Pelvic Health Issues
Do you have problems with urinary leakage? You are not alone.
A bladder control problem can be more distressing than other medical conditions. It can affect the quality of your life, making you feel embarrassed or cut off from friends and activities you used to enjoy. Many sufferers think that they are the only ones with this problem and that nothing can be done to help. Nothing could be farther from the truth. In fact, nearly 20 million Americans suffer from bladder control problems and in most cases, control can be improved or restored with simple inexpensive treatments.
Many causes for leakage
We are all familiar with individual differences in eyesight. Some of us have better eyes! In the same way, some of us have better pelvic muscles and strength. It is the nature of your structures that will determine your symptoms. Some problems are revealed in early life and others will not occur until after a pregnancy or later in life. Loss of bladder control can be due to many causes and sometimes even medical treatments can be a part of the problem.
A problem for many women
Statistics vary but suffice it to say that bladder control problems among women are significant. It someone does not personally have a problem she will have a relative or friend that does. The most common problem is stress incontinence. Urine will leak when a woman coughs or sneezes or lifts. This can be due to a loss of support and pelvic muscle weakness. Urge incontinence is the inability to delay urination when the bladder becomes full. Leakage can be a gush or a flood rather than a few drops. Urge leakage can be due to an overactive bladder that contracts inappropriately at times. Another type of leakage occurs when the bladder cannot empty properly. The bladder will overflow when it is too full.
Incontinence is treatable
The good news is that in almost every case, bladder control problems can be treated successfully. The current concept of treatment has at its core a belief that the female pelvis is a single functional entity and that the older concept of bladder, vagina and rectum existing separately and cared for by a different specialist does not address problems in a coherent seamless manner, leaving doctors and patients confused as to the appropriate specialist to see. This, in turn, leads to dysfunction in treatment. The traditional vertical organization of clinical care by organ system may not be practical when addressing the pelvic floor as a horizontal unit.
Initial Assessment:
Successful treatment begins with a through evaluation. This includes a detailed questionnaire, a complete physical exam including support evaluation, pelvic muscle strength, and a neurological evaluation. Bladder emptying will be assessed and urine testing provided.
Conservative Therapies:
All patients will be offered an individualized treatment plan that will be directed to correct reversible factors that might be causing the problem. Non-surgical approaches will be offered first and most patients will be able to improve without an operation. Estimates are that only one in ten patients will require surgery. Successful strategies will be different because each patient’s problem is unique and must be treated individually.
Some patients will benefit from changes in fluid management and toileting. Some may require medication change or dietary alteration. Bowel management may be needed. Pelvic floor muscle exercises and/or biofeedback treatments may be used.
The Role of Surgery:
If non-surgical treatments fail, additional testing may be needed. This could include x-rays, cystoscopy or urodyanamic testing. If leakage is due to a structural problem, surgical repair or reconstruction may be necessary. Many procedures can be done as an outpatient by minimally invasive techniques.
Getting Help is Easy:
There is no reason to suffer in silence. Talk to your physician about accessing Pelvic Health treatment options. For a physician, please click here.