Pelvic Floor Therapy
Pelvic Floor Therapy for Urinary Incontinence
Non-Surgical Pelvic Floor Rehabilitation with VTone by EmpowerRF™
Evaluate. Rehabilitate. Monitor.
Bladder leakage when you cough, sneeze, laugh, lift, or exercise is common — and it is not something you have to accept as a permanent consequence of childbirth or age. It is also not something to treat without first understanding what is causing it.
At Functional Healthcare of Omaha, pelvic floor therapy begins with an evaluation. Urinary incontinence has several distinct causes, and the right approach depends on which one is driving your symptoms. Some patients are appropriate candidates for in-office pelvic floor rehabilitation. Others need referral to a urogynecologist, pelvic floor physical therapist, or their primary care provider first — and we will tell you when that is the case.
What Is VTone Pelvic Floor Therapy?
VTone is an intravaginal applicator that delivers electrical muscle stimulation (EMS) and neuromuscular re-education to the pelvic floor muscles. It is part of the EmpowerRF™ platform by InMode.
VTone is FDA-cleared for intravaginal electrical muscle stimulation and neuromuscular re-education for the rehabilitation of weak pelvic floor muscles, for the treatment of stress, urge, and mixed urinary incontinence in women. That is the indication we treat for, and it is the indication this page describes.
The mechanism is straightforward. The pelvic floor is a group of muscles that supports the bladder, uterus, and bowel and contributes to urinary control. Pregnancy, childbirth, aging, prolonged inactivity, and hormonal change can weaken these muscles or disrupt their firing patterns. Voluntary Kegel exercises work for many women, but a substantial proportion perform them incorrectly, and some cannot generate a meaningful contraction on their own. EMS produces controlled contractions without requiring you to initiate them, which allows the muscle to work and to re-learn the pattern.
A small, single-use applicator — comparable in size to a tampon — is placed in the vaginal canal and delivers the stimulation. Sessions run roughly 20 to 30 minutes, and a series is typically recommended rather than a single treatment.
What This Treatment Does Not Address
Pelvic floor rehabilitation addresses muscle weakness and coordination. It does not address every cause of urinary leakage.
Incontinence can also result from pelvic organ prolapse, neurologic conditions, medication effects, urinary tract infection, diabetes, bladder or pelvic masses, or fistula. Some of these require diagnosis and treatment that this therapy cannot provide, and some require prompt medical evaluation. Blood in the urine, new or worsening pelvic pain, recurrent infections, or sudden onset of incontinence should be evaluated by a physician before any elective treatment.
Part of your evaluation is determining whether pelvic floor rehabilitation is the right answer for you, or whether you need something else first.
Why Pelvic Floor Weakness Develops
Pelvic floor symptoms rarely come from a single cause. Contributing factors often overlap:
Pregnancy and childbirth.
Carrying a pregnancy and vaginal delivery both place sustained load on the pelvic floor and can stretch or injure the supporting muscles and connective tissue.
Muscle weakness and loss of coordination.
Muscles can weaken or lose their normal firing pattern after childbirth, with age, or with prolonged inactivity.
Hormonal change.
Declining estrogen during perimenopause and menopause affects tissue in the pelvic region.
Chronic strain.
Chronic cough, repeated heavy lifting, constipation and straining, and higher body weight all increase load on the pelvic floor over time.
Your evaluation looks at which of these apply to you and whether any of them should be addressed alongside, or instead of, in-office treatment.
Your Consultation
Every treatment plan begins with an evaluation. During your initial consultation, your provider will:
- Review your symptoms in detail, including when leakage occurs and what triggers it
- Take a complete medical, obstetric, gynecologic, and surgical history
- Review current medications, since several contribute to urinary symptoms
- Perform a pelvic health assessment, if appropriate and with your consent
- Discuss whether pelvic floor rehabilitation is appropriate, whether other evaluation is needed first, and what alternatives exist
- Outline a plan, including the number of sessions anticipated
Alternatives will be discussed with you.
Supervised pelvic floor physical therapy, behavioral and bladder training, weight management, treatment of contributing conditions, pessary fitting, prescription medication, and surgical options all exist and may be more appropriate depending on your situation. This treatment is one option among several, not the only one.
Who Is Not a Candidate
Not all patients are candidates for VTone pelvic floor therapy.
This treatment is not appropriate for patients who:
- Are pregnant or may be pregnant
- Have a cardiac pacemaker, implanted defibrillator, or any implanted electrical or electronic device
- Have an active urinary tract, vaginal, or pelvic infection
- Have undiagnosed vaginal bleeding
- Have a known or suspected gynecologic malignancy, or are undergoing evaluation for one
- Are within the early postpartum period, before clearance from their obstetric provider
- Have an intrauterine device or other implant, depending on type and location — this requires individual review
- Have significant pelvic organ prolapse, which may require surgical or specialist evaluation instead
- Have impaired sensation in the pelvic region, or a neurologic condition affecting the area
- Have a history of pelvic radiation
This list is not exhaustive. Your provider will review your complete history to determine whether treatment is appropriate for you.
Risks
Pelvic floor therapy using an energy-based device is a medical procedure and carries risk.
Reported risks include discomfort or pain during or after treatment; irritation, redness, or swelling of vaginal tissue; muscle soreness; infection; bleeding or spotting; and, with energy-based devices used in this region, burns, blistering, scarring, numbness, altered or reduced sensation, pain during intercourse, and pain that recurs or becomes persistent.
The FDA has received adverse event reports involving energy-based devices used in the vaginal region, including reports of pain, burning, and numbness that lasted long-term. These risks will be reviewed with you before treatment begins, and you should raise any concern with your provider at any point during a series.
Individual responses vary. Some patients experience meaningful improvement in urinary symptoms; some experience partial improvement; some experience none. No specific outcome can be promised.
Contact the clinic promptly if you develop worsening pelvic or vaginal pain, burning, new numbness or altered sensation, unusual discharge, bleeding, fever, or pain with intercourse following treatment.
What Happens During Treatment
Every session takes place in a private treatment room, with a drape, and with attention to your comfort and modesty. No anesthesia is required. You remain clothed apart from what is necessary for placement of the applicator.
Positioning You are positioned on an exam table, similar to a routine gynecologic exam. Your provider explains each step and confirms you are ready before beginning.
Treatment A small, single-use, lubricated applicator is placed in the vaginal canal. It delivers controlled electrical muscle stimulation, producing rhythmic contraction and relaxation of the pelvic floor muscles. Most patients describe the sensation as unfamiliar at first rather than painful. Tell your provider immediately if anything is uncomfortable — the intensity is adjustable, and it should not hurt.
Completion The applicator is removed and you can dress and leave. Most patients return to normal activity the same day. You may notice mild muscle awareness for a few hours, similar to after exercise.
Aftercare You will receive written aftercare instructions, including what to watch for and when to contact the clinic.
Total session time is approximately 20 to 30 minutes.
Treatment Timeline
- Sessions typically last 20 to 30 minutes
- A series is recommended rather than a single session; your provider will specify the number based on your evaluation
- Change, where it occurs, develops gradually over the course of a series rather than immediately
- Periodic maintenance may be recommended
- Continued pelvic floor exercise at home is generally part of the plan
Individual experiences vary, and results are not guaranteed.
How Much Does Pelvic Floor Therapy Cost?
Cost depends on the number of sessions in your individualized plan. Because that number is determined during evaluation, we do not publish pricing.
Your provider will outline the recommended number of sessions, the expected timeline, and total cost before you begin. You will not be asked to purchase a series before an evaluation has determined that treatment is appropriate for you.
Why Functional Healthcare of Omaha?
- Evaluation before treatment, including screening for causes this therapy does not address
- Treatment performed by licensed medical professionals trained on the platform
- Alternatives discussed openly, including referral when that is the better path
- Private, dedicated treatment space
- Integrated with functional health assessment where relevant
We are not here to sell you a package. We are here to evaluate what is actually causing your symptoms, and to treat only when this is the right tool for it.
Frequently Asked Questions
What is VTone pelvic floor therapy?
VTone is an intravaginal applicator that delivers electrical muscle stimulation and neuromuscular re-education to rehabilitate weak pelvic floor muscles. It is FDA-cleared for the treatment of stress, urge, and mixed urinary incontinence in women.
Is this FDA approved?
VTone is FDA-cleared, which is the regulatory pathway for most medical devices and is distinct from FDA approval. Clearance means the device was found substantially equivalent to a legally marketed predicate device for its stated indication. Its cleared indication is pelvic floor muscle rehabilitation for stress, urge, and mixed urinary incontinence in women.
Can this help with urinary incontinence?
It is cleared for that indication, and it is the reason we offer it. Whether it will help you depends on what is causing your leakage, which is what the evaluation determines. Not all incontinence stems from pelvic floor muscle weakness.
What causes bladder leakage?
Common contributors include pelvic floor muscle weakness or poor coordination, pregnancy and childbirth, hormonal change, chronic strain from cough or heavy lifting, and body weight. Leakage can also result from pelvic organ prolapse, neurologic conditions, infection, medication effects, diabetes, and other causes that require separate evaluation.
Who is not a candidate?
This treatment is not appropriate during pregnancy, or for patients with a pacemaker or other implanted electrical device, an active urinary or vaginal infection, undiagnosed vaginal bleeding, known or suspected gynecologic cancer, significant pelvic organ prolapse, impaired pelvic sensation, or a history of pelvic radiation, among other factors. Recent childbirth requires clearance from your obstetric provider. Candidacy is determined by individual evaluation.
What are the risks?
Reported risks include discomfort or pain, tissue irritation, muscle soreness, infection, bleeding or spotting, and — with energy-based devices used in this region — burns, blistering, scarring, numbness, altered sensation, pain during intercourse, and pain that recurs or persists. The FDA has received adverse event reports of long-term pain, burning, and numbness following energy-based procedures in the vaginal region.
Does treatment hurt?
It should not. Most patients describe rhythmic muscle contraction that feels unfamiliar rather than painful. Intensity is adjustable, and you should tell your provider immediately if anything is uncomfortable.
How long does treatment take, and is there downtime?
Sessions run about 20 to 30 minutes. Most patients return to normal activity the same day. Some notice mild muscle soreness for a few hours.
How many sessions will I need?
This is determined during your evaluation and varies by patient. A series is standard rather than a single session.
What results can I expect?
We do not promise a result. Some patients experience meaningful improvement in urinary symptoms, some partial improvement, and some none. Response depends heavily on the underlying cause of your symptoms.
What if this isn't the right treatment for me?
Then we will say so and help you find what is. Depending on your evaluation, that may mean supervised pelvic floor physical therapy, referral to a urogynecologist or urologist, evaluation by your primary care provider, or another approach.
Do you accept insurance?
This is a self-pay service. Costs are reviewed with you before you begin.
Medical Disclaimer
The content on this page is provided for general educational purposes only and does not constitute medical advice.
VTone is a medical device FDA-cleared for intravaginal electrical muscle stimulation and neuromuscular re-education for the rehabilitation of weak pelvic floor muscles, for the treatment of stress, urge, and mixed urinary incontinence in women. FDA clearance is not FDA approval.
The U.S. Food and Drug Administration has not cleared or approved any energy-based device for vaginal “rejuvenation,” for cosmetic vaginal procedures, or for the treatment of vaginal laxity, vaginal dryness or atrophy, symptoms related to menopause, or sexual function. Functional Healthcare of Omaha does not offer or market treatment for those indications.
Pelvic floor therapy is a medical procedure and carries risk, including discomfort or pain, tissue irritation, infection, bleeding, and — with energy-based devices used in this region — burns, blistering, scarring, numbness, altered sensation, pain during intercourse, and pain that recurs or persists. Contraindications and risks are outlined above and reviewed with you before treatment begins.
Not all patients are candidates. Urinary incontinence has multiple causes, some of which require medical diagnosis and treatment that this therapy does not provide. Candidacy is determined by individual evaluation.
Individual results vary and no specific outcome is promised or guaranteed. This service is self-pay and is not a substitute for medical evaluation, diagnosis, or treatment. Always consult your physician regarding any health concern.