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Christie Cohoon, PT, DPT, St. Luke's Hospital

Urinary incontinence is common and highly treatable

It has happened to many of us. We laugh, sneeze or lift something heavy, and all of a sudden we experience bladder leakage.

Although rarely talked about, bladder leakage - or urinary incontinence - is more common than you might think. More than 25 million Americans, many of them women, experience it. Urinary incontinence and other pelvic floor disorders affect up to one-quarter of American women.

Many women suffer in silence because they're embarrassed - too embarrassed even to tell their doctors. They also may not realize urinary incontinence can be treated, or they assume it's a normal part of aging. It's not, and you don't have to just live with it.

Many things can contribute to urinary incontinence, such as the stress of pregnancy and childbirth on pelvic floor muscles, certain medications, bladder infection, chronic illness, cigarette smoking, caffeine intake and hormonal changes of menopause. Fortunately, most bladder control issues can be effectively treated with physical therapy, medication or surgical options.

There are different types of incontinence. One of most common types, stress incontinence, responds especially well to conservative treatment like physical therapy. Stress incontinence is caused when pressure is exerted on the pelvic floor-the network of muscles, ligaments and tissues that support the pelvic organs-when coughing, sneezing, laughing or heavy lifting.

If you experience incontinence, getting a prescription from your doctor to see a physical therapist trained in pelvic floor therapy is a good place to start. The therapist will provide a thorough musculoskeletal assessment, evaluating your posture, flexibility, core strength and spinal and pelvic alignment.

The therapist will develop a personalized treatment plan that may include exercises and the use of special weights to strengthen the pelvic floor muscles, bladder retraining techniques, dietary and lifestyle modifications and gentle electrical stimulation of the pelvic floor muscles.

Although physical therapy is often the first treatment approach, some cases and types of incontinence respond best to medication or surgery. The good news is that there are many effective treatments, and you do not have to live with the embarrassing and often life-limiting problem of incontinence.

Christie Cohoon, PT, DPT, is a physical therapist with the Pelvic Pain and Incontinence Program at St. Luke's Hospital. Call 314-205-6185 or visit the Pelvic Pain and Incontinence page.

This article was published in the St. Louis Post-Dispatch on June 18, 2009.

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