continence

Bladder and bowel incontinence is a prevalent problem that affects men and women of all ages and levels of health. Incontinence is a symptom, not a disease. It is often a result of weakness or nerve damage of the muscles of the pelvic floor from child birth, prostatectomy, low estrogen levels during or after menopause, urinary tract infection, or some medications.

The most common types of Urinary Incontinence are:

  • Stress incontinence: Urine leaks out during exercise, while laughing, lifting, coughing/sneezing, or during any activity that suddenly increases abdominal pressure, thereby placing pressure on the bladder. This is common after pregnancy, pelvic surgery, and during menopause. Studies have demonstrated that approximately one in three people who have stress incontinence are unable to correctly contract their pelvic floor muscles.
  • Urge incontinence: There is a sudden uncontrollable urge to void and the individual is often unable to make it to the bathroom in time. Urge incontinence is often associated with urinary tract infections, certain medications, stress, spinal cord injuries, multiple sclerosis, and neurological diseases.
  • Mixed incontinence: This is a combination of stress and urge incontinence. Left untreated, urinary incontinence can get worse. However, it is estimated that a large percentage of urinary incontinence can be greatly reduced or cured using conservative measures.

Bowel Dysfunctions include:

  • Constipation: This condition can occur due to pelvic floor muscle spasms resulting in the inability to have normal bowel movements. Spasms can be caused by surgery, injury, fissures, or hemorrhoids. Constipation can be treated using methods to relax pelvic floor muscles.
  • Fecal incontinence: Inability to control pelvic floor muscles can result in fecal incontinence. This can be a result of childbirth or anorectal surgery. This can be treated in similar ways as urinary incontinence.

We offer a non-operative treatment approach for women and men with bladder/bowel dysfunctions. Individualized treatment programs are developed utilizing numerous treatment techniques noted below.

Each patient undergoes a comprehensive evaluation. The evaluation consists of obtaining a detailed medical history and information regarding current treatment problem. In addition to evaluation of the pelvic floor musculature, lower extremity/trunk strength and flexibility will also be assessed. Based on the findings, a program is designed consisting of some of the following:

  • Pelvic floor muscle exercises, in which the patient contracts and relaxes specific pelvic muscles.
  • Biofeedback training uses a monitoring device to give the patient feedback as to the effectiveness of the contraction of the pelvic floor muscles. This can also be used to aid with relaxing the pelvic floor muscles.
  • Patient education in the following areas: fluid management, dietary considerations, good voiding habits.
  • Functional Electrical Stimulation (FES) is used to strengthen the pelvic floor muscles. This can be performed using external electrodes around the anal region or using internal electrodes placed in the vagina or rectum. FES can also be used to decrease urgency symptoms.
  • Bladder retraining and behavior modification teaches the patient to resist the initial urge to urinate. Using diaries for self-monitoring, habit training, and voiding schedules can help the patient with urge incontinence.