There is a part of the population (more than two million women) that suffers from urinary incontinence (involuntary loss of urine) and usually produce a person who suffers a series of psychiatric and social as well as organic. It affects their quality of life, people who reduce their social life and worry can be an obstacle in daily activities.
There are several types of incontinence: emergency, efforts and neurogenic incontinence.
This has not been a priority in health in Spain and change in society has a major impact. About incontinence, if we compare ourselves with other countries like England, France or the United States going after a delay of many years, so the health professionals we are dedicated to the rehabilitation of the pelvic floor, we must give a major boost for the population to be aware that there are treatments and solutions for different types of incontinence, whether urinary or fecal.
Correcting this problem has a number of facets and is a multidisciplinary, with one purpose: to benefit the person suffering from urinary incontinence.
Socially this kind of involvement is hidden because the person, either because of shame, embarrassment or lack of information does not say who suffers the loss of urine, and is limited to methods such as absorbent cloth to conceal the problem. But today there are simple and effective treatments.
Stress urinary incontinence
In this form of incontinence, urine leakage can occur from coughing, running or physical effort.
Stress incontinence is essentially due to a weak pelvic floor muscles, these muscles have the function to contain and protect the entire lower abdomen as they pass through the urethra, vagina and rectum.
These muscles are weakened for various reasons: pregnancy, vaginal childbirth, constipation, sports inadequate hormonal changes, aging. But the most important cause is pregnancy and childbirth.
The deterioration of the pelvic muscles also may cause sexual dysfunction because women do not receive enough stimulation and orgasms are less intense or not achieved.
This lack of muscle support can cause discomfort or pain sensations during sex, incontinence may occur even during intercourse.
All this can generate a deterioration of security and self esteem. This muscle weakness can not recover spontaneously and recovery is possible through Kegel exercises, mebstudio, proprioception, myofascial therapy, vaginal cones, biofeedback, electrical stimulation, …
Our job as therapists
When we get a person with this problem and carries no prescription we will do a medical history, examination and tell you visit with a specialist, either a urologist, gynecologist or Coloproctologic.
To effectively treat incontinence must be properly diagnosed, so they require a series of tests in each case and specific treatment and combined pharmacological and fisoterápico either.
Besides trying, it is also important to prevent, so always insist on antepartum courses on the musculature.
TYPES OF URINARY INCONTINENCE
The different types of urinary incontinence can be grouped in the following entities as their clinical characteristics and the population group they belong to:
Stress urinary incontinence (stress incontinence)
Urge incontinence (unstable bladder)
Mixed urinary incontinence
Urge incontinence psychogenic cause
Neurological cause urinary incontinence (neurogenic bladder)
Overflow incontinence
Bladder instability in males (unstable detrusor in BPH)
Enuresis
Urinary incontinence in older people
What is the pelvic floor?
It is a group of muscles that holds and maintains all the internal organs of the lower abdomen (urinary bladder, urethra, the lower bowel and sexual organs in women).
Through this ground ducts pass outside these organs (urethra, vagina and rectum), in addition, when emptying the bladder, is responsible for opening and closing the exit of the urinary tract. A weakened pelvic floor muscles can not fully perform this function, resulting in involuntary loss of urine, sexual dysfunction and vaginal prolapse.
CAUSES WHICH MAY CAUSE SEXUAL DYSFUNCTION OR URINARY INCONTINENCE
Pregnancy and childbirth.
By the weight of the uterus during pregnancy causes stretching of the pelvic floor muscles during childbirth increases. This stretch is increased if an episiotomy is performed or if there is excess weight.
Postpartum.
In women who are restricted only to early abdominal exercises to regain her figure is an increase in abdominal pressure that can trigger incontinence.
Sports.
Some sports that require jumping and impacts such as aerobics, athletics, jogging, … cause increased abdominal pressure. Failure to take appropriate measures weakened pelvic muscle tone, in fact, in some elite sports, with this type of activity and continuous training and racing, six out of ten sportsmen are affected by incontinence.
Menopause and aging.
Due to hormonal changes typical of menopause is a loss of flexibility of the pelvic floor muscles and the simple passage of time produces a physiological atrophy of these muscles.
Other factors.
Inheritance
Obesity
Constipation
Chronic Cough
INCONTINENCE is preventable, treatable and curable
The ideal of physiotherapy in this area is prevention, especially in pregnancy and postpartum, and when you know that there are predisposing factors for incontinence.
It\’s better than before the first symptom is see a doctor to perform a proper diagnosis so you can start a program of pelvic floor physiotherapy avoiding the problem worse
Physical therapy not only prevents but can sometimes avoid surgery. In other countries like the United States first begins with conservative treatment and then in the cases that have not given a good result considering the possible surgery.
TREATMENTS
Today is no longer the only alternative to surgical intervention, treatment proposed in the most modern facilities in the pelvic floor physiotherapy.
This branch of Physiotherapy uses various tools.
Pelvic floor exercises
Realization of active contractions, regular and specific to each case and person.
Manual therapy
Treatments visceral and myofascial structures and mobilizing the viscera to its physiological functioning
Biofeedback.
Technical information about the function constant you want to submit to voluntary control), electrical stimulation, specific exercises, …
These are all techniques that enable people to monitor the physiological responses
EDUCATION
Most appropriate feeding
Tips in daily life. Daily habits
Urge incontinence
It is the involuntary loss of urine associated with the strong desire to urinate accompanied by fear of wetting or fear of pain to retain urine.
The reason is the existence of involuntary detrusor muscle contraction is considered therefore that there is an unstable bladder.
STRESS INCONTINENCE
It is the involuntary loss of urine by insufficient closure of the urethra to increase abdominal pressure.
The loss is associated with motions, jumps, bending, coughing, sneezing ,…, and during it there is no sense of need to urinate.
CONCLUSIONS
All people with incontinence, whether urinary or fecal must find its solution.
Breaking the myth of believing that a woman is incontinent.
For a society like ours is unacceptable incontinence assume without finding a solution.
There are treatments, pharmacology, physiotherapy and surgery. Depending on the type of incontinence will be a complete solution or in other cases, though not entirely eliminate the problem, you can reach a tolerable situation.
With a correct diagnosis and appropriate treatment is achieved absolute cure for many incontinent, and in chronic patients is enhanced quality of life.
Mercedes Blanquet
Physiotherapist specializing in pelvic floor rehabilitation
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