Monday Medical: Bladder leakage treated with new technology
October 27, 2013
Steamboat Springs — Editor’s note: This article includes some information originally published in a Monday Medical column on Oct. 26, 2009.
Bladder leakage, also called urinary incontinence, is a health issue that some people are too embarrassed to discuss. Yet treatment options and new technology can treat the problem, and people do not need to suffer in silence.
Kim Miles, a physical therapist at Yampa Valley Medical Center's SportsMed in Steamboat Springs, specializes in incontinence, pelvic floor dysfunction and women's health.
"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 now has new technology to help her patients. The Prometheus unit conducts biofeedback tests and provides electrical stimulation to strengthen pelvic muscles.
"This new unit allows us to have a seamless transition from evaluation to treatment," Miles said. "It also generates medical reports that a patient can discuss with his or her doctor."
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Incontinence is sometimes but not always related to aging. It affects children and teenage athletes as well as adult men and women. Miles said most people who leak don't seek help for about seven years, on average. One reason that 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 who leak urine during the day or have bed-wetting issues at night, 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, endometriosis, hysterectomies or other surgeries, physical therapist Beth Strotbeck said. For men, prostate problems or surgery — sometimes related to cancer — can cause leakage.
Other causes 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 people 65 and older.
Men and women also may experience serious pelvic pain. Miles has treated people who suffered pain every day of their adult lives. Common causes are endometriosis, bladder inflammation, pelvic surgery or abuse. Sometimes causes remain unknown.
Since 1999, Miles has worked to improve the lives of many individuals whose quality of life was reduced by incontinence or pelvic pain. Two of them immediately come to mind.
"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 we taught him.
"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."
Miles always recommends discussing incontinence issues with a physician first. Sometimes an accompanying medical problem could be causing the symptoms. Also, insurance companies require a physician's referral before therapy can start.
"Somebody with a mild case can see a doctor, come to therapy once, learn the exercises and do well with a home program," Miles said.
"People exploring surgical options may want to begin strengthening muscles with physical therapy prior to surgery, as this can lead to better outcomes."
Christine McKelvie is a writer and editor at Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.