of Houston, Clear Lake. Starr has practiced Out Patient Rehabilitation in a variety of settings in Alabama and Texas with a specialization in Orthopedic disorders, Spinal Dysfunction, Chronic Pain and Manual Therapy. Her special interest in treatment of low back pain and its relationship to chronic pelvic pain and incontinence led her to the recent pursuit of certification in treatment of male and female incontinence, chronic pelvic pain and disorders that relate to medical management and rehabilitation of these pelvic floor disorders. Her contributions to the Women’s Health and Continence Center will be directed toward conservative approaches to treatment of these disorders as well as facilitating optimal post surgical recovery. She returned to UTMB in 2006 and currently serves as Clinical Supervisor of the UTMB Out Patient Rehabilitation Center located in Texas City, Texas.

Information about the Pelvic floor Rehabilitation Program:

• Our physical therapists will complete a thorough history and medical screening, which will include medical, surgical, gynecological, childbearing, diet, hobbies, exercise, and bladder symptom information.
• At your first appointment, You will be asked to keep a diary for two work and two nonworking days, consisting of symptoms, number of voids or wet episodes, related activities, amount lost, perception of need to urinate, observation, dietary and fluid intake, personal attitude, and physical limitations related to incontinence. The physical therapist will conduct (1) a musculoskeletal exam for posture, breathing, flexibility, and strength; (2) an abdominal exam for strength and scar tissue; and (3) a pelvic floor exam for skin condition, sensation, and muscular strength. You may be asked to contract and relax your pelvic floor muscles, bear down, or cough, as well as have your reflexes and pain response checked. The physical therapist will do an EMG test using biofeedback to determine the quality of your pelvic floor to contract, sustain a contraction, and relax following a contraction. If you are not comfortable with the procedure, feel free to share this with your therapist, who will find alternative ways to help you feel more at ease with the evaluation or treatment.
• The therapist will determine from your individual signs and symptoms what modalities and exercise will be the most helpful for your condition. A treatment plan will be developed and reviewed by you and the physicians involved in your care. Your input and commitment to this plan will be vital in reaching a successful outcome. Treatment sessions last 45 minutes to one hour and are usually scheduled 1 time a week for 4-8 weeks. Treatment possibilities most commonly used in pelvic floor rehabilitation include behavioral modification, dietary counseling, modalities such as biofeedback, neuromuscular electrical stimulation (NMES) and ultrasound. Manual therapy may also be of value along with other traditional therapeutic modalities to address chronic pain or spinal conditions that may be contributing to your current medical condition. Strengthening exercises for the pelvic floor are of vital importance for most patients, beginning with non-functional activities, such as lying down, progressing to functional activities like walking, climbing and lifting.