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TLC/Men's Health

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Urinary Incontinence

Urinary Incontinence is the involuntary loss of urine. Individuals who suffer from urinary incontinence may find it difficult to talk about, but even more difficult to tolerate, as it significantly impacts daily life. Fortunately, help is available. The prevalence of urinary incontinence in men increases with age and ranges from 3.6% in men 45 years old to 28% in men 90 years old or older. Transurethral resection of the prostate (TURP) or aradical prostatectomy increase the probability of incontinence. You are not alone and most cases can be cured or improved with diagnosis and treatment.

Types of Urinary Incontinence
Stress Urinary Incontinence - the involuntary loss of urine associated with normal activities such as laughing, coughing, sneezing, pushing, pulling, lifting, and jumping. Men at highest risk havehad a radical prostatectomy, radiation therapy or TURP. Urge UrinaryIncontinence-the involuntary loss of urine associated with the strong urge to urinate even if you just emptied your bladder.

Postmicturition Dribble (Post Urination Dribble) -involuntary loss of urine immediately after you have finished urinating, usually after leaving the toilet. This is due to muscle weakness causing pooling of urine in the urethra, which can dribble with movement.

Postprostatectomy Incontinence - symptoms of urge and or stress urinary incontinence and or postmicturition dribble. Some urinary incontinence is normal immediately after surgery and this decreases with time and healing. When incontinence persists treatment can help.

Evaluation and Treatment
During your initial visit, our physical therapist will assess the strength, coordination and integrity of your pelvic floor, abdominals, low back, and lower extremities. Based on these findings and individualized treatment plan will be established.

Typical treatment interventions may include:

  • Muscle re-education of pelvic floor and abdominals
  • Instruction in how to protect your pelvic floor muscles
  • Education about normal bladder function and irritants
  • Bladder retraining
  • Biofeedback/ surface electromyography
  • Electrical Stimulation
  • Preoperative pelvic floor muscle exercise instruction and education
  • Postoperative scar tissue management
  • Patient education
Chronic Pelvic Pain Syndromes in Men

Chronic pelvic pain syndromes(CPPS) have similar pain, discomfort or dysfunction symptoms although they have historically different causes. Traditionally the diagnoses that are associated with chronic pelvic pain are: Chronic nonbacterial prostatitis (category IIIA or IIIB), painful bladder syndrome/interstitial cystitis, levator ani syndrome, pudendal nerve entrapment, proctalgia fugax. Chronic Pelvic Pain, regardless of the source, can be difficult to discuss - debilitating, frustrating and hard to endure.

Symptoms of Chronic Pelvic Pain Syndrome
Symptoms may be intermittent or constant, and include one or more of the following:

  • Pain in any of these areas: rectum, above the pubic bone, perineum (between the scrotum and the anus), penis, anus, tailbone, pelvis, low back or groin
  • Urinary frequency, urgency, hesitancy
  • Pain or burning with urination, a sense of incomplete urinating, reduced stream
  • Pain or discomfort during or after ejaculation
  • Anxiety, depression, social withdrawal and impairment of self esteem

Evaluation and Treatment
During your initial visit, our physical therapist will assess the strength, coordination and integrity of your pelvic floor, abdominals, low back, and lower extremities. Based on these findings, an individualized treatment plan will be established.

Typical treatment interventions may include:

  • Posture and structural alignment
  • Muscle re-education
  • Muscle strengthening or relaxation
  • Soft tissue mobilization and myofascial release
  • Biofeedback / surface electromyography (EMG)
  • Manual therapy techniques
  • Toileting techniques
  • Patient education
Anal Incontinence

Anal Incontinence is the involuntarily loss of rectal contents, whether solid,liquid or gas. It is not uncommon for patients to present with combined fecal (stool) and urinary incontinence. Anal incontinence can be difficult to discuss, but even more difficult to endure. Fortunately, help is available. If you suffer from anal incontinence, you are not alone. Anal incontinence is an emotional and physical condition affecting more than 5.5 million Americans, but often unreported because of embarrassment. Most cases of anal incontinence can be cured or improved with proper diagnosis and treatment.

Causes of Anal Incontinence

  • Damage to the anal sphincter muscles
  • Pelvic floor muscle weakness and dysfunction
  • Trauma from injury
  • Radiation, surgery, medications
  • Damage to the nerves of the anal sphincter muscles or the rectum
  • Fecal movement disorders - Irritable Bowel Syndrome, diarrhea, constipation
  • Loss of storage capacity in the rectum
  • Functional impairment, aging

Evaluation and Treatment
During your initial visit, our physical therapist will assess the strength,coordination,and integrity of your pelvic floor muscles,abdominal muscles and sphincter control. Based on these findings, apersonalized program will be established. Your individualized treatment plan may include the following techniques:

  • Muscle re-education of the pelvic floor and sphincter control
  • Sensory retraining
  • Biofeedback
  • Therapeutic exercise
  • Patient education
  • Bowel retraining and behavioral interventions
  • Manual therapy techniques
  • Skin care
  • Functional retraining
  • Electrical stimulation TLC

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