Pelvic Floor Muscle Training to Treat Urinary Incontinence in FemalesLinda R. Droste, RN, MSN, CWOCN, CBIS
Bridget Mezja, MSN, RN, NP-C, CWOCN
A press release from the U.S. Department of Health Agency reported, "A type of exercise called pelvic floor muscle training is effective for treating adult women with urinary incontinence (the involuntary loss of urine) without risk of side effects, according to a new report from the department's Agency for Healthcare Research and Quality (AHRQ)." The report also found that drug-based treatments can be effective, but "the degree of benefit is low and side effects are common."
The 1,208 page AHRQ document validates the practice and teaching that wound, osotmy and continence (WOC) nurses have supported for years. WOC nurses teach pelvic floor muscle training to patients as a safe, drug free, natural treatment for women with urinary incontinence. Pelvic floor muscle training helps women to privately and independently treat their urinary stress incontinence. Over time this noninvasive treatment may help to decrease the fear of public embarrassment, promote self esteem and allow women to function in society without the worry that others will know their guarded secret.
General incontinence questions can be easily included during any female check-up/exam. It is easy to ask any female patient benign questions about the number of pregnancies and children they have, previous pelvic surgeries including a hysterectomy, age of menopause, coughing and smoking. From these general queries, risk factors can be identified and a general segue to ask about lose of urine is provided. Asking a patient about urine leakage with simple activities, coughing, or the need to wear pads for leakage protection allows the WOC nurse to begin teaching pelvic floor muscle exercises that can help to change a patient's life.
During the exam, the WOC nurse shows the patient how to correctly isolate the pelvic floor muscles so that immediate treatment for stress incontinence can be initiated. The wonder of learning the correct exercise technique is that the patient can call and report on her progress without a return trip to the clinic unless needed. Many patients call to offer thanks and to report an improvement in their symptoms. Support and encouragement can be provided by telephone allowing the patient to continue with their daily exercise regimen.
Urinary stress incontinence is estimated to affect 15-million adult women in the U.S. This condition is often ignored, overlooked or undiagnosed as a normal part of the aging process. Urinary incontinence can significantly impact the patient as well as the family. It is estimated that the cost of incontinence care in the U.S. averaged $19.5 billion in 2004 (AHQR, 2012).
With these statistics, it is easy to see the number of females who are affected and deal daily with urinary incontinence. When asked in an interested and nonthreatening manner, most women are more than willing to discuss their incontinence and, as always, are willing to do what is necessary to allow many of them to return to a normal and active life.
It is important to remember how easy it can be to ask general questions to female patients that will help garner information regarding urinary incontinence. Simple questions can allow the WOC nurse to assist the patient in returning to a lifestyle that does not include outings based on the location of public restrooms.
Muscle Training Effective in Treating Urinary Incontinence for Women. Press Release, April 9, 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/press/pr2012/muscleuipr.htm