This article first appeared in the Rushville Republican on Feb 1, 2019.
Some health problems are easier to talk about than others. The harder a problem is to talk about, the slower people are to look for help. The longer they wait to get help, the bigger the problem becomes. “Urinary incontinence” is one of those problems.
Urinary incontinence is involuntary leakage of urine from the bladder. It is much more common in women than it is in men. As women age, the condition peaks around the age of menopause and then rises again between ages 60 and 80.
There are two kinds of urinary incontinence. “Stress incontinence” happens when there is leakage due to sneezing, lifting something or perhaps even going up a set of stairs. “Urge incontinence” happens without warning and causes a sudden, uncontrollable and immediate urge to urinate. In women, stress incontinence is more common. Urge incontinence is more common in men.
Incontinence can be life changing. It is embarrassing to talk about and much more embarrassing to experience. Sufferers may have to limit the amount of time they can spend away from home, or the distance they can get from the nearest bathroom. Their ability to do their job may be affected. Depending on the severity, it can be a constant source of worry. It can keep sufferers from ever being able to relax completely.
Fortunately, there is a type of therapy known as “Continence Improvement Therapy” that offers relief. In Rushville, Rush Memorial Hospital’s Rehab department offers Continence Improvement Therapy. According to Occupational Therapist Terri Uppfalt, a specially trained Pelvic Floor Therapist, treatment leaves some patients completely free of symptoms. Other patients have a decrease in symptoms. Therapy takes about 4 weeks to show results. A full set of treatments is 8 weeks. “The more patients keep up with their exercises at home” , says Terri, “the better their results will be.” Exercises for incontinence focus on strengthening the pelvic floor. Electrical stimulation may also be used to strengthen the muscles involved in urination.
Incontinence therapy involves changes in diet and behavior as well as therapeutic exercise. Caffeine, citrus, spicy foods and other foods that irritate the bladder are eliminated from the diet for a trial period. If this helps, these foods should be avoided or decreased in the future. Patients are coached to establish a bladder routine. They use this routine to track the time between urination. The goal is to gradually increase the time they can spend away from a bathroom. Patients are also taught it how to make sure the bladder is completely emptied.
Unfortunately, not everyone who needs Continence Improvement Therapy is able to get it. Patients may be reluctant to seek help. Or worse, they may not know that help is available. “Some women think this is just what happens when you get older,” says Terri. “Some are just too embarrassed to ask for help. By the time my patients get to me, they are often just desperate. Most have had this condition for a long time. Many of them are depressed when they first come see me. Many of them have had to cut back on their normal activities”.
Occasionally healthcare providers may be part of the problem. “Some providers don’t know where to find Continence Improvement Therapy for their patients” says Terri. She continues, “They may just give their patients an informational sheet that describes exercises they can do. Continence Improvement Therapy is much more effective than just a few exercises. A “one size fits all” exercise program doesn’t work in all cases. Exercises may need to be tailored very specifically to strengthen the muscles that are weak. With more expertise on the part of the therapist, patients can get better results.”
As therapy progresses, Terri sees many positive changes in her patients. “As the therapy begins to work, my patients gain more confidence. They have a greater sense of control over their lives. They become more active and have a more positive outlook. This therapy definitely helps.”
For more information, or to schedule an appointment, contact the Rush Memorial Hospital Rehab Department at 765-932-7498.