Women's Health

Symptoms of MS occur when the brain and spinal cord are no longer communicating with the body in a normal manner, possibly affecting vision, balance, gait, strength, sensation, coordination, and bodily functions. In particular, patients with MS can experience a change in normal bladder and bowel
function. Symptoms can vary from urinary and fecal incontinence, constipation, difficulty initiating a urine stream, retention of urine, and sexual dysfunction.

Types of urinary incontinence include stress incontinence, urge incontinence, mixed incontinence, overflow incontinence, and neurogenic bladder:

• Stress incontinence occurs when there is an increase in abdominal pressure and associated loss of urine. Stress incontinence is associated with complaint of leakage of urine with cough, sneeze, laugh, or lifting heavy objects. This usually can be corrected with pelvic floor strengthening exercises (Kegels), functional task training, and endurance training of the pelvic floor and transverse abdominals.

• Urge incontinence occurs when the individual has a strong sudden urge to urinate with involuntary leakage of urine on the way to the toilet. Physical therapy treatment options include urge control / bladder retraining, internal and external release of the pelvic floor musculature, biofeedback, electrical stimulation, and education on good bladder health.

• Mixed incontinence is a combination of stress and urge incontinence noted above.

• Overflow incontinence occurs when the bladder is so full that it leaks urine. Overflow incontinence can be caused by a blocked urethra which can prevent the urethra from fully emptying the bladder or a weak contraction of the bladder causing the bladder not to empty completely. Overflow incontinence is more common in men than women. The most common cause in men is an enlarged prostate. Treatment options include medications, catheterization, and surgery.

• Neurogenic bladder involves damage to central or peripheral nerves that control the bladder. Treatment options include bladder retraining, voiding techniques, education on dietary irritants, and pelvic floor muscle training.

Fecal incontinence and constipation can be managed with diet change, fiber management, instruction in defecation dynamics, biofeedback, strengthening and / or stretching of the pelvic floor musculature, colon massage techniques, and use of electrical stimulation. Sexual dysfunction treatment options include trigger point releasing of the pelvic floor musculature, use of vaginal dilators, education in sexual positions, relaxation and stretching techniques.

Rhode Island Rehabilitation offers physical therapy services that can treat many of the urinary, fecal, and sexual dysfunctions that are associated with Multiple Sclerosis. Our physical therapist’s treating urinary incontinence are specialty trained and have completed additional coursework related to the bladder, pelvic floor musculature, and bowels. Treatment options often include strength and endurance training of the pelvic floor musculature, correction of pelvic and spinal alignment, internal and external trigger point release of the pelvic floor musculature, electrical simulation to the pelvic floor muscles or nerve to the bladder to assist with decreasing urinary urgency, education on good bladder health, dietary irritants, constipation management, urge control training, bladder retraining, and relaxation training / stretching for the hip and pelvis.

Our women’s health physical therapists are available for appointments during the day, late evening, and Saturdays. Please ask to speak with one of our therapists if you have any questions prior to scheduling an appointment.