Physiotherapy in urinary incontinence

Do you leak urine when you cough, sneeze, or laugh? Do you limit your time away from home, know where all the bathrooms are in the malls or workplaces, and always go 'just in case'?

Well you are not alone. One in every four women and one out of nine men experience incontinence, and there is a strong association between low back pain and pelvic symptoms — particularly urge or stress incontinence, which is the most common.

Seventy-four percent of people with incontinence do not seek help or too embarrassed to speak out and are unaware of the many treatment options available. They wrongly assume it is something they must live with. Physiotherapy treatment can be the rays of hopes for this unspeakable problem.

What is stress urinary incontinence?

Any activity that results in an increase in pressure in the abdominal cavity may contribute to stress urinary incontinence. This happens when pelvic floor muscles have been weakened and the bladder has slipped lower.

What are the causes?

The commonest cause of stress urinary incontinence is due to hyper mobility of the bladder neck and the proximal urethra, which results in the failure of transmission of the increased intra-abdominal pressure to the proximal urethra, preventing maintenance of closure of the urethra. But there are also some common precipitating factors like: pregnancy and vaginal delivery, repeated lifting of heavy objects ,prolonged coughing, obesity, repeated straining during urination or bowel movement and menopause.

Physiotherapy for stress urinary incontinence

* Pelvic Floor Exercises are prescribed to strengthen the pelvic floor muscles and may involve the use of vaginal cones and biofeedback. Here, Kegel exercise is the most effective .

* Electrical Stimulation Therapy makes use of electrical currents to strengthen pelvic floor muscles. It may be recommended if pelvic floor exercises have reduced effect.

* Bowel Movement Retraining teaches passing motion without straining the pelvic floor muscles.

 A qualified physiotherapist, who must have special training and education on women's health physiotherapy, will assess your condition through an assessment and a physical examination to measure the strength of your pelvic floor muscles.

Based on the findings, your physiotherapist will tailor therapy that best suits your needs and most of the cases the condition will improve within 1or 2 months.

The writer is a physiotherapist working at CRP Mirpur, Dhaka.

E-mail: maheenferdausi@yahoo.com