Posted on Mar 5, 2015 11:30:00 AM by Leslie Wooldridge, GNP-BC, CUNP, BCIA-PMD

Behavioral Therapy: Contracting Pelvic Floor Muscles

The Importance Of Kegel Exercises 

This past week I had an interesting discussion with a patient during her PTNS treatment. One of my weekly Behavorial Therapy: Contracting Pelvic Floor Musclesquestions to these patients is always, “Have you been doing your Kegels?” This week she said to me, “You know, if you didn’t ask me and remind me I probably would forget or think that those were exercises I didn’t have to do any more because of this treatment.”

It was said in such a way that I realized how important the “nagging” is in order to maintain successful outcomes. The AUA/SUFU OAB Guideline has determined that behavioral management should be the first step in treating OAB. Behavioral management is one of the most effective ways to improve OAB symptoms. Upwards of 70% of patients improve with behavioral interventions alone.

Kegels Curb Urges

The question: how far do we take them and for how long should we expect our patients to maintain a healthy bladder lifestyle? The answer: as long as patients want to be free from a life full of urgency, frequency and incontinence. Every patient has an issue that comes between them and success as far as OAB outcomes are concerned.

This patient doesn’t exercise, doesn’t remember and does not see why it is important to do so. Once again, we discussed the function of the pelvic floor muscles and how contraction of those muscles also works to reduce the urge to urinate. Practicing this tactic makes it almost automatic. Explain to your patient that when he/she gets the urge to void they should stop what they are doing, take a deep breath and do a couple of Kegel exercises. This settles the bladder down and reduces the urge. Urge comes on like a crescendo, peaks and then goes away.

Distraction

Distraction is another effective way to inhibit the urge at the peak where a lot of the times there is a leak. These strategies are helpful in reducing the severity of urge and preventing leakage. Over the next several weeks, I will talk about strategies to enhance the outcome of your PTNS treatments. I will review simple strategies for all the behavioral interventions and why compliance is so important. These are very important adjuncts to PTNS therapy and should be reviewed weekly with your patients.

Urgent PC for OAB

This blog post reflects the opinions and experience of Leslie Wooldridge, a long-standing user of the Urgent PC Neuromodulation System, and was produced under a paid consulting agreement with Cogentix Medical.

Urgent PC is indicated for the treatment of Overactive Bladder and associated symptoms of urinary urgency, urinary frequency and urge incontinence. Treatment with Urgent PC is contraindicated for patients with pacemakers or implantable defibrillators, patients prone to excessive bleeding, patients with nerve damage that could impact either percutaneous tibial nerve or pelvic floor function or patients who are pregnant or planning to become pregnant during the duration of the treatment. Most patients don't experience side-effects. If side-effects occur, they are typically temporary and include mild pain and skin inflammation at or near the stimulation site. Caution: Federal law (USA) restricts this device to sale by or on the order of a physician. For complete instructions for use, storage, warnings, indications, contraindications, precautions, adverse reactions and disclaimer of warranties, please refer to the insert accompanying each product or online at www.cogentixmedical.com. Models are for illustrative purposes only. Urgent is a registered trademark of Cogentix Medical © 2015 Cogentix Medical. All rights reserved. 

Leslie Wooldridge, GNP-BC, CUNP, BCIA-PMD
Leslie Saltzstein Wooldridge, GNP-BC, CUNP, BCIA-PMD, is Director of the Adult Bladder Control Center, Mercy Health Partners, Muskegon, Michigan USA. Ms. Wooldridge received a Master of Science degree in nursing administration, critical care nursing and postgraduate certification as a Geriatric Nurse Practitioner from Marquette University, Milwaukee, Wisconsin. In 2015, she was honored with the Women’s Health Foundation Activist Award. She is also the recipient of the 2009 National Association for Continence Rodney J. Appell Continence Champion Award. Ms. Wooldridge has published in multiple refereed journals. She authored the Genitourinary chapter in The Nurse Practitioner in Long Term Care: Guidelines for Clinical Practice (2007). She has lectured throughout the United States on geriatrics, urology and clinical practice.
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