Urinary incontinence

Urinary incontinence is a very common problem and affects especially women who suffer from it in a very high percentage.

Usually this disorder is dealt with by neurology or urology but in recent years the patients who turn to osteopathy are increasing.

In fact, in a high number of cases, urinary incontinence has an osteopathic base.

The bladder
Testut-Latarjet, Anatomia Umana
UTET, Vol.IV, pag.130

A very common type is represented by stress incontinence. This type of problem has an essentially mechanical base.

The urethra, ie the channel between the bladder and outside, receives a compression stress on the outer wall such as to cause the occlusion. That is, an intra-abdominal pressure tends to compress the bladder but also the urethra.

In this way any loss of urine is impossible, and indeed the greater the intra-abdominal pressure is greater will be the force which opposes the escape of urine.

Any osteopathic dysfunction that goes to bring the bladder to the pubis (and therefore to the pelvic floor) and consequently causes a shortening of the length of the urethra completely cancels this mechanism.

In these cases, the opening of the bladder is located almost in direct contact with the outer wall and also a minimum pressure on the bladder wall causes emptying outwards since no resistance being able to prevent it is present.

The only obstacle to the outflow of urine are the resistances of the muscle wall of the urethra, sphincters and the neurological circuits that regulate the containing function.

These mechanisms, however, are insufficient and the patient, under stress, has losses.

The woman, having the urethra much shorter than that of man, is subject to this type of disorder in much more frequently from a statistical point of view.

Following delivery, for example, it is not unusual that the bladder remains in a state of prolapse (drooping), to mention a rather ordinary possibility.

There may be other forms of incontinence, always on the basis of osteopathic related to neuro-vegetative dystonia.

In these cases the osteopathic dysfunction affect the functionality of the circuits related to urination.

The information that comes to urological structures in a compromised way and the final response is impaired.

In this category are the urgent needs, the frequent urination, the "false alarms" and similar discomforts.

In the case of stress incontinence and in the cases mentioned osteopathy can be very useful, because very often alesional framework is almost always responsible for such situations.

I'll describe the case of a 58-year old patient who complained of leakage during the execution of movements under stress and sometimes even the simple flexion of the torso down.

On examination the patient presented osteopathic dysfunctions in temporal (ie cranial) and the thoracic diaphragm; contractures were present also at the level of the pelvic floor muscles and external rotators of the hip.

Reduceding dysfunction the patient no longer complained of such problems.

However not all the problems of incontinence have an osteopathic base: sometimes it is the result of a neurological problem while in other cases the psycho-somatic component is not negligible.

On the other hand, radical changes in the bladder and adjacent organs should be weighed very carefully. A prolapse of the organs of the small pelvis (bladder, uterus, rectum) is almost always the result of an osteopathic dysfunction maintained for a long time.

In these cases do not exclude other forms of intervention but in fact the osteopathic component is almost always very important.

Therefore, a revision of osteopathy is always strongly recommended in case of urinary incontinence.