Bladder and Bowel Dysfunction
Stress Urinary incontinence
Stress urinary incontinence is leaking ( a little or a lot) of urine with any activity that increases the pressure in your abdominal cavity such as sneezing, coughing, laughing, jumping, running, etc. It is very common with up to 30% of women experience stress urinary incontinence but it is not normal! There are many factors that can contribute to the development of symptoms. Some include poor coordination, strength or relaxation of pelvic floor muscles, damage to the pubocervical connective tissue, urethral hypermobility, etc. Treatment may include pelvic floor muscle strengthening, relaxation, coordination training, optimizing your body’s ability to manage pressure, strengthening surrounding musculature.
Urinary Frequency/ Overactive Bladder/ Urinary Urgency
Overactive bladder is a bladder dysfunction with 3 main symptoms including urinary frequency, nocturia and urgency. Urinary frequency is defined as urinating more often than every 2 hours. Urinary urgency is a sudden urge to urinate that is hard to delay. The feeling of urgency may be accompanied with incontinence or leaking of urine on the way to the toilet. Nocternia is defined as waking up to urinate more than once/night. These symptoms are all treatable by a pelvic PT! Treatment is always individualized but may include pelvic floor muscle relaxation or strengthening, improving pelvic floor muscle coordination, bladder retraining, behavioral modification or urge suppression strategies.
Fecal incontinence
Fecal incontinence is the inability to control bowel movements, causing stool (feces) to leak unexpectedly from the rectum. It can range from an occasional leakage of stool while passing gas to a complete loss of bowel control. Common causes of fecal incontinence include diarrhea, constipation, and muscle or nerve damage. The muscle or nerve damage may be associated with aging or with giving birth. Pelvic floor Physical Therapy can help with improving bowel habits, improving stool consistency, address dysfunction of pelvic floor muscles, etc. Often times we will work with a dietician, gastroenterologist, functional medication doctor or nutritionist to help address all contributing factors.
Post-prostatectomy leakage
Urinary urgency and or incontinence occurs in approximately 6-8% of men who had their prostate completely removed, a surgery called radical prostatectomy. Along with the prostate gland, the surgeon removes one of the valves outside the prostate that open and close to let urine out or keep it in. Usually having one working valve is enough, but there might also be also be some effect on the nerves and muscles in the area from the surgery that allows urine to leak. Pelvic floor Physical Therapy can help to strengthen the pelvic floor muscles and improve pressure management to reduce or eliminate incontinence.
Pelvic organ prolapse
Pelvic organ prolapse is common- ⅓ of women will experience some stage of prolapse in their lifetime. It is the movement of the pelvic organs (the bladder, uterus or rectum) in a down and out direction into the vaginal wall or through the vaginal opening. The pelvic organs are held up in the pelvis by fascia and pelvic floor muscles. Overstretched fascia, torn or weak pelvic floor muscles decreases the support of the pelvic organs and can lead to this building or prolapse overtime. Prolapse is named based on the organ that has descended and is staged from 1-4 based on the distance of the descent in relation to the vaginal opening. Treatment varies based on organ and stage. Symptoms of prolapse include urinary hesitancy or slow stream, stress urinary incontinence, constipation, heaviness or dragging sensation, feeling/seeing a bulge, discomfort or numbness with penetration. Pelvic PT can help manage symptoms, provide activity modification to prevent the prolpase from progressing, pelvic floor muscle training, manage sexual dysfunction, and manage abdominal pressure etc.
Prostatitis
Prostatitis is an infection of the prostate that results in pain in the groin, painful urination, difficulty urinating, pain with erection or climax, pain with bowel movements, or pain with sitting. Acute bacterial prostatitis is often caused by common strains of bacteria. The infection can start when bacteria in urine leak into your prostate and can be detected with a urinalysis. However, 90% of the time there is no active infection and antibiotics do not work. When there is no active infection, the condition may be called nonbacterial prostatitis, chronic prostatitis or chronic pelvic pain syndrome. Often, pelvic floor muscle tension is a primary contributor to the pain and urinary symptoms experienced. Luckily, Physical Therapy is a great treatment option and resource for men with chronic pelvic pain. Research has shown that Physical Therapy focusing on PFM relaxation and improved muscle and connective tissue mobility is significantly more effective than medications treating chronic pelvic pain. We also will work on managing constipation, stress, changing seating options for work and home and looking at body mechanics with lifting and bending.
Constipation
Constipation is a condition in which you may have fewer than three bowel movements a week; stools that are hard, dry, or lumpy; stools that are difficult or painful to pass; or a feeling that not all stool has passed. There are many causes of constipation such as dehydration, lack of dietary fiber, physical inactivity, medication side effects, pelvic floor muscle tightness etc. Pelvic Physical Therapy can help along with Pelvic floor Physical Therapy can help with improving bowel habits, improving stool consistency, addressing dysfunction of pelvic floor muscles, etc. Oftentimes we will work with a dietician, gastroenterologist, functional medication doctor or nutritionist to help address all contributing factors.
