Urinary incontinence affects more than 20 million people. This quality of life condition is defined as the involuntary loss of urine. It is referred to as "Life's most embarrassing problem." Women suffer from this condition four times more often than men due to the trauma from childbirth, the loss of estrogen from menopause, and genetics. Men are often affected by incontinence following prostate surgery or other physically traumatic events.

The most common types of incontinence are stress incontinence and urge incontinence. These two types of incontinence can occur independent of each other or may appear as a combined diagnosis of mixed incontinence. Symptoms of these two types of incontinence differ.

Patients suffering from stress incontinence often complain of urine loss with exertion. Sometimes, there may be a sense of urgency, but the patient's most common complaint is urine loss associated with exertional activity. The most common types of activities which precipitate stress urinary incontinence are associated with sneezing, coughing, and laughing. These symptoms most often occur in an upright position. In the more extreme cases, the patient complains of symptoms associated with the same activities even in the sitting or lying position. Other activities which precipitate urine loss in the most severe cases are walking, bending over, or lifting.

The weakened pelvic floor muscles found in stress incontinence are unable to support the lower urinary system during time of increased abdominal efforts associated with various activities. With the loss of function of this supportive tissue of the bladder neck or sphincter allows urine to escapes from the bladder through the urethra. This loss of muscle strength and urethral closure function may be related to genetics, menopause, or trauma.

 Pelvic floor therapy rehabilitates the supportive musculature. The pelvic floor exercise program strengthens the weakened areas while the electrical stimulation helps to reeducate the musculature by demonstrating muscle awareness to the patient by contracting the pelvic floor. Once the patient can isolate and contract the muscle group correctly, he or she is taught to contract the muscle before and during the activities in which urine loss occurs.

Urge incontinence, sometimes called "overactive bladder", is due to a bladder spasm. The spasms cause a sudden and sometimes painful feeling of urgency often accompanied with urinary frequency, resulting in large volume urine loss. Some patients will associate these complaints with a predictable event such as "putting the key in the door" or "turning the water on." Additionally, those who suffer from this type of urine loss report these symptoms occur in the upright position.

Pelvic floor therapy decreases the symptoms of urge incontinence. Through rehabilitation of the pelvic floor musculature with electrical stimulation and a pelvic floor exercise plan, patients are taught how to control the urgency, frequency, and urine loss with urge suppression techniques and other behavioral interventions. These two types of incontinence do not improve without treatment and symptoms often worsen over time.

 Many patients who suffer from incontinence are fearful of addressing the problem with their health care professional. They often feet this is a normal part of the aging process. The patient fears the embarrassment, shame, and limited availability of treatment options.

In the past, the most common treatments for incontinence have consisted of medications and surgery. However, the risks associated with a surgical intervention, less than perfect surgical outcomes and the annoying side effects of medications have left the incontinent patient with few choices. Now, continence centers and physicians offices throughout the country are offering conservative management treatment programs. The success rates have been equal to or better than the surgical or medication outcomes. Pelvic floor therapy is a low risk rehabilitation program that strengthens the pelvic floor musculature to reduce or eliminate the urine loss associated with stress incontinence and urge incontinence.

Muskogee Women's Clinic has long sought to provide the best treatment for our patients.  The comprehensive Pelvic Floor Therapy program offers a highly effective treatment for most types of urinary incontinence and can be offered to nearly all incontinent patients as an alternative to surgery.

For those of you struggling and  suffering from this quality of life condition, this nonsurgical treatment of incontinence may be the preferred approach. With significantly less risk than a surgical intervention, behavioral interventions and electrical stimulation in conjunction with EMG or pressure-directed pelvic-floor exercise has repeatedly demonstrated a significant improvement without the morbidity, risk, or cost associated with surgery. Surgical interventions require a six-week recovery period in which there is a loss of wages due to the necessary home recovery period, probable financial loss due to hospital fees not covered by medical insurance and potential increased family stress due to illness. In most settings, six weeks of pelvic floor reeducation with the use of electrical stimulation offers the same success rate as surgical intervention without the cost and risks. The cost of six weekly in-office sessions of pelvic floor reeducation is far less than the cost of surgery.

Most patients' responses to a pelvic floor rehabilitation program are very positive. Those who were previously frustrated by their inability to contract the pelvic floor muscles report great satisfaction in their increased awareness and spontaneous muscle control. This is often experienced immediately after the first session. Once the patient is able to contract the pelvic floor musculature and reuse the pelvic floor to decrease urine loss associated with exertional activities or urge incontinence, there is a significant decrease in incontinent episodes and an improvement in the quality of life.

Also a new minimally invasive surgical procedure is available in our office.  Ask about GYNECARE TVT.