Monday Medical: Therapy can help incontinence

Starting a discussion can lead to important treatment

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For more information about incontinence treatment and pelvic floor rehabilitation at SportsMed at Yampa Valley Medical Center, visit www.yvmc.org/incontinence.

This column has been updated since its publication on Oct. 26, 2009.

Bladder leakage, also called urinary incontinence, is a health issue that some people are too embarrassed to discuss.

Yet by staying silent, many people simply live with the condition, unaware that there are treatment options.

Incontinence is not always related to aging; it can be a problem for children and teenage athletes as well as adult men and women.

Kim Miles and Mary Beth Strotbeck, physical therapists at Yampa Valley Medical Center’s SportsMed in Steamboat Springs, specialize in incontinence and women’s health. They like to communicate openly about this condition.

“We’re trying to get the word out that 80 percent of people who are living with this problem can get better with therapy alone,” Miles said. “The majority do not need surgery.”

Miles said most people who leak don’t seek help for about seven years, on average. One reason women wait is the misconception that incontinence is normal.

Although 70 percent of those who have this condition are female, that does not mean women should accept incontinence as inevitable or untreatable. And when it comes to kids, early treatment is preferable to waiting.

“Most parents feel that their children will ‘grow out of’ the condition,” Miles said. “They spend years trying to manage the problem instead of seeking treatment because they don’t know it is available for kids.”

Primary causes of incontinence among women are multiple pregnancies, hysterectomies or other surgeries, Strotbeck said. For men, prostate problems or surgery can cause leakage.

Other causes not related to sex are muscle weakness,

frequent bladder or urinary tract infections, urinary urgency and frequency, or just genetics.

Growing older brings a greater chance of developing incontinence. Miles said there is a higher incidence of leaking among persons 65 and older.

Incontinence is sometimes accompanied by serious pelvic pain. Miles has treated patients who suffered pain every day of their adult lives. Common causes of this condition are endometriosis, bladder inflammation, pelvic surgery or abuse. Sometimes causes remain unknown.

For the past 12 years, Miles has worked to improve the lives of many incontinence patients. Three of them immediately come to mind.

“One woman had had bladder repair surgery but was still leaking when she coughed or sneezed,” Miles said. “We provided biofeedback, therapy and a home exercise program, and she was completely dry in three months.

“Another woman who had given birth to four children was leaking urine and feeling she always had to rush to the bathroom. She was referred to therapy by her obstetrician/gynecologist. In 10 visits, she had improved dramatically.

“A man in his early 60s was still leaking four months after having had a prostatectomy,” Miles added. “This was due to the weakness of his pelvic floor muscles. He became dry after about six months of therapy and doing a home exercise program he learned in physical therapy sessions.”

Miles always recommends that a patient discuss any incontinence issues with a physician first. Sometimes an accompanying medical problem could be causing the symptoms. Also, a physician’s referral is needed before therapy can start.

“Somebody with a mild case can see a doctor, come to therapy several times, learn the exercises and do well with no further therapy,” Strotbeck said.

Christine McKelvie is public relations director of Yampa Valley Medical Center. She can be reached at christine.mckelvie@yvmc.org.

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