According to the National Institute of Diabetes and Digestive and Kidney Diseases, more than 13 million US citizens have incontinence.
Urinary incontinence is the leakage of urine at inappropriate times. With incontinence, you may have trouble starting the urine stream or holding urine when you feel a strong urge to go.
Urinary incontinence involves the muscles of the pelvic floor. These muscles attach to the bottom of the pelvic bones and run front to back, forming a bowl-like structure that lifts to support the internal organs and controls the sphincter muscles. The pelvic-floor muscles also help support the low back, stabilize the pelvic bones, and help with sexual function. Women are more likely than men to have urinary incontinence, but men can have it, too.
There are different types of incontinence:
Stress incontinence usually results from weakness and lack of support in the pelvic-floor muscles. It can happen with laughing, sneezing, or coughing or with exercise or activities such as lifting. Women with stress incontinence often have “underactive” pelvic floor muscles as a result of:
After delivery, women also can have fecal incontinence (leakage of stool) if there was tearing of the vaginal opening that extends to the anal sphincter.
With urge incontinence, you may or may not have pelvic-floor muscle weakness or pelvic muscle tension or spasm.
In functional incontinence, the cause isn’t related directly to the bladder or pelvic-floor muscles:
You can also have an “overactive bladder” where your bladder empties frequently throughout the day (more than every 3 or 4 hours during the day) or makes you get up more than once to urinate at night. There is a variety of causes, such as sensitivities to certain foods or beverages.
Your physical therapist will perform an examination to identify the causes of your urinary incontinence. Your therapist also will determine whether you should be referred to a physician for additional tests.
Based on the evaluation results, your physical therapist will individualize treatments to strengthen your pelvic-floor muscles and improve their function. Your physical therapist can help you:
Your physical therapist will show you how to “find” the right muscles and use them correctly. Using pelvic-floor exercises, the therapist will help you strength those muscles so that you can better control your bladder.
Your physical therapist will:
Depending on your symptoms and level of discomfort, your physical therapist may decide to use biofeedback to make you aware of how your pelvic-floor muscles work and how you can control them better. Electrodes attached vaginally or rectally will provide measurements of muscle activity and display them on a monitor, and the therapist will work with you to help you understand and change those readings. The therapist also may use electrical stimulation to improve your awareness of your muscles and increase muscle strength.
Your physical therapist can provide information about:
All physical therapists are prepared through education and experience to treat a variety of conditions or injuries. You may want to consider:
You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.
General tips when you’re looking for a physical therapist (or any other health care provider):
The American Physical Therapy Association (APTA) believes that consumers should have access to information that could help them make health care decisions and also prepare them for their visit with their health care provider.
The following articles provide some of the best scientific evidence about treatment of urinary incontinence. The articles report recent research and give an overview of the standards of practice for treatment both in the United States and internationally. The article titles are linked either to a PubMed abstract of the article or to free full text, so that you can read it or print out a copy to bring with you to your health care provider.
Borello-France D, Burgio KL, Goode PS, et al. Adherence to behavioral interventions for urge incontinence when combined with drug therapy adherence rates, barriers, and predictors. Phys Ther. 2010;90:1493–1505.
Borello-France DF, Downey PA, Zyczynski HM, Rause CR. Continence and quality-of-life outcomes 6 months following an intensive pelvic-floor muscle exercise program for female stress urinary incontinence: a randomized trial comparing low-and high-frequency maintenance exercise. Phys Ther. 2008;88:1545–1553. Free Article
Burgio KL, Goode PS, Urban DA, et al. Preoperative biofeedback assisted behavioral training to decrease post-prostatectomy incontinence: a randomized, controlled trial. J Urol. 2006;175:196–201. Article Summary on PubMed
Quartly E, Hallam T, Kilbreath S, Refshauge K. Strength and endurance of the pelvic floor muscles in continent women: an observational study. Physiotherapy. 2010;96:311–316. Article Summary on PubMed
This medicine works by relaxing muscles in the airways to straighten breathing. Many patients order online such medicaments like Viagra. In our generation many patients search for the exact keyword ‘azithromycin 250mg tablets‘ and ‘azithromycin without prescription‘ on the Internet. It’s active ingredient is Sildenafil. At present more than quoter of men aged 40 to 70 reported some degree of erectile difficulties. Commonly when something goes wrong with your penis, it can influence your sex life as well as your overall well-being. A long list of prescription medications can lead to erectile dysfunction, including several blood pressure medicines, pain medicaments, and certain antidepressants.