In my last post, I wrote about my decision to get treatment for stress incontinence.
To recap, stress incontinence is a condition that causes people to leak a little bit of pee when they are doing something that stresses the pelvic floor muscles. Exercise, sneezing, and even simply standing up can result in stress incontinence. This condition is quite common in women who have gone through childbirth. For years, I was too embarrassed to talk about my problem, but I finally talked to my doctor. She referred me to a physical therapy office that specializes in pelvic floor muscle problems.
My first physical therapy appointment focused on determining the exact cause of my stress incontinence.
My physical therapist asked me many questions to help pinpoint the extent of my symptoms. She also showed me a model of the pelvic floor muscles and explained how they function. I learned how weakness in the pelvic floor muscles can lead to bladder leakage during high physical activity. My physical therapist performed a pelvic exam to determine my course of treatment. I required four more weekly appointments and a daily homework assignment. I had to perform Kegel exercises once or twice a day and wait at least two hours between trips to the bathroom.
At my next physical therapy appointment, I tried biofeedback therapy.
Biofeedback therapy is when an electrical sensor is placed inside the vagina and hooked up to a computer to show what happens during pelvic muscle contractions. This is definitely the most awkward part of stress incontinence treatment, but at least it’s not painful. The visual information on the computer screen lets you see what is happening when you contract your pelvic floor muscles. It can also detect areas of weakness. By placing another sensor on your stomach, the physical therapist can also determine if you are using your abdominal muscles to help contract your pelvic floor muscles. Ideally, you will be able to isolate your pelvic floor muscles.
My physical therapist also increased my daily homework assignments after this appointment. Now I have to perform three sets of Kegel exercises each day. Each set consists of ten short pelvic muscle contractions and ten longer contractions, with a period of rest between each contraction. Also, I need to contract my pelvic floor muscles right before they get stressed. Mostly, this is right before sneezing or standing up suddenly. My therapist explained that these exercises train the pelvic floor muscles to contract whenever they are under stress even when you aren’t thinking about it.
The next appointment added in electrical stimulation. This was not my favorite experience, but it was certainly tolerable.
After another round of biofeedback, my third physical therapy appointment ended with about ten minutes of electrical stimulation. The therapist attaches a small device to your biofeedback sensor that sends out electrical current. The waves of electricity contract your pelvic floor muscles, making them stronger. Apparently, this can be uncomfortable for some people, but I just felt a strange tingling sensation. I will put up with awkward treatments if they will cure my stress incontinence!
My homework also increased. Now I have to perform four to six sets of Kegel exercises each day. My physical therapist said that 80 to 120 pelvic muscle contractions daily are the ideal. This is a challenge for me. I have a bad habit of forgetting to perform my Kegel exercises until late in the day. Since I have to wait at least an hour between each set, this often doesn’t work out for me. I am trying to find times to build the Kegel exercises into my daily routine so they become automatic and I won’t forget to perform them. Luckily, there are apps that can help you remember!
I continued working with biofeedback and electrical stimulation at my next appointment.
I learned that it is a bad idea to wear pads just in case of bladder leakage. Pads make it so you don’t pay as much attention to your pelvic floor muscles because a little leakage isn’t a big deal anymore. Also, you can leak small amounts of urine and not even realize it if you are wearing a pad. My physical therapist said that the pad is like a bandage. It will mask the symptoms, but won’t fix the problem. Instead, focus should be spent on strengthening the pelvic floor muscles.
My homework changed a bit after this visit. I am still supposed to perform four to six sets of Kegel exercises each day. Before, I always did them either lying down or sitting down. Now, I am going to try one set each day standing up while leaning against something, like a wall or a counter. Leaning against something helps you isolate your pelvic floor muscles from your abdominal muscles.
At last, I reached my final appointment with my physical therapist.
Once again, we discussed how my week had progressed and we monitored my Kegel exercises on the computer using biofeedback. I filled out a questionnaire and discussed the results with my physical therapist. My long-term goals include continuing the Kegel exercises and doing a few stretches to help my pelvic floor muscles relax. These include common stretches such as child’s pose, deep squats, and butterfly stretches.
At this point, it is now up to me to monitor my own body for signs of stress incontinence. My physical therapist suggested re-evaluating myself in three months. If I continue to have any symptoms, I should make another physical therapy appointment to try some different treatment options.