Urinary incontinence (UI) is the accidental and involuntary loss of urine. Ten million Americans suffer from this problem and both men and women of all ages can be affected. It is the second leading reason for admission of the elderly into nursing homes. While incontinence is common, it is not normal and can be treated by a medical team approach, including a physical therapist. The two most common types of UI are stress and urge incontinence.
Stress incontinence is the loss of urine during simple activities such as laughing, coughing, sneezing or sudden movements. These activities increase abdominal pressure and put pressure on the bladder, which can cause a loss of urine. Stress incontinence can be caused by weakness or damage to the integrity of the pelvic floor, hypermobility of the urethra, persistent or heavy straining, chronic coughing, neurological damage, and decreased estrogen during menopause. This is very common with women, especially those who have had children. Men frequently have incontinence following prostate surgery.
What are the causes of stress incontinence?
The muscles of the pelvic floor support the bladder and control the flow of urine. A loss of strength and coordination of pelvic floor muscles can lead to a loss of control. There are also medical conditions such as the dropping /or prolapse of the pelvic organs (the bladder, rectum and uterus) which will cause leakage as well.
Urge incontinence is defined as the involuntary loss of urine in conjunction with a strong desire to void. It is the result of bladder instability or irritability. People with this problem are not able to reach the bathroom in time, because they are unable to prevent the bladder from contracting. Frequently, simple everyday things bring on the urge such as running water, putting the key in the door when you first get home.
What are the causes of urge incontinence?
Possible causes of urge incontinence are neurological diseases (such as stroke, Multiple Sclerosis and Parkinson’s disease), and infection of the bladder or urethra. Irritability of the bladder can occur due to diet or medications. Pelvic floor muscle weakness often contributes to urge incontinence.
How do I know if physical therapy will help me?
Due to the complex nature of urinary incontinence, it is best to have a urological exam by your doctor to determine the cause of incontinence and to rule out other factors that might influence incontinence. If the doctor determines that therapy is appropriate, you will be evaluated by a physical therapist and an individual therapeutic program will be designed for you. In most cases, several follow-up sessions will be needed to assure your success. Significant results are usually obtained within 1-4 treatments. Please remember, all information about your care is confidential.
Your physical therapy program may include:
A custom home exercise program to address your specific needs
Personal instruction on correct lifting and moving techniques
Instruction in a bladder diary
Use of biofeedback equipment
Strategies to calm down the bladder and achieve normal voiding
Recommendations on food to avoid which are irritants to the bladder