6 Physiotherapy treatments for urinary incontinence

In physiotherapy there are great treatment options to control urine, which are indicated before or after surgery.

Physiotherapy consists of strengthening the pelvic floor muscles to prevent involuntary loss of urine, but in order to have the expected effect, it must be performed daily at home, in addition to going to the clinic at least once a week.

In physiotherapy for urinary incontinence, Kegel exercises, electrostimulation, biofeedback and vaginal cones can be used. This type of treatment can be indicated for all cases of incontinence, be it urgent, stress, in men, women, children, and even after the removal of the prostate.

Below we show how each technique can be done.

1. Kegel exercises

To perform the Kegel exercises you must first identify the pelvic floor muscles: just try to hold the pee while urinating. If you can at least reduce the amount of urine a little, it means you are contracting the right muscles.

To perform these exercises, you must empty your bladder by peeing, and then you must lie on your back and do this contraction 10 times in a row, and then you must rest for 5 seconds. Then 9 more repetitions of this series should be done, totaling 100 contractions.

After a few days, a ball can be added between the legs or elastic bands to help maintain concentration and facilitate the completion of the complete set correctly.

2. Hypopressive exercises

Hypopressive Gymnastics

To perform these exercises, you should sit or stand, and shrink your belly as much as possible, while also sucking the pelvic floor muscles. While performing this exercise you should breathe normally, but to ensure that the muscles inside the vagina are being contracted correctly, it can be associated with the use of electrostimulation.

3. Vaginal cones

A few weeks after being able to perform the Kegel exercises correctly, the physiotherapist can indicate the introduction of small cones into the vagina, to further strengthen the pelvic floor muscles. The cones have different weights, and you must first start with the lightest. For best results the physiotherapist can indicate that the exercise is performed in different positions, sitting, lying or standing, in order not to let the cone fall from the vagina.

The first exercises should be performed with the woman lying down and then the intensity of the exercises should be increased until the woman is able to keep the cone inside the vagina for at least 5 seconds in the standing position, and then when performing a squat, for example. Another exercise is to insert the cone into the vagina and not drop it while walking for 15 to 20 minutes.

5. Electrostimulation

Electrostimulation is another resource in which the device is placed inside the vagina or around the penis and the penis emits a light electric current, fully bearable, which causes the perineum to contract involuntarily. Studies have proven that this does not bring a great benefit in the treatment, but it can be of great help for women who do not know exactly which muscle to contract, being a good option for the first sessions.

5. Biofeedback

Thus, as with electrostimulation, a small device must be inserted into the vagina, connected to a computer, which will generate images and sounds during the contraction of the perineum. This device can be useful for the woman to be able to identify the muscles she should contract, being more aware of the strength she needs to perform during each movement.

6. Good sitting posture

Correct posture for sitting

It is also part of the treatment to always maintain good sitting posture, because this way there is less pressure on the pelvic floor, which helps to cure incontinence faster. In order to sit in the correct posture, one should always sit on top of the little bones of the butt, without crossing the legs, and maintain a small contraction of the abdominals. In this position, the pelvic floor muscles are naturally strengthened.

How to know if the treatment is taking effect

In order to confirm that the treatment performed is having the expected effect, the physiotherapist can use the perineometer (Wilcoxon test) and the test where 2 fingers are inserted into the vagina, being asked to contract the perineum (Wilcoxon test). Thus, it is possible to assess the ability of these muscles to contract from the first session.

Treatment time for urinary incontinence

The time taken to treat urinary incontinence depends on the degree of impairment of the perineum and the person's efforts to perform the exercises. The average duration of treatment varies from 6 months to 1 year, and in approximately 6 to 8 weeks it is possible to notice the first results. But after this period it is advisable to continue performing the exercises weekly, to guarantee the results for long periods.

In some cases the doctor may recommend surgery to cure incontinence, but in approximately 5 years, it is common for the same symptoms to reappear, and it is necessary to resort to physical therapy again.