November 17, 2019

Do you know someone who is having a hard time answering to nature’s call? Someone who always have trouble using the toilet, who constantly have a leakage accident and appears to have poor control over bowel and bladder function? Well that someone might be experiencing pelvic floor dysfunction and urinary incontinence. Pelvic floor dysfunction is the inability to correctly tighten and relax the pelvic floor muscles to have a bowel movement. While urinary incontinence is defined as “the complaint of any involuntary leakage of urine”.

Now, let’s understand what the prevalence are, risk factors, and impact of pelvic floor dysfunction and urinary incontinence in our life. Pelvic floor is a group of muscles in the pelvic area. These muscles support the organs in the pelvis, and some form a sling around the rectum and vagina. The organs in this area include the bladder, uterus (women), prostate (men), and rectum (the area at the end of the large intestine where the body stores solid waste). By contracting and relaxing the pelvic floor muscles, you enable bowel and bladder movements. People with pelvic floor dysfunction contract these muscles rather than relax them. Because of this, they have difficulty in evacuating a bowel movement, they have an incomplete bowel movement, or they may leak urine or stool. Urinary incontinence is a common problem in the female population with prevalence rates varying between 10% and 55% in 15- to 65-year-old women. Estimates suggest that the prevalence of UI gradually rises during young adult life, comes to a broad plateau in middle age, and then steadily increases from that plateau after age 65. Therefore, over the next 40 years, as the elderly population expands in size, the number of women affected by UI will significantly grow. Urinary Incontinence can be subdivided into three:

  • Stress Urinary Incontinence or SUI is the complaint of involuntary loss of urine on effort or physical exertion (such as during sporting activities) or on sneezing or coughing.
  • Overactive bladder (OAB) and Urgency Urinary Incontinence (UUI) is the complaint of involuntary loss of urine associated with urgency; it often occurs in the setting of OAB, which is defined as the syndrome of urinary urgency, usually accompanied by frequency and nocturia, with or without UUI, in the absence of urinary tract infection or other obvious pathology (such as neurologic dysfunction, infection, or urologic neoplasm).
  • Mixed Urinary Incontinence is the presence of both SUI and OAB/UUI. Stress and urgency urinary symptoms often present together. In fact, 10% to 30% of women with stress symptoms are found to have bladder overactivity on subsequent evaluation.

Pelvic floor dysfunction can be challenging. The range of concerns you may be dealing with can be leakage of stool/urine with or without your awareness, feeling that you need to have several bowel movements during a short period of time, constipation or straining pain with bowel movements, painful urination and pain in your lower back that cannot be explained by other causes. Treatment for Pelvic floor dysfunction depends on the type of incontinence, its severity and the underlying cause. Sometimes a combination of treatments may be needed. Treatments may include biofeedback, medication, surgery, or pelvic physical therapy.

Pelvic floor physical therapy involves the pelvic floor muscle group, which is responsible for a variety of functions. These muscles support the pelvic organs, assist in bowel and bladder control, and contribute to sexual arousal and orgasm. Pelvic physical therapy can help not only with pain but also reduce symptoms of other conditions caused by pelvic floor problems. Relaxing contracted and shortened muscles can help alleviate pain in the pelvic floor, just as it would in other muscles in the body. According to Dr. Hur. “Stretching in general helps muscles relax and prevents excessive cramping and tightening,”

Pelvic floor physical therapists might use several techniques:

  • Education. Patients may need to learn more about their pelvic anatomy and how different components work alone and together. They may also need to learn how habits or hygiene affect their symptoms.
  • Pelvic floor exercises. Patients are taught how to contract and relax pelvic floor muscles in relation to other muscles. They are also taught breathing and timing techniques to make the exercises more effective. Such exercises can stretch tight muscles, strengthen weak ones, and improve flexibility.
  • Manual therapy. A physical therapist may use hands-on massage or stretching to help with posture, blood circulation, and mobility.
  • Pelvic floor biofeedback. Biofeedback is a technique that can help patients “see” how the pelvic floor muscles are working. To do this, a probe is inserted into a woman’s vagina or a man’s anus and results are displayed on a computer screen.
  • Electrical stimulation. A low voltage electrical current may be used to teach patients how to coordinate their muscle contractions.
  • Vaginal dilators. These tube-shaped plastic devices can help women learn to relax their pelvic muscles to allow easier penetration. Women who have been treated for gynecological cancer may also find them helpful for vaginal rehabilitation after treatment.

Pelvic floor physical therapy may be part of a treatment plan involving primary care physicians, sex therapists, and mental health professionals.
The issues are not always a cause for alarm but is the body sending a message. If a change in the person’s normal habits is sudden, it could be an indication of a temporary medical problem. To help you identify and contract the right muscles, your doctor may suggest you work with a physical therapist. When nature’s calls get out of control you can count on Tribeca.

Tribeca Physical Therapy is officially reopened for in-person physical therapy sessions and continues to offer Telehealth PT or Virtual PT. Call us at 2124068080 or message us and book your first session free.

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