“An ounce of prevention is worth a pound of cure” is a quote attributed to Ben Franklin. In medicine, we have all learned quite well over the years that prevention is often the best treatment. This has held true for a range of health conditions, from the simple to the complex. Wearing seatbelts prevents injuries with car accidents. Smoking cessation and weight loss prevent heart attacks. But bowel and bladder leakage have not always been thought of as problems that can be easily prevented. Some new published studies indicate otherwise, particularly during pregnancy. Turns out, muscle training during pregnancy might be the best strategy for preventing incontinence after pregnancy.
Pelvic Floor Training During Pregnancy
In a recent 2021 analysis in the Journal of Physiotherapy, authors Brennan and colleagues in Australia analyzed 17 trials that attempted to prevent urinary incontinence with pelvic floor training exercises during pregnancy. The results indicate that the strategy of preventing incontinence by pelvic floor therapy exercises during pregnancy may be the most cost-effective method of preventing later incontinence. More specifically, on a cost basis, group therapy with directed pelvic floor exercises appear to be the most economical approach.
Like many centers, the Continence Center in northern Nevada takes a holistic, integrative approach, utilizing several techniques to resolve bowel and bladder leakage. While the most successful therapy in the published literature and in our experience rests up on the cornerstone of sacral neuromodulation treatment, every single patient is also enrolled in a pelvic floor physical therapy program.
Our center has a unique strategy which involves the Center contracting on a practice-wide basis for highly specialized pelvic floor therapy, such that once a patient is a member of the practice, the therapy is free. In this way, we try to lower any barriers to treatment for the patient.
The combination of advanced technology combined with advanced techniques of pelvic floor therapy results in over 90% resolution of bladder and bowel incontinence.
This recent study suggests that the therapy should begin even sooner and that we and expectant mothers should take a more preventive approach.
- Brennen, R., Frawley, H.C., Martin, J. and Haines, T.P., 2021. Group-based pelvic floor muscle training for all women during pregnancy is more cost-effective than postnatal training for women with urinary incontinence: cost-effectiveness analysis of a systematic review. Journal of Physiotherapy.