There are various forms of urinary incontinence, and those caused by weakness of the pelvic floor muscles can often be treated by specifically strengthening these muscles. Since many affected individuals find it difficult to consciously activate the pelvic floor, combining pelvic floor training with biofeedback can be used as supportive therapy—especially in the initial phase, when the goal is to develop the correct sense of muscle control in the first place.
What biofeedback actually is
Biofeedback is used to visualize bodily functions that normally occur unconsciously. The method originally comes from psychology and is intended to help patients consciously perceive and control a specific bodily function. In incontinence therapy, special probes are used for this purpose, which are inserted either vaginally or rectally—similar to a tampon or a suppository. The probe measures the activity of the pelvic floor muscles and transmits the signal to a screen or provides acoustic feedback. This allows the contraction to be tracked in real time, and those affected learn to deliberately engage the correct muscles.
How strong is the evidence really?
As clear as the principle is, the evidence base is assessed rather soberly. The current S2k guideline “Urinary Incontinence in Women” and several systematic reviews consistently conclude that pelvic floor training with biofeedback offers no clear additional benefit in terms of quality of life and continence outcomes compared with well-instructed pelvic floor training without biofeedback. The key factor is regular, correct training for at least three months—this can significantly increase pelvic floor muscle strength and often markedly improve existing incontinence.
Biofeedback provides real added value primarily for two groups: first, people who initially cannot feel their pelvic floor at all; and second, after surgical procedures or childbirth, when sensation in this region has temporarily been lost. In these cases, biofeedback is a valuable learning aid—not as a long-term therapy, but as an entry point into sustained, independent training.
Key takeaways for those affected
If stress or urge incontinence is suspected, a medical evaluation is advisable before starting training. Physiotherapy instruction by a specialist with expertise in the pelvic floor significantly improves the chances of success—regardless of whether biofeedback is also used. Patience is an important factor: noticeable improvements usually occur only after several weeks of consistent training.
Sources
AWMF – S2k guideline “Urinary Incontinence in Women” (Registry No. 015-091, 2023): register.awmf.org/de/leitlinien/detail/015-091
AWMF – S2e guideline “Urinary Incontinence in Geriatric Patients” (Registry No. 084-001, 2024): register.awmf.org/de/leitlinien/detail/084-001
European Association of Urology (EAU) – Guidelines on Non-neurogenic Female LUTS: uroweb.org/guidelines/non-neurogenic-female-luts
German Continence Society – Information on urinary incontinence: kontinenz-gesellschaft.de
Herderschee R et al. – “Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women”, Cochrane Database of Systematic Reviews: cochranelibrary.com/CD009252
Urological Foundation for Health – Urinary incontinence in women: What is the benefit of biofeedback?: urologische-stiftung-gesundheit.de/harninkontinenz-frau
The content of this article is for general information purposes only and has been prepared with the utmost care based on recognized medical sources. It does not constitute a healing claim, diagnosis, or therapy recommendation and in no case replaces a personal consultation with a qualified physician. In case of doubt or persistent symptoms, please seek medical advice immediately. Medipee assumes no liability for decisions you make based on the information provided here.
