Researchers at Rush University Medical Center have found that a program of pelvic floor muscle exercises, combined with pelvic health education, can be an effective way to manage urinary incontinence in elderly women.
The study, involving 65 women between the ages of 67 and 95, is being presented this week at the annual meeting of the North American Menopause Society in San Diego.
Urinary incontinence, or loss of bladder control, is a frustrating, and often embarrassing, problem for more than 13 million Americans. It is twice as common in women as in men, and, according to some estimates, affects half of older women. In women, the muscles that help support the bladder may become weak due to multiple pregnancies and vaginal births.
"Urinary incontinence can take a very real emotional and social toll. Not knowing when and where you might have an accident can impact everything from household chores to dinner dates and bowling games," said physiatrist Dr. Sheila Dugan, co-director of the Program for Abdominal and Pelvic Health at Rush and lead author of the study.
"Many treatment options exist, but strengthening the pelvic floor muscles, as our study has shown, can be very effective even for older women, avoiding the need for drugs or more invasive procedures."
The women in the study's treatment group underwent a supervised chair-based exercise program for six weeks. The program focused on identifying, isolating and strengthening muscles that support the pelvic area: the transversus abdominus, the corset-like swath of muscles that wraps around the abdomen; the multifidus, which extends along the back of the trunk; and the pelvic floor muscles, which form a sling to hold up internal organs like the bladder. In addition to the exercises, the program incorporated an educational curriculum (four sessions) on basic bladder and pelvic health. The control group received one session of educational basics and no supervised training in pelvic exercises.
At the end of the program, 83 percent of the women in the treatment group reported that their symptoms had improved. On the whole for the control group, there were no statistically significant improvements.
The researchers found statistically significant improvements in the treatment group in a number of areas. Problems with frequency of urination, urine leakage related to feelings of urgency and urine leakage caused by physical activity, coughing or sneezing had all decreased. Bladder control problems were less bothersome and also had less of an impact on daily activities like household chores.
The women in the treatment groups also reported less urgency during night-time hours, better bladder management (especially when physically active or sneezing) and increased self-confidence. Eighty-two percent reported that they planned on continuing the exercise themselves after the intervention.
The study was supported by a grant from Pfizer.
The Program for Abdominal and Pelvic Health at Rush University Medical Center provides a multispecialty comprehensive approach to diagnosing and treating a wide range of abdominal and pelvic conditions in women and men of all ages.
Rush University Medical Center includes a 674-bed (staffed) hospital; the Johnston R. Bowman Health Center; and Rush University (Rush Medical College, College of Nursing, College of Health Sciences and the Graduate College).
Rush is currently constructing a 14-floor, 806,000-square-foot hospital building at the corner of Ashland Avenue and Congress Parkway. The new hospital, scheduled to open in 2012, is the centerpiece of a $1-billion, 10-year campus redevelopment plan called the Rush Transformation, which also includes a new orthopedics building (to open in Fall 2009), a new parking garage and central power plant completed in June 2009, renovations of selected existing buildings and demolition of obsolete buildings. The new hospital is being designed and built to conserve energy and water, reduce waste and use sustainable building materials. Rush is seeking Leadership in Energy and Environmental Design (LEED) gold certification from the U.S. Green Building Council. It will be the first full-service "green" hospital in Chicago.
Rush's mission is to provide the best possible care for our patients. Educating tomorrow's health care professional, researching new and more advanced treatment options, transforming our facilities and investing in new technologies—all are undertaken with the drive to improve patient care now, and for the future.