Problems and Causes
Studies have suggested that 5-15% of men are affected by incontinence. Approximately half of all men who undergo prostate removal surgery because of prostate cancer will experience leakage during the first six weeks after surgery and about 20% of those will continue to have significant problems with leakage, or stress urinary incontinence.
It is estimated that 17 million men have an enlarged prostate or symptoms of Benign Prostate Hyperplasia. The prostate gland wraps around the urethra, therefor an enlarged prostate can constrict or block the urethra. Prostatic obstruction can compromise the bladder’s ability to effectively empty, causing chronic retention of the urine. This can also lead to overactive bladder symptoms caused by bladder or prostate infection, kidney stones, bladder cancer, and nerve damage. Another factor for leakage is obesity.
Treatment
There are various levels of intervention, depending on the severity and duration of urine leakage. Pelvic floor exercise, also known as kegels, are an important part of the behavioral treatment technique to help increase bladder control and decrease bladder leakage. Biofeedback therapy may be necessary for some men who need additional assistance with pelvic muscle rehabilitation. Additionally RUSI (rehabilitative ultrasound imaging) is available to determine if the correct muscles are being used.
Biofeedback
Biofeedback helps detect and record pelvic floor muscle activity by placing small sensor close to the muscles on the pelvic floor. The information collected during biofeedback can be used to both ensure that a man is correctly contracting his pelvic floor and plan a personal exercise program to increase the strength and holding power of the muscles to control urination.
Therapeutic Exercise
The muscles of the pelvic floor are located in the base of the pelvis between the pubic bone and tail bone. These muscles have three main functions: Support the abdominal and pelvic contents, control bladder and bowel function, and they are involved with the sexual response.
Exercises that will be included in PT are to help strengthen not only your pelvic floor but your lower abdominals which also are in control of bladder leakage. This can be done with the use of an exercise ball and other abdominal exercises.
In some cases, incontinence may require methods outside the realm of physical therapy, such as medication or surgery – to treat infection, replace hormones, stop abnormal bladder muscle contractions, tighten sphincter muscles, correct positioning of the bladder or remove
tissue blockage within the bladder. Therapists at Midwest Physical Therapy work closely with physicians to augment these treatment methods.
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