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23 May 2005
Physiotherapists More Successful At Curing Incontinence 
Stress incontinence, brought on by physical exertion, is the most common reason for urinary incontinence, affecting about one-in-three women from all age groups. "Stress incontinence is the type of stress that occurs when women cough, sneeze, or undertake physical activities such as running and jumping; and it is these physical forces that push down on the bladder and force urine out," said Researcher Trish Neumann, from the University of South Australia. "For a long time, stress incontinence was treated by surgical procedures without going through physiotherapy as a first option, but the outcomes of surgery have not always been positive with success rates as low as 50 percent recorded in a recent study and with the potential of complications." The key to an effective physiotherapy regime is pelvic floor muscle training, according to Neumann. "Being able to understand how to contract the pelvic floor muscles the right way is essential for a successful outcome," said Neumann. "About one-third of women who are given a brochure about pelvic floor exercises, get the basic action wrong and don't do well on their own with pelvic floor muscle training. They need expert guidance to achieve the correct technique, not from a general physiotherapist, but a specially trained continence physiotherapist." The women in the study had an average of five treatments over several months, as well as a home program that was monitored. Of the women who took part in the study, the majority were either cured or significantly improved and were happy with the outcome. After one year, about 80 percent of the study participants indicated that they were still happy with the outcome of treatment. "Age is not a factor in the success of the treatment but maintaining a strong pelvic floor once the muscles have been strengthened with regular exercise built into their daily lives is the key to long-term success. Exercise takes very little time and can be done at times that suit participants, and as part of their everyday activities. There's new evidence showing that if women train the pelvic floor muscles for strength, the muscles actually improve in their tone and form a firmer support for the bladder, performing automatically to control urine. That's partly what we're aiming for with our training program, improvement in strength and tone," Neumann said. Neumann concluded by suggesting that when women go to their doctors seeking help, it is important that they are referred for physiotherapy in the first instance because it has been proven to be effective, rather than being referred for surgery first.
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