Understanding the Cause of Incontinence
There are three types of incontinence. The first is Stress Urinary Incontinence where "stress" refers to coughing, running, laughing, sneezing, etc. The second is Over-Active Bladder which can be caused by multiple different things. Urinary tract infections, kidney stones, prior surgery, low estrogen, and interstitial cystitis can all cause you to have an over-active bladder. The third is mixed incontinence, where you exhibit symptoms of both.
Stress incontinence is usually related to a bladder that has dropped. Before ladies have kids, their urethra and bladder are being "held up" by a tough tissue. During childbirth, that tough tissue gets slightly torn away from the pelvis and starts to drop a little bit causing the bladder and urethra to sit more inside the pelvis. Muscle contractions are stronger in the pelvis therefore when you cough or sneeze, you will leak urine.
Also note that the bottom of your urethra is estrogen dependent so if you don't have enough estrogen, that lining is weakened and will not contract appropriately when you cough or sneeze to hold urine in.
For patients that have an over-active bladder, if there is a strong urge to go you may actually leak a little urine before you can make it to the restroom. These patients may also experience pain and frequency along with their urgency.
Pelvic reconstructive surgery is an option to alleviate structural abnormalities causing the incontinence. The success rate is about 85% but the side effects may cause you to have over-active bladder issues.
Another option is a physical fitness program called Pfilates. In order to see which muscles need to be strengthened in order to improve or eliminate your incontinence, we will perform a test by adhering electrodes to your transverse abdominis, buttocks, inner thigh, and the perineum. A trained Pfilates instructor will then have you complete the ten different exercises known to strengthen muscles in control of incontinence. The electrodes will document the strength of each muscle. We will then craft an exercise routine for you to strengthen the weaker muscles, of which has a success rate of 80-85% - the same results as surgery. We have a fitness center on site for those that would like to sign up for private sessions or group classes for Pfilates.
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