Bladder Concerns
Urinary Leakage:
Urinary leakage is more common than you may think and can occur at any point during the life cycle. Urinary leakage can affect women and men, and can come from sources other than weakness. This may be why kegels haven’t helped if you tried them in the past. The two most common types of leakage that we address in the clinic are:
- Stress urinary incontinence– leakage occurring with exertional activities such as coughing, laughing, sneezing, exercise, and sexual activity.
- Urge urinary incontinence- leakage occurring with a strong sudden urge to void. Commonly associated with triggers such as water running, opening the door when returning home, or loss just prior to reaching the toilet.
Many patients report a combination of symptoms which we refer to as mixed urinary incontinence.
Frequent Urination:
Frequent urination can disrupt your sleep and overall well being-scheduling your day around trips to the bathroom. Common symptoms include consistently voiding with less than 2 hours in between voids, feeling the need to void just after using the restroom, voiding multiple times before going to sleep, feelings of incomplete emptying, hesitancy to start the void, and waking up multiple times during the night. Frequent urination may be accompanied with an overactive bladder (OAB) diagnosis but not necessarily.
Painful Bladder Syndrome:
The bladder has a highly concentrated number of pain receptors making painful bladder syndrome one of the most painful and debilitating diagnoses seen in the clinic. Painful bladder syndrome can include pain with bladder filling, emptying, after voiding, or all of the above. Painful bladder syndrome can be associated with additional diagnoses including interstitial cystitis, endometriosis, chronic pelvic pain syndrome (CPPS), pudendal neuralgia, and overactive bladder.
How Physical Therapy Can Help:
The causes of bladder dysfunction are usually multifactorial which is why detailed history taking and comprehensive evaluation are both key. History taking, although specific to the patient, will likely include investigation of bladder and bowel habits, possible dietary triggers, past medical and surgical history, autoimmune history, and stress and lifestyle factors. Physical therapy assessment, although specific to the patient, will likely include assessment of the pelvic floor muscles, abdominal and pelvic organs, fascial and ligamentous connections between the structures, neurological screening, strength, posture, breathing, and special test assessment as appropriate. Once we understand how these relationships are contributing to your symptoms we can get started on a treatment plan together.