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If
Incontinence Has Put Your Life on Hold...
Consider
The Benefits of Exercise Therapy
Incontinence.
It's one of those embarrassing topics that
traditionally haven't been considered appropriate
for polite conversation.
Yet, for more than 12 million people in this
country who face temporary or chronic incontinence, it
is a condition that, in very basic terms, controls their
lives.
Simply
defined, incontinence is the unexpected
loss of urine -- in any amount -- on a regular basis.
It is not a disease, but a symptom with several
potential causes.
It may be the result of a birth defect, injury,
disease or the predictable physiological changes that
occur naturally with age.
For women, incontinence often occurs after the
childbearing years when muscles have been stretched and
no longer have the elasticity to provide the necessary
bladder control.
ELEMENTARY
ANATOMY
Urination
is controlled by a series of nerves and muscles in the
urinary system which includes: the kidneys (that
filter the blood, separate the by-products of the body's
metabolism and excrete them as urine), the ureters
that carry urine from the kidneys to the bladder,
the body's urine reservoir.
The urethra connects the bladder to the
outside of the body.
In men, the prostate gland can also impact
on the urinary system.
Normally,
the kidneys produce about a quart of urine each day.
The ureters empty small amounts of urine into the
bladder about every 10 to 15 seconds.
When the bladder is full, the brain signals the
muscles of the bladder to contract, and those in the
urethra to relax to allow urination to occur.
The
whole process relies on the proper functioning of nerves
and muscles throughout the urinary system.
When a malfunction occurs, and the urine storage
or emptying functions are not coordinated, urine can
leak in small quantities or suddenly be completely
released from a full bladder.
TYPES
OF INCONTINENCE...
Generally
speaking, anyone who has "accidents" on a
regular basis, day or night, is considered incontinent,
although each case is different. There are several kinds
of incontinence.
Stress
incontinence
applies to leakage of small amounts of urine when
coughing, sneezing, lifting -- or doing anything that
causes abdominal pressure to override the bladder's
closure mechanism.
Urge
incontinence
is the strong need to urinate and the inability to delay
long enough to get to a toilet.
This urge can happen
at any time, without warning, even just after voiding.
The
term overflow incontinence applies when small
amounts of urine "run over" without the urge
to void. Either
continuous leakage or periodic expulsion of the
bladder's contents is called total incontinence.
People
view incontinence according to their own experience.
Some consider the condition only a slight
nuisance; others view it as a life-altering personal
tragedy.
The
important things to point out are that incontinence is not
a normal consequence of aging and there
are several, very effective methods to treat it!
DECIDING
ON TREATMENT
Less
than a decade ago, a diagnosis of urinary incontinence
would have been a "life sentence."
Today, however, people who have difficulty with
bladder control have something more to look forward to
than adult diapers.
Lisa
Naeger,
LPT, owner of Northwest Houston Physical Therapy
Group in The Woodlands, offers real assistance to
women who have been told they just had to
"live" with incontinence.
"In
the past," the physical therapist explained,
"many women were reminded, 'You've had
children...what do you expect?'
Some are candidates for surgery; others try
medication and develop coping strategies.
Most are unwilling or too embarrassed to even
discuss their problem with family or friends, and
structure their lives around the distance to the nearest
bathroom."
"For
a long time, physicians have been telling their patients
that exercise could help them manage incontinence,"
Ms. Naeger continued, "but not many could provide
the instruction necessary for patients to learn the
exercise techniques.
We have teamed up with Dr. Birken to tackle this
problem more aggressively with a new therapy
program."
THERAPY
THAT WORKS...
The
culprit in urinary incontinence is the pelvic floor
muscle, which supports the bladder.
This therapy program -- which involves
rehabilitating the pelvic floor muscles -- incorporates
techniques that have been used successfully in Europe
for many years, along with Biofeedback and the
electrical stimulation of the pelvic floor.
"The
therapy is painless and, after an individualized regimen
is created and training is underway, it can be performed
in the privacy of the patient's home using a portable
unit.
The information we gain from the muscle
tests," she explained, "allows us to design a
specific program to help the patient learn to contract
the pelvic floor muscle while relaxing the abdominal
muscles to keep them from pressing down on the
bladder."
"It's
like the child's game of patting your head and rubbing
your tummy at the same time.
It takes concentration and practice, but once
you've learned the technique, it is not all that
difficult to do."
The
treatment program can last from one to three months,
depending on muscle control and how faithfully the
patient follows the regimen.
The equipment helps promote patient compliance
because it charts how well the muscles are re-learning
how to contract and respond.
"Obviously,
results vary from patient to patient," said Dr.
Birken, "but we are very encouraged by the
experiences reported by women who try this treatment.
For others, surgery remains the only viable,
long-term solution.
But, we have to remind our patients that nothing
can be accomplished if they don't report the
problem."
"So
many of the old 'taboos' are gone now, and people are
talking about incontinence more openly.
This is a problem that will not go away by
itself," he said, "so the sooner treatment can
begin, the better the chances are that continence will
return."
WHEN
SURGERY
IS
NECESSARY...
In
cases of stress incontinence, sometimes surgery is
necessary to reposition the muscles and connective
tissues that support the bladder so the bladder neck is
positioned correctly to function normally.
There
are a number of surgical techniques and procedures than
can be used; some of which may be accomplished
coincidentally with other gynecological surgeries.
According
to national statistics of the US Department of Health
and Human Services, about 78 to 92 percent of patients who need surgery to treat
their incontinence are cured.
For
additional information about the diagnosis and treatment
of incontinence, call Dr. Birken's office to schedule an
appointment.
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