Monday, September 3, 2012

Urinary Incontinence and Pelvic Floor Strength

Urinary Incontinence and Pelvic Floor Strength

Urinary incontinence is a common problem, affecting approximately 25 percent of women at some point in their lives. Some of the most common times that women experience incontinence are during pregnancy, after childbirth or around menopause. Since incontinence is often caused by weakened pelvic floor muscles, building pelvic floor strength through exercise is typically the first line of treatment, and has proven very effective for many women. On the other hand, some women with severe urinary incontinence that hasn't been helped by less invasive measures may need corrective surgery.

Kegel Exercises

If you are one of the many women who suffer from urinary incontinence, chances are you've been instructed to do Kegel exercises to strengthen your pelvic floor muscles. Kegels are good. In fact, there is a lot of scientific evidence behind that recommendation, with many studies showing that they are an effective means of reducing the symptoms of incontinence, especially stress urinary incontinence, or SUI. However, studies have also shown that they must be done correctly to be effective, and that women who are guided by a physical therapist or fitness professional to ensure proper technique achieve much better results than those who do Kegels on their own.

However, Kegels probably aren't the only exercise you should be doing. There is an ongoing debate about Kegels. While they have long been the standard in the treatment of pelvic floor disorders, there are experts who feel that too much emphasis is placed on them, and that strengthening just the pelvic floor muscles in the treatment of pelvic floor disorders may be counterproductive. The pelvic floor muscles play a primary role in pelvic health, but there are other muscles that contribute, so some fitness and medical professionals advise that just working pelvic muscles and neglecting the rest creates an imbalance in the body that can be detrimental to pelvic health and the long-term management of urinary incontinence.

A Broader Approach
Some physical therapists are broadening their approach in the treatment of pelvic floor disorders like SUI. Many are working with patients to strengthen core muscles, gluteal muscles, hamstrings and others, rather than focusing exclusively on pelvic floor muscles. While it hasn't been proven that this more comprehensive approach to exercise is better for pelvic floor health than Kegels, it certainly can have benefits in weight management and overall health, both of which can help improve incontinence.

While non-invasive treatments help most women, surgery may be necessary for some. However, it is important to be aware that SUI surgeries that use transvaginal mesh implants, in the form of bladder slings, have been associated with serious complications. Common problems reported to the Food and Drug Administration (FDA) include mesh erosion, organ perforation, mesh contraction and infection. Many women have been affected by these dangerous complications and some have even filed bladder sling lawsuits. 

The FDA has issued safety alerts on these devices, warning that reports of serious complications with mesh procedures are rising dramatically. The agency advises that most cases of SUI can be treated successfully without transvaginal mesh and urges surgeons and patients to consider traditional SUI surgery as a safer alternative to bladder sling procedures. Even with all the complications the FDA has still not mandated a transvaginal mesh recall.

Guest blog written by Elizabeth Carrollton who writes about defective medical devices and dangerous drugs for Drugwatch.com.