Post on 23-Aug-2020
transcript
Urinary Incontinence and Pelvic Organ Prolapse
Rebekah Wolinetz, PT, DPTReact Physical TherapyLakeshore East clinic
What is pelvic health (women’s health) therapy?● Provided by a physical therapist or a physical therapist assistant● Advanced training and education on women’s specific conditions● Advanced training and education on conditions related to pelvic
floor dysfunction● Specialized assessment and treatment of the pelvic floor muscles
Anatomy
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https://portmelbournephysio.com.au/wp-content/uploads/2017/10/DRAM-1.jpg
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Urinary Incontinence● What is it?
○ Involuntary loss of urine● Most common types
○ Stress Urinary Incontinence (SUI)
○ Urge Incontinence○ Mixed Incontinence
(combination of SUI and urge)
Stress Urinary Incontinence● What is it?
○ Involuntary loss of urine with exertion or effort such as coughing, sneezing, exercising, etc.
● What causes it?○ Pelvic floor dysfunction○ Weakness in abdominal
muscles○ Changes in hormones https://vibrance.com.my/wp-content/uploads/2018/08/Fig-2-Strong-Weak
-PFM.jpg
Urge Urinary Incontinence● What is it?
○ Involuntary loss of urine associated with a strong urge to urinate
○ Usually a stimulus or outside event such as running water, walking by the bathroom, putting the key in the lock
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Risk factors for urinary incontinenceStress urinary incontinence● Pregnancy and childbirth● Pelvic organ prolapse● Obesity● Asthma● History of abdominal or pelvic
surgery● Post-menopausal
Urge urinary incontinence● Habitual causes● Bladder irritants● Overactive bladder
What can you do?● Keep a schedule● Avoid “Just in case” urination● Avoid bladder irritants● Do not limit fluid intake● “The Knack”● Physical therapy
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Pelvic Organ Prolapse● What is it?
○ Descent of pelvic organs (bladder, uterus, or rectum) in the pelvic bowl
● Symptoms: ○ Heaviness, pressure, bulge○ Urinary symptoms○ Bowel symptoms○ Sexual symptoms
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Risk factors for pelvic organ prolapse● Number of vaginal deliveries and instrument delivery● Trauma to pelvic floor muscles during childbirth● Chronic constipation● IBS● Maternal history of POP● Heavy physical work● High impact exercise● Overweight● Chronic illness that results in excessive coughing
What can you do?● Avoidance of Valsalva
(bearing down)● Constipation
prevention/management● Avoid heavy lifting and
prolonged standing/walking● Weight loss● Physical therapy
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The overflow principle
“So if I don’t know if I should be doing kegels or not, how do I improve my symptoms of urinary incontinence or pelvic organ prolapse?!”
● Use surrounding muscles to activate the pelvic floor muscles
How can pelvic floor therapy help?
● Evaluation and assessment done in a private treatment room● Hands-on therapy or manual therapy to address muscle
imbalances● Exercises recommended are based off of an examination and are
specific to YOU! ● Lifestyle modifications and recommendations are specific to you
Questions?
Rwolinetz@bereact.com312.929.3646
React Physical Therapy @Lakeshore East
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