*How to help prevent urinary tract infections (UTI’s)

The National Institute of Health recommends the following tips to preventing urinary tract infections.

1. Drink lots of water to flush your system
2. Do not try to hold urine for long periods of time
3. Always wipe from front to back to avoid spreading fecal bacteria to your urinary tract
4. Avoid use of douches, feminine hygiene sprays or perfumed soaps

It may also help to do showers instead of baths.  Cranberry juice and cotton panties may also be beneficial. 

Signs of a UTI include burning with urination, frequent urination, pain in the lower belly, urine that smells bad or is dark, and fever.  If you have any of these symptoms, see your health care provider. 

http://www.nichd.nih.gov/health/topics/urinary_tract_infections.cfm



* What does it mean when my bladder "falls"?

All your pelvic organs are designed to be held up in place by a combination of pelvic floor muscle and connective tissue and ligament strength.  Sometimes in women, due to aging (darn that gravity), childbirth, repetitive heavy lifting, high impact activities and such, the organ support system looses holding capacity and the organs can “fall” or drop into the vaginal canal.  Imagine that piece of elastic in your favorite pants that looses its snappy spring over time only to cause you to have droopy drawers. 

While the bladder is the most common organ to fall, any pelvic organ can drop. Falling of the bladder it is called a cystocele, the rectum is a rectocele, the uterus is a uterocele, and intestines are an enterocele.  Collectively, any dropped pelvic organ is called pelvic organ prolapse or POP for short. 

Most people are not aware they have a prolapse early on.  The organs remain in the vaginal cavity.  Over time, it may actually protrude outside the body.  Fortunately, while this doesn’t sound good, most women have no pain and few symptoms with a prolapse.  If caught early they respond very well to conservative physical therapy including pelvic floor muscle training.  If this fails, surgery can be used to lift and tuck the organ back in place. 

*Pregnancy- Abdominal separation common in pregnancy-increases risk of incontinence

A study in the International Urogynecology Journal found that more than 50% of women seeking urogynecological examination presented with a separation of the “six-pack” abdominal muscle (diastasis recti). This occurred most frequently after pregnancy or abdominal surgery. Patients more likely to have this separation were mothers of multiple children, older, Caucasian or Asian, menopausal, using hormone replacement therapy, had abdominal surgery, and had weaker pelvic floor muscles.

A large percentage of the women who had this separation also had stress urinary incontinence (leakage of urine with cough, laugh, sneeze), bowel incontinence, or pelvic organ prolapse.

This suggests the importance of treating the separation to prevent these problems. Physical Therapists specializing in women’s health can show patients how to correctly train this muscle to decrease the separation and likelihood of future problems.

Spitznagle TM, Leong FC, Van Dillen LR. Prevalence of diastasis recti abdominis in a urogynecological patient population. Int Urogynecol J Pelvic Floor Dysfunct 2007; 18:321-328.