Physiotherapy is effective in treating stress incontinence in about 80 per cent of cases, according to the first national study undertaken in clinical practice by researchers at the University of South Australia.
According to PhD physiotherapy student Trish Neumann from UniSA's School of Health Sciences, stress incontinence - incontinence during physical exertion - is the most common reason for urinary incontinence, affecting about one in three women of all ages,.
"Stress incontinence is the type of stress that occurs when women cough, sneeze, or undertake physical activities such as running and jumping; and it is these physical forces that push down on the bladder and force urine out," Neumann said.
"Previous studies confirm that 13 per cent of 18-year-old Australian women suffer from incontinence and this figure rises to 20 per cent when women have had their first baby. But not all women with stress incontinence have had children. They might have a family history of stretchy connective tissue, be overweight, have a chronic cough, constipation or have had surgery," Neumann said.
While women are the main sufferers, incontinence can also be a problem for men, especially after prostate surgery.
"For a long time stress incontinence was treated by surgical procedures without going through physiotherapy as a first option, but the outcomes of surgery have not always been positive with success rates as low as 50 to 60 per cent recorded in a recent study and with the potential of complications. This led to recommendations that physiotherapy be tried first, which carries no risks, and keep the surgery option open to people who fail pelvic floor muscle training.
"To find out how effective physiotherapy could be in curing stress incontinence, we conducted the most comprehensive study ever undertaken in Australia in this field involving a trial of 274 women with stress incontinence. After an initial assessment, the women, aged from 23 to 77 years, undertook pelvic floor muscle training taught by specialist continence physiotherapists in 35 centres across all Australian states," Neumann said.
Being able to understand how to contract the pelvic floor muscles the right way is essential for a successful outcome, according to Neumann.
"About one-third of women who are given a brochure about pelvic floor exercises, get the basic action wrong and don't do well on their own with pelvic floor muscle training. They need expert guidance to achieve the correct technique, not from a general physiotherapist, but a specially trained continence physiotherapist," Neumann said.
The women in the study had an average of five treatments over several months, as well as a home program that was monitored.
Of the women who took part in the study, the majority were either cured or significantly improved and were happy with the outcome. After one year about 80 per cent of the study participants who responded to a questionnaire indicated that they were still happy with the outcome of treatment. In all, 15 of the women went on to have surgery.