Nurses really do talk about anything and everything holding back very little when it comes to body functions, illness or any other topic for that matter. As I started doing research and talking to my friends and colleagues it didn’t take long to realize that bladder function, or the lack thereof, is a growing concern for individuals and families who suffer with these problems. Stress incontinence, overactive bladder and nocturia (awakening at night to pass urine more than once) are common and sometimes crippling conditions facing many people- especially the elderly. These conditions can have a significant impact on the environment, the individual, family, self esteem and social economic factors.
The spectrum of the overactive bladder usually has symptoms of urgency, frequency, nocturia, and is sometimes associated with urge urinary incontinence. Another type of urinary incontinence is stress incontinence, which is typically associated with anything causing pressure in the abdomen such as, coughing, sneezing, laughing, and straining which results in urinary leakage. Many patients will suffer with both stress and urge incontinence. However, about two thirds of patients with frequency, urgency and nocturia will not suffer from incontinence. Generally, younger populations suffer from stress incontinence; whereas, older populations suffer from urge and or mixed incontinence.
So what are the financial cost of stress and urge incontinence? According to a healthcare provider it is not uncommon for patients to spend $300 to $1,000 per year on routine care or “cover-up”, which are pads and diapers. On the high end that’s a little over $83 per month. The vast majority of money spent is on routine care with less than 1% being spent on a diagnostic work ups, and about 9% for conventional treatments including medications and surgical options. It becomes easy to see that the rest of the estimated $16.3 billion per year (1995 costs) are spent on covering up the problem rather than fixing it.
If you suffer from any of these urinary problems you are not alone. Studies show that about 16% of our population suffers from some type of urinary dysfunction. The National Overactive BLadder Evaluation (NOBLE) study stated “overactive bladder, with and without incontinence, has a clinically significant impact on quality-of-life, quality-of-sleep, and mental health, in both men and women.” There are many in our community who are unaware of treatment options or may be too embarrassed to seek treatment. Always discuss any changes in your urinary health and function with your healthcare provider.
The important message I want to stress is there are treatment options to address all of these conditions from nocturia and frequency to incontinence. There are many options ranging from behavioral modification, medications, bladder Botox, to surgery. Discuss your current medications with your pharmacist or healthcare provider to understand how medications may affect your urinary output. Reducing caffeine intake, smoking cessation, and weight loss for those overweight may also help to improve your condition.
Physical therapy for urinary and fecal incontinence is a viable option. Physical therapy for incontinence shows improvement for most people who can participate in therapy. Don’t be shy, talk openly with your healthcare provider to see what treatment options are right for you. Physical therapists that specialize in Pelvic Floor Dysfunction are sometimes difficult to locate. Discuss treatment options with your healthcare provider or call a physical therapy center in your area for a list of specialized therapists near you. Be proactive, take control you’ll be happier in the end.
Howard Baker, RN BSN
For questions, comments, or suggestions on topics you want to read about please email me at: letters@ubiquitousnurse.com
Knoxville has several physical therapy centers specializing in incontinence and pelvic floor dysfunction. These are only facilities of which I am aware and by no means a personal recommendation. Discuss referral options with your healthcare provider.
Mountain Spirit Physical Therapy, Inc.
Donna Edwards, PT, OCS
10429 Hickory Path Way
Knoxville, Tennessee 37922
865.560.2709
Parkwest Therapy Center
Joy Friley, PT
200 Fort Sanders West Blvd.
Building 1 Suite 201
Knoxville, Tennessee 37922
865.531.5710
The University of Tennessee Medical Center
Rehabilitation Services Northshore Medical Plaza
Lisa Gable, PT
9625 Kroger Park Drive, Suite 100
Knoxville, Tennessee 37922
865.539.0403
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