Physical Therapy for Stress Incontinence

The inability to control urination is called incontinence. People with incontinence can experience occasional leaks or actual wetting of the pants. Incontinence is caused by a weakening of the pelvis floor muscles that support the bladder and the urethra. This condition can be treated by physical therapy and by retraining the weakened muscles.

Kegel Exercises

• Kegel exercises are a mainstay for incontinence and have been proven effective in a study (Shamlivan et al. 2008) to manage or alleviate the symptoms of urinary incontinence. During Kegel exercises, the patient contracts, holds and releases the pelvic muscles, similar to attempting to stop the flow of urine. These exercises can be performed throughout the day. The buttocks or leg muscles should not be contracting when performing Kegel exercises.The physician or physical therapist may add biofeedback techniques or tiny weights (vagina cones) to strengthen the muscles of the pelvic wall. Use of these techniques may be enough to treat the urinary incontinence.

Electrical Stimulation and Biofeedback

• If pelvic exercises are not effective, the physical therapist may suggest additional therapy such as electrical stimulation. Electrodes are temporarily inserted into the rectum or vagina to stimulate and strengthen the pelvic muscles. This procedure is expensive and can often take months to work.

  With biofeedback, the therapist uses an electric patch to show the patient how the pelvic floor muscles work. The patch causes the muscles to contract, allowing the patient to learn how to better exercise muscle control.

Behavioral Changes

• Lifestyle changes are a significant part of urinary incontinence treatment. Timed voiding, when trips to the restroom are planned, and bladder training, in which the patient learns to delay urination, can help the patient to learn to control bladder function and feel more confident. Bladder training also helps the patient learn to control the urge to urinate. Using these techniques, the trips to void are extended until the bladder is trained to empty every few hours instead of every few minutes.

  Management of diet and fluid intake can also be used to quell incontinence. Losing weight, avoiding alcohol or caffeine and reducing liquid intake may be a part of a physician's recommended regimen.