Middle-aged women participate in
Urinary Incontinence Health Fair
Rey-Hwa Lee and Ya-Ling
Hu reporting from
Tzu Chi Foundation Medical Development Department
(Translated by Yan Huang, Northern California)
October 20 was Urinary
Incontinence Awareness Day in Taiwan. During this full day
of activities, four regions of the Tzu Chi Medical Center-the
eastern, southern, northern, and central divisions-concurrently
held a Health Fair called "The Problems of Urinary Incontinence
in Middle-Aged and Elderly People." Events took place
at each medical center, as well as at Meilun Park, Hualien.
The Kegel exercise-a repetitive, isometric tightening and
relaxing of the pubococcygeal muscles (a group of muscles
in the female pelvic area)-was introduced and taught by nurse
practitioners and physical therapists. This event attracted
hundreds of women who responded with enthusiasm.
The second round of the health fair in Hualien
was led by Tsai Cheug-show. The event started at 9 a.m. on
the first floor of the Tzu Chi Medical Center building. Ms.
Tsai, the director of the Foundation of Urinary Incontinence,
Taiwan, is also an instructor at the Tzu Chi Technical College
and has been conducting research in women's urinary incontinence
with Dr. H. C. Kuo from the Tzu Chi Medical Center. She talked
about the problems and treatments for women's urinary incontinence,
and she taught the audience how to do Kegel exercises in standing,
sitting and lying positions to correct over-relaxed pelvic
muscles.
Urinary incontinence is a common medical
problem in women, especially among women in their fifties
and sixties, Ms. Tsai said. Many people do not seek medical
attention because they are ashamed of admitting they have
such a condition. Without early intervention, this problem,
caused by over-relaxed pelvic muscles, usually leads to urinary
and vaginal infections. Over-relaxed pelvic muscles are usually
caused by childbirth, as well as other medical reasons. The
Tzu Chi Medical Center hot line for serving women with this
problem is 011-886-03-8561825 ext. 2289.
According to another instructor at the health
fair, Tsai Shaw-mang, RN, from the Urological Department of
the Tzu Chi Medical Center, urinary incontinence can be categorized
into three types: incontinence from coughing, from lifting
heavy loads and children, and dripping before going to the
bathroom. A combination of two categories can occur in patients
with severely relaxed pelvic muscles. Clinical studies conducted
at the medical center show that Kegel exercises provide great
improvement in patients with urinary incontinence.
Kegel exercises are a series of muscle movements
of the pelvic and rectal muscles. They can be practiced while
sitting, standing, or lying down. One starts by tightening
the pelvic and rectal muscles and holding them for five or
more seconds, and then relaxing the muscles; this cycle should
be performed at least fifteen times a day. Many of the symptoms
of incontinence improve after patients practice Kegel exercises
for more than three months. However, this regime must be continuously
practiced, or else the muscles become relaxed again and lose
strength and tightness.
Although the Kegel exercises sound easy
to do, some patients find it difficult to move the right muscles.
There are methods and treatments that can help these patients,
such as electrical stimulation and surgery. These patients
receive initial evaluations by a medical doctor and a physical
therapist. Electrical stimulation and physical therapy are
then introduced to help patients find and stimulate their
pelvic muscles. For patients with severe muscle conditions,
surgery comes as a last resort.
Mrs. Yu, a woman in her sixties, has been
doing Kegel exercises for years. She used to have trouble
controlling her urinary muscles before she started the exercises.
Now after years of strengthening her pelvic muscles, she has
resumed her favorite activity: hiking in the mountains. Before,
Mrs. Yu said, her incontinence would usually occur while she
was walking downhill. Now she does not worry too much about
going downhill when she goes hiking. Doing a couple of muscle
tightening exercises before heading downhill makes her trip
a pleasant one.
