I Only Leak When I Laugh
Couldn't attend our “I Only Leak When I Laugh” seminar? Here's what you missed:
Daniel L. Kim, MD, FACOG and Director of Urogynecology & Reconstructive Pelvic Surgery at Sinai Hospital gave an educational presentation on urinary incontinence. Dr. Kim is a Urogynecologist which means he is a gynecologist with specialized training in problems of the pelvic floor. Did you know that:
- One in four women suffer with pelvic floor issues leading to urinary incontinence
- 35% of women experience urinary incontinence in the postpartum period
- $20 billion are spent each year in treating incontinence
- 55% of women do not discuss this issue with their provider
- 17% of women wait for 5 years before opening up a discussion with their provider
- 80% of women can be treated
Urinary incontinence often leads to quality of life issues such as loss of self esteem and self confidence. It can negatively affect your social life, exercise, sexual relations, work life and can lead to depression.
There are two main types of urinary incontinence, stress and urge. Urge Incontinence is caused by an increase in bladder contractions resulting in an urgency and frequency of urination. Nerves in the spine control bladder function and anything that disrupts nerve communication to the bladder can lead to urge incontinence. Contributing factors may be hormone changes, diabetes, high blood pressure, back and neurological problems, age, foods high in acidity, caffeine, and alcohol. Pelvic organ prolapse (in the uterus or bladder, for example) also contribute because these organs drop down in the pelvic floor, putting pressure on the bladder.
MOST WOMEN HAVE NO RISK FACTORS!
Treatment for Urge Incontinence consists of:
- Kegel exercises - helps to improve the nerve connection to the bladder and pelvis;
- 30-50 kegels per day is recommended
- Pelvic Floor physical therapy and the use of Biofeedback
- Medications are available but many cause dry mouth, dry eyes, or constipation; Myrbetriq is a new drug approved by the FDA one year ago and does not have those side effects. However, it can increase blood pressure. Be sure to consult with your provider. Myrbetriq’s action allows the bladder to stretch more.
- Nerve stimulation therapy is also available but not used as often as medications and physical therapy
Stress incontinence is caused by pressure transmitted from your abdomen to the bladder when you cough, sneeze, or laugh. Ligaments in the urethra can be stretched or torn. Contributing factors for stress incontinence is childbirth, hormone changes, weight gain, chronic straining from constipation and chronic coughing.
Treatment for Stress Incontinence consists of:
- Treat constipation and chronic coughing
- Kegels and other pelvic floor exercises
- Pelvic Floor physical therapy
- 50% of women report an improvement from the use of a Pessary: a soft medical device worn in the vagina to hold the bladder up
- Sling procedure: most scientifically studied and is usually a 30 minute procedure as an outpatient
In summary, urinary incontinence is common and treatable with many safe and effective options. Most can be treated without surgery and if necessary, short outpatient therapies are available. If you think you may need pelvic floor treatment, please call Trish Reggio MSN, RN Women’s Health Navigator at 240-215-1447.
PRI stands for Postural Restoration Institute. It's a specialty branch of physical therapy that addresses the body as a whole unit and how, by design, we are predisposed to certain postural faults. Cindy Anderson, a physical therapist at the Women's Center at FMH Crestwood, has been practicing PRI concepts for seven years. She shared that, for example, a PRI therapist knows how your postural alignment and rib cage affect the your shoulder and can develop a treatment plan to address any issues you may be experiencing. Postural alignment has an impact on the health of every joint and organ system in the body. The exercises and postural adjustments are very different than conventional physical therapy.
If you're interested in postural alignment, feel free to reach out to Cindy at 240-215-1425.