Foundation Physical Therapy 

"Getting Results"

Urinary Incontinence Program

 

Physical Therapy can help......

 

 Urinary Incontinence

Did you know there are between 13 and 33 million Americans who suffer from incontinence? 30-40% of people over 60 years old have urinary incontinence. Actually, 1 out of every 6 women over 45 has urinary incontinence. So, it's a common condition that you don't need to be embarrassed about.

     Exactly what is urinary incontinence? Incontinence is the involuntary loss of urine that can occur when exercising, coughing, sneezing or just laughing. People lose urine when coughing, sneezing and laughing because the muscle tone in the abdominal muscles is greater that the muscle tone in the muscles that control the urine. Urine is usually lost in small amounts but it can be a continuous stream or a complete leakage. What causes urinary incontinence?  See below for Men and Women and why they experience UI.

 

 Women with Urinary Incontinence

Millions of women experience involuntary loss of urine called urinary incontinence (UI). Some women may lose a few drops of urine while running or coughing. Others may feel a strong, sudden urge to urinate just before losing a large amount of urine. Many women experience both symptoms. UI can be slightly bothersome or totally debilitating. For some women, the risk of public embarrassment keeps them from enjoying many activities with their family and friends. Urine loss can also occur during sexual activity and cause tremendous emotional distress.

Women experience UI twice as often as men. Pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference. But both women and men can become incontinent from neurologic injury, birth defects, stroke, multiple sclerosis, and physical problems associated with aging.

Older women experience UI more often than younger women. But incontinence is not inevitable with age. UI is a medical problem. Your doctor or nurse can help you find a solution. No single treatment works for everyone, but many women can find improvement without surgery.

Incontinence occurs because of problems with muscles and nerves that help to hold or release urine. The body stores urine—water and wastes removed by the kidneys—in the bladder, a balloon-like organ. The bladder connects to the urethra, the tube through which urine leaves the body.

During urination, muscles in the wall of the bladder contract, forcing urine out of the bladder and into the urethra. At the same time, sphincter muscles surrounding the urethra relax, letting urine pass out of the body. Incontinence will occur if your bladder muscles suddenly contract or the sphincter muscles are not strong enough to hold back urine. Urine may escape with less pressure than usual if the muscles are damaged, causing a change in the position of the bladder. Obesity, which is associated with increased abdominal pressure, can worsen incontinence. Fortunately, weight loss can reduce its severity.

 

Men with Urinary Incontinence

Men can experience urinary incontinence as a result of having or being treated for prostrate conditions.  The prostate is a male gland about the size and shape of a walnut. It surrounds the urethra just below the bladder, where it adds fluid to semen before ejaculation.

·         BPH: The prostate gland commonly becomes enlarged as a man ages. This condition is called benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy. As the prostate enlarges, it may squeeze the urethra and affect the flow of the urinary stream. The lower urinary tract symptoms (LUTS) associated with the development of BPH rarely occur before age 40, but more than half of men in their sixties and up to 90 percent in their seventies and eighties have some LUTS. The symptoms vary, but the most common ones involve changes or problems with urination, such as a hesitant, interrupted, weak stream; urgency and leaking or dribbling; more frequent urination, especially at night; and urge incontinence. Problems with urination do not necessarily signal blockage caused by an enlarged prostate. Women don’t usually have urinary hesitancy and a weak stream or dribbling.

·         Radical prostatectomy: The surgical removal of the entire prostate gland—called radical prostatectomy—is one treatment for prostate cancer. In some cases, the surgery may lead to erection problems and UI.

·         External beam radiation: This procedure is another treatment method for prostate cancer. The treatment may result in either temporary or permanent bladder problems.

If you have any of the following symptoms you could be dealing with urinary incontinence: 1) Frequent urge to urinate even when the bladder is not full. 2) Frequent trips to the bathroom at night. 3) Involuntary loss of urine that can occur while exercising, coughing, sneezing or laughing. 4) Difficulty going out for a length of time during the day for fear of frequent bathroom use. 

 

Treatment  Options

     If you have experienced any one of these conditions, we here at Foundation Physical Therapy can help. Physical therapy can increase the strength in the "Pelvic Floor Muscles" that control the sphincters used for urine and feces control.

Biofeedback is used as an auditory and visual tool to see if you have weakness in the pelvic floor muscles. Biofeedback is a monitoring tool of a specific physical activity by monitoring the electrical activity of the muscle. In the case of urinary incontinence, it is monitoring the pelvic floor muscles by producing a graph on a hand held unit or by producing a sound. It gives a person feedback of muscle activity or lack of muscle activity of the pelvic floor muscles. The patient is evaluated with the biofeedback unit to see a baseline of muscle strength so improvement can be checked regularly. Biofeedback is also used as a treatment tool, and there is a home biofeedback unit that can be used to guide muscle strengthening. 

     The act of urinating should be at least 8 seconds, and urinating in less that time is a sign that you really don't need to urinate. This condition can interfere with being away from home for any length of time. As with pelvic floor muscle weakness, with the use of biofeedback, a physical therapist can teach patients simple exercises that will retrain the bladder.

     There really is help for anyone suffering with urinary and fecal incontinence. We can help you to resume a normal functional lifestyle of work, exercise and play without fear of urinary/fecal problems. Physical therapy treatment plans for urinary/fecal incontinence is non-invasive, does not have any significant side effects, it affordable when compared to other alternatives and it covered by most insurances. Improvement can be seen within four weeks with daily exercises and attending Physical Therapy one time a week. The patient will begin to notice less urine leakage, less urge to urinate, and overall improvement in quality of life. Call your physician today and get a referral to set up an appointment. Once you make sure that you are medically cleared, have your physician write a prescription for us to evaluate and treat urinary incontinence. There is absolutely no reason for anyone to limit their lifestyle or fear any social embarrassment.

If you want to learn more, call (727) 784-6088 and ask for Gina Parsonis, PT, DPT, MTC