According to research, 25 million adult Americans suffer with urinary incontinence. Of these Americans, 75% to 80% are women; and 9 million to 13 million of them suffer with severe symptoms.
There are two primary types on urinary incontinence, stress and urge. Stress incontinence is the involuntary loss of urine with activities such as coughing, laughing, changing positions or with exercise. Urge incontinence is the involuntary loss of bladder control due to an overwhelming and sudden urge to urinate. It is often difficult to get to the bathroom before having an accident.
In the case of women, statistics show that 10% to 60% of women suffer from urinary incontinence, and that 30% to 50% do not seek treatment. That’s because women often view urinary incontinence as either an unavoidable consequence of childbirth or a normal part of the aging process. Sadly, patients are unaware of treatment options other than surgery. This problem is often made worse by doctors telling them to “just do Kegels.” The logic behind this is that incontinence is caused by weak pelvic floor muscles and Kegel exercises are meant to strengthen the pelvic floor. The problem with this advice is that, according to recent research, 51% of women could not perform a Kegel properly with verbal cueing alone. And 25% of the women in the study were actually performing the attempted Kegel in a manner that could promote incontinence.In my experience, incontinence can be more of a coordination dysfunction rather than a loss of strength. Bad habits can also contribute significantly to incontinent episodes.
Fecal incontinence is the inability to control your bowel movements, causing stool (feces) to leak unexpectedly from your rectum. Also called bowel incontinence, fecal incontinence ranges from an occasional leakage of stool while passing gas to a complete loss of bowel control.
Muscle damage is involved in most cases of fecal incontinence. In women, this damage commonly occurs during childbirth. It’s especially likely to happen in a difficult delivery that uses forceps or an episiotomy. An episiotomy is when a cut is made to enlarge the opening to the vagina before delivery. Muscle damage can also occur during rectal surgery such as surgery for hemorrhoids. It may also occur in people with inflammatory bowel disease, constipation or diarrhea.People can often compensate for muscle weakness. Typically, incontinence develops later in life when muscles are growing weaker and the supporting structures in the pelvis are becoming loose.
Damage to the nerves that control the anal muscle or regulate rectal sensation is also a common cause of fecal incontinence. Nerve injury can occur in the following situations:
- During childbirth.
- With severe and prolonged straining for stool.
- With diseases such as diabetes, spinal cord tumors and multiple sclerosis.
Fecal incontinence may also be caused by a reduction in the elasticity of the rectum, which shortens the time between the sensation of the stool and the urgent need to have a bowel movement. Surgery or radiation injury can scar and stiffen the rectum. Inflammatory bowel disease can also make the rectum less elastic
Pelvic organ prolapse (POP) occurs when the vagina and/or uterus have dropped from their normal position in the pelvis. Prolapse can be caused by injuries sustained during childbirth, aging, chronic coughing and/or heavy lifting.Research shows that 50% of women that have had children develop POP, and while 30% to 50% of these women never seek treatment, the reality is that 80% to 90% can be successfully treated. Physical therapy is the first-line treatment for women with POP. Your pelvic floor muscles, in addition to connective tissue, provide support for your pelvic organs. Symptoms of Pelvic Organ Prolapse can include: pelvic pressure, lower backache, organ protrusion from the vaginal opening, discomfort during intercourse.