incontinence Archives - Elevation Physiotherapy & Wellness

Prostate Issues are Not Just for your Grandpa

Prostate cancer is often diagnosed in men in their 50s and 60s, but younger men can experience this as well. About 40% of men diagnosed with cancer are low-risk, and will have “active surveillance” over time, but it should start with a blood test to see the PSA (prostate-specific antigen) level. If this is at all concerning, then it can be followed up with an MRI to see if a biopsy is even needed.

Often men will first have their PSA tested at age 50, but it is now recommended that a man has his first test in his mid-40s. If the PSA level is low, then it needs to be repeated only every 5 years until about age 60. Doctors are suggesting that healthy lifestyle choices might help to lessen the chance of developing prostate cancer—regular exercise, maintain a healthy weight and eating less animal fat.

For those who develop prostate cancer, it needs to be treated aggressively. If a man has to have the prostate removed, better surgical techniques have been developed that allow sparing of the nerves that control the bladder for urination, as well as erection and ejaculation. For several months after the surgery, almost every man will experience urinary incontinence and erectile dysfunction, but pelvic floor physiotherapy can be helpful to return to a much better quality of life.

The pelvic floor is a group of muscles that sling under the pelvis, and act as support and stability, as well as assisting as a sphincter. These muscles work collectively, and are generally ignored by all until there is a problem with leaking urine. Your pelvic physiotherapist can help you to make sure that you are engaging these muscles correctly and effectively, as well as teaching you how to manage the abdominal pressure changes that come with coughing, sneezing laughing or moving around.

There is much that can be done, and seeing a physiotherapist who practices pelvic health can get you back on the road to full function quickly.

Kegels are your Friend—Get to Know Them!

If you’re leaking urine when you cough, sneeze or laugh, it’s no laughing matter—but there is a lot that you can do to help it. It is not normal to leak even if you’ve had kids, nor is it an inevitable part of aging.

The muscles of the pelvic floor work like every other muscle in your body, they are just tucked up inside, so people don’t given them much thought. Due to this weakness, they often don’t work to squeeze effectively around the urethra, and leaking can happen. They also work to hold up organs like the bladder, uterus and colon, and need to be kept strong to keep these organs from sinking down.

It’s not just women who have had kids that have problems with their pelvic floor—it can happen to any woman. A decrease in hormone levels with menopause can cause irritability in the bladder and pelvic floor muscles, and gravity can help things descend if there is poor external support.

The good news is there is so much that can be done before and after you notice any problems. It is important to get to work on strengthening your pelvic floor muscles, and of course, it is necessary to make sure you’re doing them correctly. A proper pelvic floor contraction is a lift—for example, imagine a ping pong ball sitting outside your vagina and you want to lift it inside. Once you have the lift movement down, try to do 10 contractions in a row. Keep practicing—you will get better strength and control as you practice.

It is worth seeing a physiotherapist who works in pelvic health who will do an internal assessment to make sure that you are engaging the muscles properly, and then give feedback on the strength, endurance and control. A pelvic physiotherapist can also give you exercises to work your other core muscles along with your pelvic floor and proper breathing—breath is very important to train with your pelvic floor muscles. Working the pelvic floor regularly –and properly—can help you get to the point where you can cough or laugh without leaking, and that is nothing to sneeze at!