Incontinence


According to the International Continence Society (ICS) urinary incontinence is defined as “a condition in which involuntary loss of urine is a social or hygienic problem.” Incontinence affects 15-25 million Americans, is present in greater than 50% of nursing home residents, and is responsible for a total cost of $27.9 billion annually. Types of urinary incontinence include urge incontinence, stress incontinence, and mixed incontinence as well as overactive bladder.

Do you have a fit bladder? Take this short quiz to find out:

  • I urinate no sooner than every 3 to 4 hours. Y___ N___
  • I am able to be active in my community without having to plan my schedule around the location of the closest restroom. Y___ N___
  • I am able to urinate/void (?) for a count of 8 Mississippi. Y___ N ___
  • I drink 6-8, 8 oz glasses of liquid per day. Y___ N___
  • Roughly 2/3 of the fluid I drink each day is water. Y___ N___
  • I sleep through the night without having to get up to use the restroom. (or if over 65 then 1-2 trips maximum) Y___ N___

If you answered “No” to any of these questions, your bladder may not be as fit as you think. Many people have poor bladder habits that restrict their freedom to enjoy life to its fullest. Men, women, and children of all ages deal with symptoms of urinary incontinence, the inability to control urination, and or urinary urgency or frequency. Physical therapy treatment can cure or make significant improvements in a person’s control over their bladder.

Urge incontinence is the symptom of urine loss that occurs with a strong desire to urinate (urgency) with a few seconds to minutes warning. The bladder contracts when you don’t want it to.

Stress incontinence is the involuntary loss of urine during physical exertion. (ICS definition) Loss of urine with cough, sneeze, lifting, or laughing are typical signs of stress incontinence. High impact sports or ballistic exercises often cause urine loss in patients with stress incontinence.

Mixed incontinence is a combination of both stress and urge symptoms.

Overactive bladder is defined by symptoms of increased frequency of urination (urinary frequency), urinary urgency, and/or urinary leakage that is associated with a strong urge to void. It is characterized by leakage occurring on the way to the bathroom or during change of positions such as from sit to stand and getting up several times at night because of the need to urinate (nocturia). Patients with overactive bladder don’t necessarily have incontinence.

Treatment options for incontinence and overactive bladder include medications prescribed by a patient’s physician, surgery, and physical therapy.

What are the pelvic floor muscles? The pelvic floor muscles attach to the bottom of the pelvis forming a sling or hammock of muscle supporting the internal organs. When these muscles are tightened, they help stop the flow of urine and the passage of gas. They assist in normal sexual function.

How can physical therapy help? Therapy can help you to locate the pelvic floor muscles and make them stronger so they can work normally. Biofeedback is used to help you know when you are using the right muscles. Bladder retraining and education regarding healthy bladder habits may be needed to restore normal bathroom habits. A home exercise program for pelvic floor strengthening will be given. Generally patients with incontinence are seen for 6-8 visits. According to the research, 67%-91% of patients are improved or cured with therapy treatment!