Last week, we discussed the causes of incontinence in women. We also learned that 13-25 million Americans struggle with incontinence symptoms, of which 85% are women.  Since incontinence can severely affect and limit so many women’s daily activities, it is important that we share the various treatment options available for this condition.

If you experience any signs of incontinence, you should speak to a physician immediately. There is no need to struggle with these symptoms when there is treatment available. In fact, you might be surprised by the number of treatment options available. These include:

Physical Therapy Treatment (non-surgical)

Behavioral Modification:

  • Patients are educated on appropriate voiding intervals depending on their level of incontinence. Voiding schedules are discussed and advanced according to the patient’s progress.
  • Urge control techniques: Many trips to the bathroom can be avoided with implementation of these behavioral techniques.

Diet:

  • Physical therapists teach the patient about the foods and drinks that could potentially exacerbate their symptoms of urinary or bowel incontinence since they may increase the acidity of the bladder. Examples include alcohol, coffee and tomatoes, to name a few.

Pelvic Muscle Rehabilitation:

  • Kegel Exercises. This exercise regimen strengthens the pelvic floor, which aids in control of bowel and bladder habits. Many women have heard of these exercises, but they are very commonly misunderstood and performed incorrectly. The physical therapist will aid the patient in identifying the correct muscles. Once the patient is able to isolate this musculature, the physical therapist will instruct the patient in a program to train these muscles to improve bladder and bowel control.
  • Biofeedback. This is a tool that many physical therapists use to allow the patient to improve awareness and control of their pelvic floor musculature, thus decreasing incontinent episodes.
  • Electrical Stimulation. This treatment option may sound scary, but rest assured, it is far from it. This is only another tool to aid the patient in locating the pelvic floor muscles. It is common that women are unable to elicit an isolated contraction of the pelvic floor voluntarily. This intervention sends electrical signals to these muscles and stimulates a muscle contraction. In most cases, as the patient gains voluntary control of the pelvic floor musculature, electrical stimulation may no longer be needed.

Exercise:

  • Patients may be taught exercises that improve strength of core muscles (abdominals, hip, back), as core strength is related to improvement of continence.

Pharmacological Treatment:

As with any medication, there are possible side effects. You and your doctor should discuss these risks prior to beginning a new medication. Here are some that may be prescribed for your condition:

  • Anticholinergics: These are commonly used to treat urge incontinence.
  • Topical estrogen: This is typically a cream used to aid in “plumping” the vaginal tissues and improve incontinence.
  • Imipramine: This is an anti-depressant used to treat mixed incontinence.
  • Duloxetine (Cymbalta): This anti-depressant is used for stress incontinence.

Surgical Treatment:

Surgery for incontinence may be necessary if conservative treatment is unsuccessful or the patient seeks definitive treatment. Here are some of the most common surgical treatments for urinary incontinence.

Surgery:

  • Sling procedures
  • Bladder suspension
  • Colposuspension
  • Artificial urinary sphincter
  • Nerve stimulator

Injections:

  • Urethral bulking agents
  • Botulinum toxin type A

Other Options:

  • Pads: Use of pads may be beneficial until treatment is begun for controlling incontinence or if previous interventions were unable to completely eliminate symptoms of incontinence.
  • Intermittent Self-Catheterization. Your doctor may recommend this if it is found you are incapable of fully emptying your bladder.

What now?

If you struggle with any signs of incontinence, please contact North Hills Outpatient Physical Therapy at 817-255-1672. We can assess your condition and help you find the right treatment so that you can get back to the lifestyle you enjoy. If you need a physician referral, please call us at 1-855-5NHILLS.

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