Pelvic floor rehabilitation

Urinary Incontinence(UI)

• Urinary incontinence is the unintentional,

accidental, loss of urine (ICS).

• More frequent in women(Hunskaar et al 2004).

200 million women live with incontinence
(Norton & Brubaker 2006).
 Causes of urinary incontinence

• Congenital anomalies
• Injuries and diseases of the nervous system
• Anomalies of the detrusor and its innervation
• Effect of pregnancy and delivery
• Ageing
 Types of UI
• The type of urine leakage is classified
according to what is reported by the woman
(symptoms), what is observed by the clinician
(signs) and on the basis of urodynamic studies.
 Types of urinary incontinence in women ICS(Haylen2010)

• Stress urinary • Involuntary urine loss during

incontinence physical
exertion/exercise(coughing,
sneezing, sports) without
urgency

• Urge incontinence • Involuntary urine loss

combined with sudden
sensation of urgency
– With detrusor instability
– Without detrusor instability
• Mixed incontinence • Involuntary urine loss
associated with urinary
urgency but also with physical
exertion
• Special forms
• Neurogenic incontinence,
extraurethral
incontinence,overflow
incontinence, giggle
incontinence
 Intrinsic sphincter deficiency
• Nerve and vascular injuries due to
ageing,menopause,pelvic surgery,radiation
therapy,neuropathies(DM)-weaken the
spinchter and poor closure of of the
spinchetric urethra -SUI
 Revolutionary view(Corcos and Mattieson
2007)
• A relaxatory mechanism in the urethra
increases the opening of urethra –functional
disorder
• Trauma,fatigue can lead to relaxatory
mechanism
 Treatment of stress urinary incontinence

Conservative interventions-
Physiotherapy
Lifestyle Intervention
Behavioural Training
Anti Incontinence Devices
Pharmaceutical Interventions And Surgery.