Physical Therapy is an Effective Treatment for Urinary Incontinence
Urinary incontinence (UI) is a common problem; it affects over 50% of women and almost 14% of men. Managing UI is inconvenient, difficult, and it also has a big impact on quality of life. Individuals with UI report depression, anxiety, poor health, social isolation, decreased physical activity, problems with sexual relationships, difficulty with getting jobs and decreased productivity at work. Although UI can be a stand alone disorder, it is often associated with a number of other medical and musculoskeletal conditions including pregnancy, pelvic pain and spine pain.
In many cases, individuals with UI do not seek intervention for the condition despite the significant impact on health and quality of life. In a study done last year, researchers looked at data from 599 men and women who answered “yes” to the following question on a physical therapy medical history intake form: “During the last three months, have you leaked urine (even a small amount)?” They found that of those reporting UI, only 44% were seeking care for UI; 52% were seeking care for spinal pain, pelvic pain or arm/leg disorders.
Risk Factors For Urinary Incontinence
There are several risk factors for UI include aging, smoking, obesity and consuming carbonated drinks. For women, there are the additional risk factors of pregnancy, delivery, episiotomy, maternal age (older than 30), more than three deliveries and in postmenopausal women weakness of pelvic floor muscles. For men, additional risk factors include pelvic floor muscle changes following prostate surgery.
Types of Urinary Incontinence
There are three types of UI: stress incontinence (SUI), urge incontinence (UUI) and mixed incontinence (MUI). SUI, the most common type, is involuntary leakage on effort or exertion such as when sneezing or coughing. This occurs because abdominal pressure with exertion overpowers the pelvic floor muscles. UUI is involuntary leakage with a feeling of urgency that occurs either just before or at the same time as the leakage. This is believed to be related to abnormal bladder contraction associated with external cues such as hearing the sound of running water. MUI is involuntary leakage with qualities of both SUI and UUI .
There are several options for treatment of UI, including bulking agents, medication, radiofrequency, surgery and pelvic floor muscle retraining (PFMT). PFMT is generally recommended as the first option for treatment of UI. It is low cost, non-invasive and effective, especially in the short term. Short term rates of cure/improvement have been reported to be as high as 97%. Long term benefits (> one year) have been more difficult to determine; they appear to be dependent on if the patient continues with their program of lifestyle changes and exercise.
PFMT should only be provided by physical therapists who have undergone specialized training. At New Heights Physical Therapy Plus, Marie Long, MSPT, COMT and Julie Burtis DPT, CMTPT begin with screening and evaluation. This includes a detailed history of UI, assessment of type and severity of UI and an internal exam if indicated. Treatment for PFMT is focused on education regarding anatomy and physiology, lifestyle and dietary changes and customized pelvic floor muscle exercise, but may also include biofeedback, electrical stimulation, manual techniques and trigger point therapy.
Physical Therapy is an Effective Treatment for Urinary Incontinence in Portland OR and Vancouver WA
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