In Australia 1 in 4 Australians over the age of 15 report incontinence. An estimated 30 per cent of men who visit their GP are affected by incontinence, yet more than 60% of men do not discuss the issue. Studies have shown that the prevalence of urge related incontinence, which is strongly associated with prostate disease, is fairly low in younger males and increases to 30% for men aged 70-84 and 50% for men aged 85 years and over (Australian Institute of Health and Welfare, 2006). It is still a condition that can affect younger men but increases with age.
Bladder dysfunction can present in a number of ways including:
- Urinary incontinence is the accidental or involuntary loss of urine from the bladder. Often this occurs with coughing, sneezing, walking, lifting or playing sport. Sometimes this is known as stress incontinence. Overall this is less common in men but very common after prostate surgery.
- Urinary urgency is the compliant of a sudden and compelling desire to pass urine, which is difficult to defer. Sometimes it can be associated with certain locations or circumstances such as putting the key in the door, seeing a toilet of being near running water.
- Urinary frequency which is the complaint by a person who thinks that they void too often. Normal voiding is about every 3-4 hours or 4-7 times per day.
- Incomplete emptying of the bladder or dysfunctional voiding
- Dribbling after urinating
- Repeated urinary tract infections
- Painful bladder is felt just above the pubic bone and usually increases as the bladder fills and may persist after emptying the bladder
Management of bladder conditions includes:
- A thorough assessment of the condition, medical history and current health, including diet and fluid intake, exercise levels and mobility, all the medicines you are currently taking, and any other factors that could affect bladder function
- Physical assessment of the pelvic floor function, strength and endurance
- Rehabilitation which may include pelvic floor muscle exercises, otherwise known as Kegel exercises, bladder retraining and changes to lifestyle and bladder habits and pain management.
- Use of Real Time Ultrasound to facilitate rehabilitation
- Assistance with continence aids such as pads and pants.
Outcomes from Physiotherapy treatment may include:
- Performance of correct pelvic floor muscles exercises which can increase the size, strength and length of the pelvic floor muscles.
- Decreased leakage, reduced usage of pads, improved control and reduced urgency.
- Improved understanding on dysfunctional voiding and strategies implemented to maintain function.
- Improved emptying and reduced after dribble
- Increased confidence and reduced financial burden