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Incontinence and Pelvic Floor Dysfunction

WHAT IS INCONTINENCE?

Incontinence is the involuntary loss of urine (either a few drops, or enough to wet through clothing) resulting in social and/or hygienic problems.

According to the Department of Health and Human Services 10-25% of women between the ages of 15-64 experience problems with urinary incontinence.

Incontinence is not a disease. Correct diagnosis is essential for effective treatment. There are different kinds of incontinence and different causes.

STRESS INCONTINENCE refers to a condition where urinary leakage is provoked by the force of stress of coughing, sneezing, laughing, exercise and sometimes even walking. A contributing cause of stress incontinence is pelvic floor relaxation. Weakness of the pelvic floor muscles that surround the urinary sphincter, urethra, vagina and rectum is common in pelvic floor relaxation.

URGE INCONTINENCE (also known as "overactive bladder") refers to the condition where urinary leakage is provoked by strong and sudden urges with the need to go to the bathroom. Often people may make frequent trips to the bathroom for small amounts. Urges may be brought on by cold air, nervousness, or even by listening to running water.

OVERFLOW INCONTINENCE occurs from incomplete bladder emptying. Symptoms may include losing small amounts of urine frequently during the day and night or going to the bathroom frequently at night. The bladder may feel that it does not empty completely, and voiding may produce little urine.

HOW CAN URINARY INCONTINENCE BE TREATED?

Physical therapists traditionally design and direct exercise programs to strengthen muscles weakened by disuse or atrophy. These same principles are used in strengthening the pelvic floor.

Using an effective and specialized treatment approach, urinary incontinence can be dramatically improved and often even cured.

Our success rate is 80-90%. We find that success is not dependent upon age, just commitment to the program.

The specially trained Physical Therapists at FIRST CHOICE REHABILITATION SPECIALIST utilize state of the art technology and proven therapeutic strategies to develop an individual treatment plan that is sensitive to the concerns of the patient. Depending on the nature and extent of the pelvic floor problem, procedures such as biofeedback and neuromuscular reeducation exercise may be used. Patients receive a thorough evaluation and a home program is developed. Some may benefit from electrical stimulation of the pelvic floor muscles or home training devices.

WHAT IS PELVIC FLOOR DYSFUNCTION?

Pelvic floor dysfunction may relate to any problem with constipation, pelvic pain, vulvodynia, fecal incontinence, or even muscle weakness as in a "falling out sensation" or organ prolapse (i.e. cystocele, rectocele).

HOW CAN PELVIC PAIN BE TREATED?

Most often treatment is directed at relaxing muscle tension, restoring function and eliminating pain. Treatment techniques include biofeedback, manual therapy techniques, massage, electrical muscle stimulation and therapeutic exercises. Vulvodynia is usually characterized by an intense burning or itching. Therapy can be helpful in easing the discomfort and restoring normal muscular habits.

WHY IS POST SURGICAL THERAPY NEEDED FOLLOWING A BLADDER REPAIR OR HYSTERECTOMY?

Typically 2 or 3 treatment sessions may be all that is needed to ensure a better surgical outcome by reducing the risk of injury to a recent surgical procedure!

The primary concern following a pelvic operation is to protect the surgical procedure! The female anatomy is vulnerable to organ prolapse but most of the time problems are caused by weak, inaccessible muscles and detrimental pushing habits. Chronic constipation and failure to activate the pelvic brace are a prescription for surgical failure over time. Therapy is directed at teaching the patient to correctly perform a pelvic brace and properly use abdominals without pushing. A Bladder Journal Diary is utilized to educate the patient on proper fluid and fiber intake. Biofeedback may be used to aid in activation of poorly recruited pelvic floor muscles.