By DR THOMAS KAISER [email protected]
Dr Thomas Kaiser is the Medical Director of the Vale do Lobo Medical Centre and is a specialist in traditional General Practice for the whole family, state of the art aesthetic and cosmetic medicine.
IT’S NOT only the elderly who suffer, young women also experience urine incontinence – an involuntary loss of urine – and often find it a very difficult subject to talk about which makes the whole situation even more unbearable.
Causes of this common situation can vary – from a prolapse of the uterus or rectum, incorrect toilet habits, back problems, childbirth complications, consequences of surgery, excessive workouts or simply pelvic floor muscle weakness.
Unfortunately, women still feel very uncomfortable about it, even ashamed, and it can therefore become a social problem, leading to isolation or other forms of limitations.
The incontinence problem can rule woman’s life. A common example is missing out on trips because of being unsure whether there will be a toilet on the way.
There are three different kinds of incontinence problems: stress incontinence – loss of urine while sneezing, coughing, laughing or running; urge incontinence – inability to control the urge; and a combination of these two.
Women suffer more frequently from incontinence problems then men because of the difference in anatomy which makes the pelvic floor in women more vulnerable to weakening and after a pregnancy – pelvic floor stressed by increased abdominal weight – and childbirth – overstretching the pelvic floor muscles (PFM) in natural birth procedure.
As the PFM are ‘hidden’, we tend to ignore them, although they are muscles like any other and they become weaker over the years, also needing attention.
The PFM are like a bowl lying in the cavity of the pelvis, they partly control the urine flow, but they also have an important role for the stability of the spine and the support of our abdominal organs.
Incontinence problems are complex and personal, demanding sometimes a multidisciplinary approach from your GP, gynaecologis, urologis and physiotherapis.
Women with pelvic floor muscle weakness, a light prolapse of the uterus or rectum will be very much helped with physiotherapy treatment.
How to train the pelvic floor muscles
Women actually know very little about the PFM – even less how to strengthen them! Some try on their own but really most women don’t know what should be done and how to train properly. This small muscle group demands a specific training programme depending on each individual needs.
A prevention programme is useful for all women but especially for women who already feel a weakness in the pelvic floor (loss of ‘a few urine drops’ or difficulties in ‘holding up’) and is also important for women after giving birth.
This programme is based on body awareness and active exercises to strengthen the PFM. One can work on an individual basis but also in small groups where automatically mutual motivation and shared experiences boosters stimulation.
A rehabilitation programme for women who suffer from incontinence is totally individual and based on the diagnosis of the situation and the pelvic floor condition.
This rehabilitation is an intensive training of body awareness, active exercises of the PFM and electrotherapy.
The treatment is guided by an EMG (electromyogram), giving the women the possibility to see and follow the PFM training on a screen – a great booster for motivation and proof of improvements.
Studies have shown that 50 per cent of problem cases are solved by this rehabilitation, 35 per cent felt a big improvement and only 15 per cent felt little improvement. There is no age limit to this treatment.
Karen Peters is a physiotherapist specialising in this area who can help you with a prevention or rehabilitation programme.
Dr Thomas Kaiser can be contacted by telephone on (00351) 289 398 009 or by emailing [email protected]