Archive for the ‘Urinary Incontinence’ Category

Pelvic floor exercises for men

January 15, 2016

Historically, pelvic floor exercises, have been recommended for women with urinary incontinence.  However, doctors have discovered that these same exercises are useful for men as well.  This blog will discuss the use of pelvic floor exercise for men.

The muscles of the pelvic floor not only hold organs in place, but they are also important for bladder control. Because these muscles often weaken with age, men are advised to exercise them regularly by doing pelvic floor exercises in order to maintain their continence of urine as well as having improvement in their sexual functioning.

What are the pelvic floor muscles?

The muscles that support the organs in the pelvic area are known as pubococcygeus or pelvic floor muscles. These muscles are like a trampoline or sling that stretches along the bottom of the pelvic area from the pubic bone in the front to the tail bone (or coccyx) at the back, as well as from side to side between the sitting bones. In men, they support both the bladder and the bowel, with the urethra (the tube carrying urine from the bladder) and the rectum (back passage) passing through the muscles. Pelvic floor muscles are also important for erectile function, and they work with other muscles to help stabilise the back. 

Why exercise the pelvic floor muscles?

The pelvic floor muscles naturally stretch and weaken with age, which can gradually make them less efficient. The muscles can also be weakened in men who often strain to empty their bowels – such as having constipation on a regular basis – who have a chronic cough, bronchitis or asthma, who perform tasks that involve repeated heavy lifting, and who are overweight or generally unfit. Having surgery for an enlarged prostate gland can cause the pelvic floor muscles to weaken, as can neurological damage such as from a stroke, diabetes, multiple sclerosis or a spinal injury.

Weak pelvic floor muscles in men can lead to stress urinary incontinence, in which small amounts of urine leak when pressure is placed on the bladder – for example, when bending forward, sitting, coughing or laughing – or urge incontinence, when there is an urgent need to urinate more often. You may leak just a few drops of urine, have a dribble after you finish urinating or leak a steady stream of urine. Weak pelvic floor muscles can affect erectile function too.

However, in a similar way that you can strengthen the muscles of your arms or legs through exercise, you can also strengthen your pelvic floor muscles.

These exercises are also recommended for men prior to having surgery for an enlarged prostate or prostate cancer to help improve their bladder control. They are also recommended for men who experience chronic pelvic pain syndrome – performing the exercises when pain starts can help to interrupt a cycle of pain-spasm-pain.

How can you find your pelvic floor muscles?

Before you start doing pelvic floor muscle exercises, it’s important to find the correct muscles to ensure you are exercising them. The next time you urinate, stop urinating mid-stream and concentrate on the muscles that allowed you to do this – these are also the same ones you use to prevent passing wind. Once you have emptied your bladder (don’t stop the flow mid-stream more than once), try contracting the same muscles – you should notice the base of your penis rising towards your tummy and see your testicles move up as you contract the muscles.

Another way to find your pelvic floor muscles is to sit comfortably or lie down, ensuring the muscles of your abdomen, thighs and buttocks are relaxed. Now, tighten only the muscles that control your back passage as if you are trying to avoid passing wind for a few seconds, then relax.

To ensure you aren’t squeezing other muscles, try squeezing your pelvic floor muscles again and:

  • Rest your hand on your tummy – you should not feel your abdominal muscles tighten
  • Pay attention to your breath – if you are holding your breath, you are using your chest muscles; try to breathe normally while squeezing your pelvic floor muscles
  • Sit in front of a mirror – if you notice your body moving up and down, even slightly, you are squeezing your buttocks
  • Watch your thighs – their muscles should be relaxed without noticeable movement in the upper legs. 

How should men do pelvic floor exercises?

Now that you’ve identified your pelvic floor muscles, simply contract them, squeezing and drawing up the muscles around your urethra and back passage at the same time, and holding them for a count of 5, then release the muscles slowly. By doing this simple technique, you have just flexed your pelvic floor muscles. Don’t hold your breath, and make sure you are not working other muscles such as those in the buttocks, thighs or abdominal area.

Wait a few seconds before repeating the technique, doing a set of 8-10 squeezes using strong slow contractions, then follow with one set of 8-10 quick rapid contractions. Repeat this sequence 4-5 times a day. Once you find it easy, you can increase the count for longer, up to 10 seconds. However, take care you don’t over-exercise the muscles and cause muscle fatigue towards the end of the day, thereby increasing urine leakage.

It will take 4-6 weeks before you notice any improvement, but after about 3 months you should experience the full benefit of doing pelvic floor exercises. At this point, you can change your routine to doing pelvic floor exercises twice a day.

If you have problems with incontinence or have recently had prostate surgery, you may be referred to a specialist who will help train you in how to do the exercise correctly and establish a program based on the strength of your muscles.

Pelvic floor exercises take very little time and can be done while sitting, standing, lying down or walking. Because others will not notice the muscles moving, you can do them discreetly during your everyday activities, such as while on a bus or train, sitting in a car, even standing in a queue – the main thing is to get into a routine of doing them every day. Try getting into the practice of doing them at the same time, such as when brushing your, after urinating, when commuting home from work or during advert breaks while watching the TV in the evening.

Bottom Line:  Pelvic floor exercises aren’t just for women but men can also benefit from these exercises.  Men should consider doing these exercises that don’t require any equipment, very little time, and have very effective results.

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Urinary Incontinence: Gotta Go, Gotta Go Right Now!

November 28, 2015

Urinary incontinence affects millions of Americans and causes havoc with their lives.  It I a source of embarrassment, shame and often depression.  Other medical consequences of incontinence include skin irritation, urinary tract infections, and pelvic pain.  This blog will discuss treatment options including medications and non-medical solutions.

Urinary incontinence means that the person suffering from it starts losing his/her control over the bladder. This leads to several kinds of problems of the urinary system including sudden urination, slow but steady leakage of urine, or dripping of urine when one undertakes a physically stressful exercise like lifting weight.  Those who have incontinence often lose urine with coughing, laughing, or sneezing.

Although this is a common medical problem, many suffers continue to suffer in silence, living a secluded and reclusive life.

While these causes cannot be controlled, it is important to take note of and control factors that can worsen the condition:

Medication

If you have a problem of urinary incontinence and the symptoms have gone from bad to worse, you need to check with your doctor about the medication or drugs you have been taking. For, chances are that some of these may be exacerbating the problem. Certain drugs to treat high blood pressure are linked to an increase in incontinence.

Alpha blockers dilate blood vessels to reduce blood pressure and they also often relax the muscles of the bladder, furthering urine flow. Some drugs to treat depression can contribute to worsening incontinence symptoms.

Anti-depressants work by relaxing the nerves of the mind and may also affect the ability of the bladder muscles to contract (side effects).

Diuretics are another set of drugs that are associated with increased

urination. In fact, these drugs are also called ‘water pills’, and are designed to flush out excess salt from your body to treat conditions like high blood pressure.

Caffeine

Caffeine is an important component of our daily lives as most of us consume it through coffee, tea and chocolates. Excessive consumption of caffeine is associated with the problem of increased urination. While mild consumption doesn’t have a negative effect, excess consumption can affect the renal system, as caffeine is a stimulant. It stimulates the cardiovascular system, increasing the heart rate as well as blood pressure. This increases the rate of blood to be filtered. It also relaxes the bladder’s detrusor muscles, causing them to feel fuller more frequently. So, limiting caffeine intake is healthy.

Type 2 diabetes

Type 2 diabetes is a major health concern of today as it affects the functioning of the entire body. It also increases the risk of urinary incontinence, as well as its severity. Efforts should be made to prevent and control diabetes by keeping your weight under control, exercising regularly and leading a healthy lifestyle.

Excessive weight also puts extra pressure on the pelvic muscles and weakens them. Therefore, it is also important to control body weight.

Solutions

Besides controlling the aforementioned factors, it is important to take medical help to treat and manage urinary incontinence.

In some patients, adopting behavioral changes may help. For example, decreasing fluid intake to average levels, urinating more frequently to decrease the amount of urine that is held in the bladder and keeping regular bowel habits (as constipation can worsen the problem) may have a positive effect.

Pelvic muscle training exercises, aka Kegel exercises, can specifically help those who suffer from incontinence. The exercises help patients exercise better control of their detrusor muscles.

Weight loss has also been shown to help decrease symptoms in overweight people.

Bottom Line:  Urinary incontinence is a common condition affecting millions of American men and women.  Help is available and no one needs to “depend on Depends”!

Men You Don’t Have To Depend on Depends After Prostate Surgery

October 24, 2015

Many men after prostate surgery will have a problem of urinary incontinence. The good news is that it is usually temporary and lasts only a few days or weeks. However, after prostate cancer surgery, the incontinence may be worse and last for a longer period of time. Help is available. Men can use Kegel exercises, which are the same exercises, that women use who have a problem of losing urine.

About 30 percent of prostate cancer patients nationally are affected by incontinence a year after surgery, and another 14 percent still feel the effects after five years.

Urinary incontinence has been shown to cause significant distress in men following prostate cancer treatments. Men become reclusive and even depressed if they have incontinence. Men are afraid to travel or attend other social gatherings because there may not be a restroom nearby.

A study from the Cleveland clinic detailed results from 244 men randomly assigned to one of three approaches to reduce leakage and manage symptoms.

The first two approaches offered the men one session of biofeedback-assisted pelvic exercises and six biweekly sessions—either in a peer support group or by phone—to learn how to self-manage their symptoms. In the biofeedback sessions the men learned how to perform Kegel exercises.

In the third approach, men received information and a doctor’s directions for care or sought information on their own.

By the third month, the first two methods—biofeedback, plus support group or telephone contact—showed better results. The number of leakage episodes decreased.

At the last assessment at six months, the men receiving biofeedback and support recorded the greatest reduction in leakage amount.

For more information on Kegel exercises please go to my website, www.neilbaum.com or copy and paste this into your browser: http://neilbaum.com/articles/kegel-exercises-for-men-2

Bottom Line: urinary leakage can be depressing for both men and women. Help is available. Just remember, a Kegel a day can keep the doctor away!

Non-Medical Steps To Control Bladder or Urine Leaks (Overactive Bladder)

September 13, 2015

Urine Leaks/loss of bladder control is common among women and is one of the most embarrassing maladies affecting anyone who suffers from this problem.

The condition affects women between ages 18 through 65 and it could get worse it not properly managed.

Loss of bladder control/urine leaks/urinary incontinence can be contained with simple lifestyle changes without having to undergo any form of surgery or take any medications with its associated side effects.

Tips that work:

  1. Kegels

Kegels are known to help tighten the pelvic floor muscle. Try ‘squeezing’ the pelvic muscle slowly.

A common way to do this is to stop urine flow while at it counting up to 20 before starting the flow, holding each squeeze for 10 seconds.

  1. Reduce fluids intake

Drink water when you have to/regularly but don’t drink too much to overwork the bladder.

  1. Reduce acidic foods in your diet

Foods with high acid content should be reduced. Oranges, apples, lemon and alcohol contain acid known to irritate the bladder. If you have urinary incontinence, reduce intake of these foods.

  1. Relax

It’s best to relax as this also helps the whole body relax which reports reveal could reduce urinary incontinence.

  1. Use tampons

You can use tampons to stay dry especially when involved in high impact activities or moving around a lot.

Tampons slightly lift up the urethra (which is the bladder opening) to support it when you are moving around. Be sure to remove it as soon as you are done with the activity.

Bottom Line: You don’t have to suffer in silence. Help is available. If you suffer from urinary incontinence or other problems “down there”, see your doctor.

For more information on “down there”, I recommend my book, What’s Going On Down There- Improve Your Pelvic Health, available from Amazon.com (http://www.amazon.com/Whats-Going-Down-There-Siddighi/dp/1477140220/ref=sr_1_13?ie=UTF8&qid=1442165577&sr=8-13&keywords=What%27s+Going+On+Down+There)

What's Going On Down There-Improve Your Pelvic Health (amazon.com)

What’s Going On Down There-Improve Your Pelvic Health (amazon.com)

Kegel Your Way To Treating Urinary Incontinence

August 15, 2015

Urinary incontinence affects millions of American women. Certainly there are medications and surgery that can help control the problem. However, first line treatment is often natural methods and exercises to help with women suffering from urinary incontinence.

Many people don’t realize it, but physiotherapy is a really effective, low-risk treatment for urinary incontinence. Here is how physiotherapy can help you.

Physiotherapy is one of the best and most effective treatments for urinary incontinence. Not only is it a low-risk solution, but a good physiotherapist can help you retrain your bladder and strengthen your pelvic floor muscles to help resolve the problem.
Depending on the different types of urinary incontinence, there are many different exercises and ways in which physiotherapy is beneficial. Leaking isn’t just a symptom of a weak pelvic floor, it could also be a sign of muscles that are too tight as a result of knots in the pelvic floor, endometriosis or even constipation. This is why a full assessment is vital.
1. Stress incontinence: This refers to the involuntary need to urinate when there is increased intra-abdominal pressure – such as coughing, jumping or running. The pelvic floor muscles are not being used properly to keep the bladder closed when it is subjected to pressure.
2. Urge incontinence: Also known as an overactive bladder, this is characterized by an overwhelming need to urinate and the involuntary passing of urine because of this. Sometimes this can be triggered by something as small as hearing running water or seeing the toilet.
3. Mixed incontinence: This is a combination of both forms.
A physiotherapist should be able to diagnose the type of incontinence following a short examination which includes obtaining details about your bladder control, your health history including any surgeries or pregnancies, your diet and your current lifestyle.
The ultimate goal of physiotherapy is to help you regain control of your bladder, and is primarily focused on the pelvic floor muscles and how to tighten or relax them so that they function properly to keep you dry.

Exercises and treatments
Behavioral modification, which involves re-learning how to go to the toilet and learning how to effectively empty the bladder. Simple as it sounds, she says some incontinence issues stem from bad toilet-going habits such as pre-emptive urination (going to the toilet when you don’t actually need to), as well as straining excessively when on the toilet. Both put unnecessary pressure on the bladder and weaken it over time.
Pelvic Floor Exercises are probably the most well known forms of exercise for pelvic dysfunction. This involves a conscious tightening of the muscle around the anus, vagina and front passage to “lift it up” and inwards without clenching the buttocks. These can either be done in a slow-squeeze and hold or a fast squeeze with no hold. Both are most commonly known as Kegel exercises and are designed to strengthen the pelvic floor.
Neuromuscular stimulation is another method used which activates nerves and their associated muscles. In the case of incontinence, an internal probe with light electrical currents is applied to the pelvic floor to stimulate the nerves and cause muscle contractions with the aim of teaching the correct action and use of the pelvic floor muscles or calming of overactive nerve responses.
Weighted vaginal cones are plastic, cone-shaped devices which the physiotherapist inserts into the vagina to help exercise the pelvic floor muscles. Weights can be added to them or removed and they work by gradually stretching the vaginal opening as the cone drops lower. This stimulates the pelvic floor to contract and tighten up to try and hold the cone in place. It’s the sensation of falling out which triggers a contraction to keep it in.
Bladder retraining literally means retraining the bladder how to work. Although bladder training can take at least six weeks before it has a noticeable effect, many people find it a successful endeavor.
Tips for training the bladder:
– Don’t pee “just in case”: Try to wait a little longer when you feel the need to urinate, which will stretch the bladder and encourage it to hold bigger volumes.
– Keep calm: When the urge to go appears, try to sit down and hold a pelvic floor contraction hard enough to prevent leaking for as long as you are able, allowing the “desperate urge” to pass, and buying you a few more minutes.
– Keep hydrated: Don’t restrict your fluid intake as this will only result in stronger urine, which will only irritate the bladder. If you wake to go to the loo during the night, however, limit your liquid intake two hours before bed.
– Limit caffeine and alcohol: Some bladders react negatively to caffeine and alcohol and limiting your intake of these substances may reduce your need to urinate.

Bottom Line: Urinary incontinence can almost always be controlled and in some cases actually cured. Help is available. Speak to your doctor.

Urinary Incontinence In Women Athletes-Don’t Suffer In Silence!

July 12, 2015

One of the most common, but rarely discussed issues that female athletes face is urinary incontinence during exercise. This phenomenon is also known as stress urinary incontinence and is defined as the involuntary leaking of urine during activities like running, jumping, laughing or coughing. This problem affects nearly 50% of women who exercise but mostly only a few drops come out and not considered a significant problem. This can often be controlled using Kegel exercises. (see my website for more information on Kegel exercises, http://www.neilbaum.com)

One study estimates that leaking of urine occurs in 47% of exercising women (average age was 38 years in this study). Many attribute this problem due to pregnancy and childbirth; however, studies have shown that 25-28% of high school and collegiate athletes who have never been pregnant report stress urinary incontinence. These numbers are even higher in sports that significantly increase the intra-pelvic pressure like gymnastics and trampoline where 60-80% of athletes report incontinence!
What’s the Cause of Stress Urinary Incontinence (SUI)?
In most cases, SUI is caused by a dysfunctional pelvic floor. The pelvic floor is made up of muscles, connective tissue and sphincters. These three types of structures have three main functions: 1) stabilize the spine and the pelvis, 2) support the pelvic organs, and 3) control the retention and release of urine and stool.
One reason the pelvic floor can become dysfunctional is that the muscles and connective tissues become stretched or weak during or after pregnancy. However, they can also become too tight or “stay on” too much of the time, so that they can’t contract quickly or strong enough during high-impact activities, like in running or jumping sports.
The Impact of SUI
Stress urinary incontinence is not only embarrassing for women, but many either stop exercising altogether or stop doing sports/activities that they love to avoid this problem. In addition, pelvic floor dysfunction can also lead to pain – during intercourse or at rest, so this problem can negatively impact many areas of women’s lives.
Treating SUI
Fortunately, there are several ways to improve pelvic floor function and stop episodes of incontinence. The first step is to be evaluated by a physician who specializes in the pelvic floor (certain sports medicine physicians, gynecologists or urologynecologists). Often patients are referred to women’s health physical therapists to learn exercises to improve their pelvic floor function. It’s important to note that the exercise regimen is more unique and comprehensive than Kegel’s for every woman. Some women improve with Kegel’s, but others need to learn to relax their pelvic floor rather than strengthen it. In addition to therapy, there are medications, injections and surgical procedures that can be used if necessary.
Bottom Line:
For the female athlete, pelvic floor dysfunction and incontinence is under-reported, under-diagnosed and under-treated. It can lead to women avoiding sports or exercise as well as decreased performance. With the right diagnosis and treatment, it can be completely resolved. Don’t suffer in silence. See your doctor.

Foods and Fluids That Worsen Overactive Bladder

May 4, 2015

One of the most devastating problems affecting many men and women is the problem of overactive bladder. This is the bladder that has a mind of its own. When the bladder decides to empty its liquid contents and doesn’t wait for the owner’s permission, it is called overactive bladder.
There are some foods and beverages that you should avoid, since they could worsen your condition.

Water (too much or too little)
You might think that drinking less water will make you want to pee less often, but that theory backfires in reality. Drinking too little water causes your urine to become more concentrated, which can irritate your bladder. On the other hand, drinking too much water can be a problem as well. Try to find the right balance to meet your needs and avoid drinking a lot of water after 6 pm, so that you don’t keep waking up to go to the bathroom at night.

Caffeine
Coffee, tea, soft drinks and energy drinks all contain caffeine, which is a diuretic that causes your body to produce more urine. Drinking less caffeine will give you better control over your bladder.

Chocolate
Chocolate is another source of caffeine that can worsen your bladder control. If you don’t want to give up chocolate, try to consume it earlier in the day, or switch over to white chocolate.

Spicy foods
Spicy foods also irritate your bladder, so try to dial down the amount of chilli you add to your meals and avoid spicy snacks and sauces.

Citrus fruits
Citrus fruits like lemons, oranges, grapefruits and limes are all acidic. Acidic foods irritate your bladder and worsen urinary incontinence, so try to limit your intake of these fruits
Pineapples
Most people aren’t aware of this, but pineapples are actually acidic fruits as well. Limit your intake of pineapple and avoid drinking pineapple juice.

Tomatoes
Tomatoes also worsen urinary incontinence, since they are also acidic. They will be pretty hard to cut out of your diet, since tomato-based foods also have the same effect, so you would have to avoid sauces, gravies, ketchup, and other tomato-based items.

Onions
Onions can also irritate your bladder, so try to cut down your onion intake and avoid eating raw onions. You can even switch to a milder vegetable like shallots instead.

Cranberries
Cranberries are an effective remedy for urinary tract infections, however they are pretty acidic so they could reduce your control over your bladder.

Alcohol
All forms of alcohol dehydrate your body, but they do so by increasing the amount of urine, which means you need to visit the bathroom much more frequently. Alcohol also interferes with the signals that the brain sends to the bladder about when to release urine, so if you suffer from urge incontinence, where you sometimes lose control of your bladder, you should avoid alcohol as much as possible.

Sugar
Both sugar and artificial sweeteners affect the bladder. Try to cut sugar out of your diet for a few days and see whether it makes a difference to your bathroom habits.

Carbonated drinks
Avoid carbonated drinks like soft drinks, soda, sparkling water and fizzy juices. The fizz irritates your bladder, and makes you need to pee more often.

Sauces
Certain condiments like mustard, vinegar, soy sauce, ketchup and chili sauce can all worsen your condition, so consume them sparingly. Switch over to healthier chutneys and spices instead.

Processed foods
The artificial colors, flavors, additives and preservatives in processed foods could also be adding to the problem. Try to cut them out of your diet and eat more home-cooked meals instead.

Bottom Line: By modifying your diet you cannot cure overactive bladder but you certainly can use these techniques to help control the problem. It may not be necessary to eliminate completely all of these dietary irritants but if you can use them in moderation, your bladder will thank you!

Clinical Management of Urinary Incontinence in Women

March 30, 2015

Incontinence is a devastating condition affecting millions of American women. It is a source of embarrassment that results in women becoming reclusive and deciding not to engage in socialization. Urinary incontinence, defined as the involuntary leakage of urine, affects 20 million persons nationwide Help is available. You don’t have to depend on Depends! This blog will discuss the problem and the treatment options for urinary incontinence.
Most cases of urinary incontinence in women fall under one of three major subtypes: urge, stress, or mixed. I believe in going from tshe least invasive (behavioral modification) to more invasive (surgery) interventions is the best approach. Bladder retraining and pelvic floor muscle exercises are first-line treatments who present with urge incontinence or “I gotta go right now”! Medication with anticholinergic medications is another option for treating urge incontinence if behavioral therapy is unsuccessful; however, because of adverse effects such as constipation and blurred vision and confusion, these agents are not recommended in older adults.

Pelvic floor muscle exercises or Kegel exercises are considered first-line treatment for stress incontinence or loss of urine with coughing, laughing or sneezing. Alternatives for treating stress incontinence include vaginal pessaries. At this time no medications are approved by the U.S. Food and Drug Administration for treating stress incontinence. Minimally invasive procedures injection of periurethral bulking agents, can be used if stress incontinence does not respond to less invasive treatments.

Third line treatment consists of surgical interventions, such as sling and urethropexy procedures, should be reserved for stress incontinence that has not responded to other treatments.

Bottom Line: Women suffering from urinary incontinence do not have to suffer and should speak to their doctor about treatment options. Usually some of the options are helpful and can make women comfortable and able to engage in most activities without the embarrassment of the loss of urine.

Non-Medical Treatments of Urinary Incontinence

Incontinence is a devastating condition affecting millions of American women. It is a source of embarrassment that results in women becoming reclusive and deciding not to engage in socialization. Urinary incontinence, defined as the involuntary leakage of urine, affects 20 million persons nationwide Help is available. You don’t have to depend on Depends! This blog will discuss the problem and the non-medical treatment options for urinary incontinence.

WEIGHT LOSS
Women who are overweight or obese and who experience stress incontinence should be encouraged to lose weight, which has been shown to reduce the frequency of incontinence symptoms.32

BEHAVIORAL TREATMENTS
Pelvic floor muscle exercises are the mainstay of behavioral therapy for stress incontinence. Up to 38 percent of patients with stress incontinence alone who follow a pelvic floor muscle exercise regimen for at least three months experience a cure. Increased effectiveness is demonstrated in women undergoing longer training and in those following comprehensive clinic-based training rather than self-help booklets.
Manual feedback (palpating the pelvic muscles during the exercises) and biofeedback (using a vaginal or anal device that provides visual or audio feedback about pelvic muscle contraction) have been used to teach patients the correct technique. Weighted intravaginal cones have also been used for improving technique when women have difficulty identifying their pelvic floor muscles. Although these strategies may improve technique and, consequently, symptoms in the short term, there is no evidence that they result in higher rates of long-term improvement or cure than the exercises alone.

ELECTRICAL AND MAGNETIC STIMULATION
Electrical stimulation of the pelvic floor muscles with a vaginal or anal electrode can be used in women who cannot voluntarily contract pelvic floor muscles.13 This can be done at home and typically consists of two 15-minute sessions daily for 12 weeks. Medicare has approved its use in patients who have incontinence that does not respond to structured pelvic floor muscle exercise programs.

Extracorporeal magnetic innervation involves a series of treatments in which the patient sits, fully clothed, on a chair that generates a low-power magnetic field. Patients typically undergo two or three treatments per week for six to eight weeks. One early study showed this method to be most effective for women who have mild stress incontinence (i.e., using three sanitary pads per day or fewer). A more recent study found it to be more effective than sham treatment for women who are unable to generate adequate pelvic floor muscle contractions.

DEVICES
Vaginal inserts, including incontinence pessaries and incontinence tampons, can be used for treating stress incontinence in pregnant women, in those who are not surgical candidates, and in those whose symptoms have not responded to previous surgeries. Vaginal inserts compress the bladder neck and urethra, thus decreasing urine loss caused by stress incontinence. Although pessaries are not widely used, their associated risks and costs are low, and they achieve results quickly. There are few contraindications to pessary use (e.g., active pelvic infection, severe ulceration, allergy to product materials, noncompliance). Incontinence tampons, which also place pressure on the bladder neck, are available in Europe.
[corrected] Urethral plugs are devices that are inserted into the urethra to prevent urine loss during activities that cause stress incontinence (e.g., running). They are available in two lengths: 3.5 cm and 4.5 cm. There is limited evidence promoting or discouraging their use, and they are associated with a number of adverse effects, including urinary tract infection (occurring in up to 31 percent of women over a two-year period), hematuria or blood in the urine (3 percent), and migration into the bladder (1 percent). Despite this, multi-year studies indicate a high degree of patient satisfaction, and the likelihood of significant adverse effects diminishes with continued use.

Bottom Line: Urinary incontinence is a devastating problem affecting millions of American women. You don’t have to suffer in silence. Help is available; speak to your physician

Urinary Incontinence-Don’t Suffer In Silence

December 20, 2014

Urinary incontinence is one of life’s most embarrassing problems. Millions of American women suffer from incontinence in silence. I see dozens of women every month with this problem and so many of them have been wearing pads and diapers for years because they were too embarrassed to bring up the problem with their physician. This blog will discuss the problem and why it is important to see a physician to get treatment.

There are millions of people who deal with the embarrassing and disruptive effects of urinary incontinence, yet it’s a health secret that is rarely discussed. Contrary to what a lot of people think, urinary incontinence is not a normal sign of aging. Yes, it is more common in older men and women but you don’t have to live with the problem as treatments are available.

There are several reasons for urinary incontinence, but for women, one of the most common is weakened muscles in the pelvic floor.
A woman’s body goes through many changes during a lifetime and weakness or injury to muscles in the pelvic floor can cause health issues for women of all ages. The group of muscles in the pelvic floor can be affected by aging, childbirth, posture or injury. This loss of support of the pelvic muscles can result in incontinence, pelvic pain, or pain with intercourse.

Weakened pelvic floor muscles can be strengthened with Kegel exercises. (see my website, http://www.neilbaum.com, for more information on Kegel exercises). For the problem of urgency and frequency and urge incontinence or overactive bladder, there are effective medications to treat this condition. Finally, for women with both kinds of incontinence due to weakened pelvic muscles, they can be treated successfully with physical therapy.

If you answer yes to any of these questions, you should speak to your physician as help is available:
Do you usually get a strong urge to urinate?
Do you always make it to the bathroom on time?
Do you leak urine when you sneeze or cough?
Do you leak urine during physical activity?
Do you get up more than once per night to urinate?
Do you feel heaviness in the pelvic area?

Bottom Line: If you’ve been keeping urinary incontinence a secret, you’re not alone. You don’t have to accept it. Help is available. Talk to your doctor.

Bladder Symptoms-Stop Depending On Depends!

November 28, 2014

Millions of American women suffer from urinary bladder problems. Unfortunately, they suffer in silence as women feel too embarrassed to discuss their symptoms with their physicians. This article will discuss the common symptoms of bladder control and what can be done about it that doesn’t require a diaper or Depends.
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The involuntary leaking of urine is a distressing symptom which is associated with loss of confidence, self esteem, relationship difficulties and sometimes depression. Some women deal with the situation by avoiding socializing with family and friends, wearing dark clothes and frequently changing their clothing, using scents, sanitary pads and even diapers.
Bladder difficulties can affect all age groups, but are more common in middle age and older women. It is likely that as many as one in five women experience incontinence at some stage in their lives. Approximately 70 per cent of urinary incontinence sufferers tolerate the symptoms and those who seek medical help wait for an average of four years because of embarrassment, shame and stigma.

Talking about these symptoms is difficult but women do not need to feel reluctant about seeking help as so many women can be effectively treated without surgery.

The biggest risk factor for women is damage to the pelvic floor especially related to pregnancy and child birth. Other conditions include extreme sports, chronic coughing and heavy lifting. Contributing causes include obesity, smoking and drugs that affect the bladder or the muscle that holds urine inside the bladder.
There are two main types of incontinence: stress and urge. Urine loss in the stress type is preceded by increasing the pressure within the abdomen such as occurs with laughing, sneezing, or coughing. Women experiencing urge incontinence have a compelling urge to pass urine, which is impossible to control and causes leaking.

Treatment can start with measures, which do not involve medication, but can be followed by pharmacotherapy if the conservative measure are not effective.

Initially patients are advised to decrease the intake of caffeine and carbonated drinks, smoking and avoiding constipation.
Pelvic floor exercises or Kegel exercises, are the recommended first line treatment for stress, mixed and urgency incontinence and result in significant improvement in up to 80 per cent of cases. Bladder training and electrical stimulation are other effective ways of treating incontinence.

Bottom Line: Wearing a diaper to staying at home because of the loss of urine, is not acceptable to most women who suffer from incontinence. It doesn’t have to be that way. See your doctor and he\she can often find a solution that will make you dry, comfortable, and lead you to a healthy lifestyle.