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Don’t Suffer Needlessly...
Loss of bladder control affects at least one of every 10 adults. Half of all women experience urinary incontinence (the accidental loss of urine) at some point in their lives. Although it is more common in women, children and men also experience urinary incontinence.
The problem is all around us, yet almost no one talks about it. Even fewer seek treatments that can help them. Only 50 percent of those with some form of incontinence ever tell their physicians.
Involuntary loss of urine (incontinence) is not a
normal part of aging, but it is a sympton of other medical problems.
Incontinence may be the result of pelvic muscles weakened from
childbirth, stroke, diabetes, bladder infection, side effects of medication,
prior surgery, or radiation treatments.
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What is Urinary
Incontinence?
Urinary Incontinence is an unplanned loss of urine.
Urine loss can be in large amounts or only a few drops.
People with urinary incontinence often need to protect themselves with
diapers or pads. Urine loss can
often be cured or improved. Millions
suffer needlessly from embarrassment and discomfort.
Understanding the problem is the first step in helping you gain control.
The goal of our program is to help you stay drier and reduce the need for
protection
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There Are Three Types of
Incontinence:
¨ Urge Incontinence: Having a strong desire to urinate and being unable to wait long enough to get to the toilet. Frequency can also be a problem
¨ Stress Incontinence: Leaking urine when you sneeze, cough, laugh, exercise or lift heavy objects.
¨ Overflow Incontinence: Dribbling urine throughout the day and never feeling like you have completely emptied your bladder.
The purpose of our clinic is to help people manage urine
loss, frequency, and urgency. Patients
have access to the following range of service as needed:
·
Assessment of the problem.
·
Exercises that strengthen the pelvic floor muscles.
·
Fluid and dietary management.
·
Biofeedback to help you learn to find and work your pelvic floor
muscles.
·
Relaxation exercises to help control the urgency to void.
·
Appropriate medication therapy.
· Bladder training to manage leakage, establish a schedule of voiding, and help with frequency.
Kegel exercises were designed to help you enhance the strength and tone of your pelvic floor muscles. These muscles act as a hammock which extends from the pubic bone to the coccyx (tail bone). They support your bladder, vagina and rectum. These muscles can become weak due to the stretching of childbirth, chronic constipation, vaginal or pelvic surgery, and the effects of aging. Kegel exercises can help restore tone and function to your weaken pelvic floor muscles and help you to restore continence.
The exercises were developed in the late 1940’s by a gynecologist named Arnold Kegel. Recent studies have shown that only 51% of the women taught these exercises can perform them correctly. With the biofeedback program that you have just begun, you will be assured that the exercises that you do will be correct and effective.
To find the right muscles to use when performing Kegels tighten the pelvic floor muscles as if you are trying to hold back gas or trying to stop the flow of urine. Do not try to stop and start you stream when you are voiding. Over a period of time this could cause damage to your urinary tract.
A woman can insert one finger in her vagina and feel the muscles contract when performing a Kegel. A man should see his penis move slightly if he is using the proper muscles.
You should do your Kegel exercises at least three times a day. Hold your muscles tight for five second and relax for ten seconds, repeat this twenty times. Gradually work up to holding your muscles for ten seconds. Remember, it is just as important to relax as it is to contract. Place one hand on your abdomen during the exercise to make sure you are not using the wrong muscles. Remember to relax, breath and squeeze.
You can do your Kegel exercises anywhere, anytime and in any position. You will feel the muscle move better if you are sitting or lying down.
As your muscles become stronger, try to do your exercises while walking, climbing stairs and running in place. Squeeze and tighten just before a sneeze, a cough, lifting heavy objects and when rising from a chair or a bed.
Imagine that your pelvic floor is an elevator. When the muscles are relaxed you are on the ground floor. Slowly pull your muscles up to the second floor, stop, them pull as tight as you can to reach the third floor, stop, go back to the second floor, stop, relax completely and return to the ground floor. Take a deep breath – repeat.
Squeeze and release your muscles as fast as you can five times in a row. Relax ten seconds – repeat. These are great exercises to do when waiting in lines, etc.
Long Haul:
Pull your muscles as tight as you can for as long as you can. When you feel the muscle weaken then relax. Only do this once a day to avoid fatiguing your muscles.
The hardest part of this program is remembering to do your exercises daily. To help you remember, you could:
Set a timer or alarm clock
Associate your exercises up to something that you do every day, such as brushing your teeth, mealtimes, watching television, etc.
Buy yourself a few plastic lemons or cut some from yellow construction paper. Place them where you are sure to see them in the course of your day. When you see the lemon….you will be reminded – to squeeze!!!!
In the morning put three bracelets or three rubber bands on your wrist. As you do each set of exercises move one bracelet or rubber band to the opposite wrist.
By exercising daily and visiting the office once a week you should start to notice improvement in about three to four weeks. This is not a “quick fix” but requires some time and effort on your part in order to be successful.
Eventually you will use these exercises as part of your daily routine. Do them when brushing your teeth, eating, talking on the phone or waiting in line at the grocery store. The pelvic floor muscles are internal, and when you are doing the exercises correctly, no one will know.
Remember, it took time for your pelvic floor muscles to become weak….it will take time for them to regain strength. Once you have improved your bladder control you must continue to do the Kegel exercises daily to keep the muscles in shape. This is a program for life.
I imagine you are going to succeed
A aim to restore muscle strength and tone
M motivation is your most important tool
D devote time each day to exercise
R remember, it will take time to regain control
Y you are the key to your success
Controlling the urge to urinate is not a difficult or
impossible task. This technique may
not work right away. Be patient and
do not get discouraged. With
practice you will learn to control urge incontinence.
Adapted from Staying Dry by Kathryn Burgio, Ph.D., K. Lynette Pearce, R.N.P. & Angelo J. Lucco, M.D.
All alcoholic beverages Honey
Apples Cranberries
Apple juice Grapes
Cantaloupe Guava
Carbonated drinks Lemon juice
Chilies/Spicy foods Peaches
Coffee Pineapple
Tea Plums
Strawberries Tomatoes
Vinegar Onions
Nutra-Sweet Vitamin B complex
Citrus fruit/juices Chocolate
If bladder symptoms are related to dietary factors, strict adherence to a diet, which eliminates the above food products should bring significant relief in about 10 days. After 10 days you may begin to add the above foods back into your diet one by one. This way, if something does cause you symptoms, you will be able to identify what it is. When you begin to add foods back into your diet, it is crucial that you MAINTAIN A SIGNIFICANT WATER INTAKE. You should drink at least 1-2 quarts of water daily.
Pelvic biofeedback/pelvic floor stimulation is a program of physical rehabilitation for the bladder and pelvic floor. It is combined with a program of behavior modification in order to help patients achieve urinary control (continence). This is a non-operative, minimally invasive office based treatment program that involves sessions with the patient and the nurse in the physician’s office. These usually occur at weekly intervals and take anywhere between 45-60 minutes per session. Patient cooperation is essential to the success of this program in helping the patient to achieve better urinary control.
Biofeedback translates the contraction from the pelvic
muscles into a signal that can be heard or seen on a screen (like a TV screen).
It is a teaching tool to learn how to control the muscles.
Therapy
Program Plan
Session
1 includes:
Review of your urinary
history
Fill out form about your problem
Biofeedback session
Pelvic floor stimulation
Biofeedback session
Set goal for therapy
Discuss daily exercise “routine”
Session
2-5 will be:
A review of your week:
leaks, pain and success
Biofeedback/Pelvic floor stimulation/Biofeedback
Reinforce daily exercise routine and answer questions
Session
6 will be:
Review of your goal for therapy
Fill out form about your problem now
Biofeedback/Pelvic floor stimulation/Biofeedback
Follow up with doctor
Patients who are NOT candidates
Prolapse beyond the hymenal ring
Type III stress incontinence
Pt.’s with pacemaker
Pt. With denervation of pelvic floor
Pt. With reduced cognitive abilities
Pregnant or attempting pregnancy
Menstrual cycle with heavy flow
Active pelvic malignancy
Acute cystitis or vaginitis
Untreated vaginal atrophy
Ectopic ureters or fistulas
Metal IUD
Patients who WILL benefit from pelvic floor therapy
Type I and II stress incontinence
Urge incontinence
Mixed incontinence
Interstitial cystitis
Painful urination
Pelvic pain
Vulvular pain
Psuedo dysinertia
Urgency without leakage
Urinary incontinence with Multiple Sclerosis
Side Effects
Local irritation
Muscle soreness
Increased S/S first day of therapy