By Leah R. Tobey, PT, DPT
UAMS Arkansas Geriatric Education Collaborative
First and foremost, having a candid conversation with your healthcare provider is the very best way to manage leakage, whether it be urine or bowel. But, do keep reading this article for your personal and professional knowledge. According to the National Association for Continence (NAFC). bladder control problems affect about 25 million Americans, and 85% of them are women. But this is rarely talked about. Probably one of the hardest things for patients is to bring up the topic of urinary leakage to their healthcare providers due to the private nature of this topic. As a general statistic, women wait about 6.5 years to talk to their doctor about urinary leakage. Although the statistic is moving in the right direction, from about 10 years, that’s still too long to live with symptoms when there are proven, evidence-based treatments available. The Women’s Preventive Services Initiative (WPSI) disseminates evidence-based clinical recommendations for women’s preventative healthcare services in the United States. The WPSI estimates 55% of women with urinary incontinence did not report symptoms to their healthcare providers because of embarrassment, stigma, or acceptance as normal. Starting the conversation and using appropriate screens for urinary incontinence could help identify these patients who might be uncomfortable initiating the conversation.
The National Institute on Aging (NIA) defines urinary incontinence as leaking urine by accident. Earlier this month, the AGEC had the pleasure of hosting a webinar on “Urological Issues in Older Adults & Pelvic Floor Physical Therapy Interventions.” Let’s test your knowledge of pelvic health and aging. Is incontinence a natural part of aging? Is incontinence after childbirth normal? Is it normal to wake up to urinate every night? The answer to each of these questions is no. They are all myths for which we might have at one time believed to be a part of the aging process. According to the NIA and International Continence Society (ICS) weak bladder or pelvic floor muscles can cause leakage as can damage to the nerves that control the bladder from Parkinson’s disease or diabetes, for example. Associated with aging, diseases like arthritis can make it difficult to get to the bathroom in time or blockage from an enlarged prostate in men can cause urinary leakage. The NIA reports incontinence can happen to anyone and it is more common in older people, especially women; but this doesn’t have to be the case. For the dedicated patient, incontinence can be significantly reduced or cured with the help of behavioral, lifestyle, pharmacologic and nonpharmacological treatment, including physical therapy treatment. Pelvic floor muscle exercises (also known as Kegels) when performed correctly can effectively strengthen the core and pelvic floor, allowing the muscles to more strongly hold urine and prevent leakage. A physical therapist with certification in pelvic floor therapy can help educate and teach patients about Kegels, timed voiding, lifestyle changes and evaluate other related back or hip problems which could make urinary leakage worse. For more information visit the National Association for Continence www.nafc.org.
Leah R. Tobey is a doctor of physical therapy, and has been treating patients with incontinence for over 10 years.