By DR THOMAS KAISER
IT’S NOT only the elderly who suffer, younger women also experience urine incontinence (an involuntarily loss of urine) and often find it a very difficult subject to talk about, a situation which only increases the problem.
Causes of this common situation can vary – from incorrect toilet habits, back problems, childbirth complications, consequences of surgery, excessive workouts or simply pelvic floor 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 limitation. The incontinence problem takes over and dominates the sufferer’s life; a very common example being women missing out on trips because they are unsure whether they will find a toilet on the way.
There are three different kinds of urine incontinence problems: stress incontinence (loss of urine when, for example, coughing, sneezing, laughing, running), urge incontinence (inability to control the urge) and a combination of the two mentioned.
An incontinence problem is complex and very personal, demanding the multidisciplinary attention of gynaecologists, urologists and physiotherapists.
Women suffer from incontinence problems more frequently than men because of the difference in anatomy and due to childbirth (overstretching of the pelvic floor).
As this muscle group is ‘hidden’, we tend to ignore it, although, being muscles like any other, they also become weaker over the years and need attention.
The pelvic floor muscles are like a bowl lying in the cavity of the pelvis. Besides being the control muscles of the urine flow, they have an important support function for the lower part of our organs and spine.
Medical specialists do not offer much help in explaining how to train the pelvic floor and women, unfortunately, know little about the pelvic floor muscles – even less how to strengthen them! Some try on their own initiative, but most women don’t really know what should be done and how to train properly. This small muscle group demands a specific training programme depending on each individual’s specific needs.
Karen Peters, a physiotherapist and specialist in this area, can help by giving professional guidance through a prevention or rehabilitation programme.
A prevention programme is especially useful for women who already feel a weakness in the pelvic floor and is also very important for women after giving birth. This programme is based on body awareness and active exercises to strengthen the pelvic floor muscles.
One can work on an individual basis but also in small groups, where, of course, mutual motivation and shared experiences are a big help and stimulation.
A rehabilitation programme for women suffering from incontinence problems is totally individual and is based on the diagnosis of the situation and the pelvic floor condition. This rehabilitation is an intensive training of body awareness, active exercising of the pelvic floor muscles and electrotherapy. The whole treatment is guided by an EMG (electromyogram), giving the woman the possibility to see and follow her pelvic floor contraction and whole workout on a screen – a great booster for motivation and proof of even the smallest improvement and good workout.
Studies have shown that 52 per cent of problem cases are solved by this rehabilitation, 35 per cent felt a big improvement and only 13 per cent felt little improvement. There is no age limit for this treatment.
• If you require help or advice about your symptoms, contact your family doctor or Karen Peters in the Family Medical Centre, Vilar de Golf, Quinta do Lago, 289 398 411 or mobile 919 899 531 and let her help you. Portuguese, Dutch, English and German spoken.