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Dr. Andre A. Kulisz
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Urinary Incontinence - Dr. Kulisz's View
Urinary incontinence (UI) is a form of voiding dysfunction that affects about 50% of women at one time of their life or another. It also affects men, but to a much smaller extend. Generally, it could be stated that in women incontinence occurs naturally, while in men it occurs iatrogenically, or, to put it more bluntly is inflicted by a physician.
The rule is that women seek treatment because they are incontinent while men are incontinent because they were treated.
Although there is a plethora of publications on the treatment of female UI, very few
physicians committed their specialization to this medical condition. Primarily, because
the condition is not terminal, and because, in women, it has been always associated with
old age and child bearing. For many, therefore, it is a "natural" condition.
I strongly believe that the initial stages of the stress urinary incontinence are fully
curable by means of proper exercises. Well, the word "proper" is the key word
here. The group of muscles that keep women dry are the muscles of the pelvic floor. As we
age our muscular structure gets more flaccid and even atrophied, we or some parts of us
get weaker and, eventually, we loose some of the functions that we used to take for
granted. A good example here is our ability to read fine text. Most of us past forty years
of age are using reading glasses. This is the way to make up for the lost accommodation of
eyes.
As the pelvic floor gets more and more flaccid, the organs imbedded in it get more flaccid
and weaker too. In the case of the urinary system, these organs are the bladder neck and
the urinary sphincter. There are many volumes of very wise medical books that have
been written on this subject. To make this story short: if the stress urinary incontinence
is not attended to properly at the early stage, it may, and in some women will, develop to
a major problem of what is called the intrinsic sphincter deficiency. In plain language it
may mean two to four adult diapers a day. Do not get to this stage! Take care of your
body. It is the only one you have.
There are other, more gynecological considerations as position of the uterus or lack of
it, prolapses, fistulas, etc. The proper position of the uterus plays a substantial role
in preventing incontinence! Also obesity is an important consideration. If you are
incontinent always be seen by a gynecologist that has incontinence experience, and by a
urologist. Compare notes, get the second opinion. There are more and more of
uro-gynecologists, so you may be in luck if you find one and make one visit to the doctor
rather than two.
Another option is to see an osteopath (DO rather than MD). There are some that can help
tremendously. Take your time and look around. But the most important: do not hesitate to
interview prospective caregiver (doctor, nurse, physical therapist, insurance company,
etc...) If you are not happy, keep on looking. Trusting your doctor does
miracles. Finding the right one will be good for the both of you.
In most cases exercising the pelvic floor will do just fine. The problem is that many
people never developed any awareness of their organs and often don't even know where the
pelvic floor is. Instruction from a physical therapist or a nurse experienced in
incontinence will definitely help. Do exercise! Exercise you pelvic floor.
Exercise. Do aerobics, stair steppers, walking, weight lifting.
Anything. Just exercise. But always exercise your pelvic floor. And
remember: if it took you 50 years to become incontinent, give yourself at least 5 months
of exercises to recover from it. It may be worth it. Otherwise the surgery
maybe the only option. Sometimes many of them.
There are some interesting devices that
you may consider using to make your exercise more beneficial. I am continuously
looking for such devices and will post information about them here. So, stop by
again. Will be happy to see you here.
For personal telephone consultation with Dr. Kulisz click here.
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