Category: Research

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Scary Statistics

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A recent poll about female bladder control confirmed a very saddening fact- too many women are suffering in silence. The University of Michigan Institute for Healthcare Policy and Innovation, in conjunction with AARP, conducted the national poll under the direction of Dr. Preeti Malani, a professor at the university with a specialization in geriatric medicine. Over 1,000 women between the ages of fifty and eighty responded to the survey. Some of the most disturbing statistics that emerged from the poll are as follows:

 

  • Almost 50% of women in the targeted age bracket experience urinary incontinence
  • Of these women, approximately 33% experience symptoms almost every day
  • According to respondents, the most common triggers associated with leakage were coughing or sneezing (79%), while en route to the bathroom (64%), laughing (49%), and exercising (37%)
  • Approximately 66% of these women have not discussed this with their physicians
  • 41% of women experiencing urinary incontinence reported that this issue is either a “major problem” or “somewhat of a problem”
  • Only 38% of poll respondents participate in a pelvic floor muscle strengthening exercise program

 

We live in society where marketing and misinformation has conditioned many to believe that urinary incontinence is simply par for the aging course. Adult diaper products and advertisements bombard us in our pharmacies and on television, and this subtly communicates the message that incontinence is inescapable. Too many women have been trained to believe that urinary incontinence is a normal part of the aging process. While continence may prove to be more challenging as one gets older due to physiological and hormonal changes, it is not inevitable.

 

Pelvic floor muscle strengthening, or uptraining, is an evidenced based approach for improving continence. Women who experience urinary incontinence should discuss these symptoms with their doctors and request prescriptions for pelvic floor physical therapy. Obviously, this is a sensitive and delicate topic, and it is understandable that women may feel awkward initiating a conversation of this nature. However, it’s probably even more uncomfortable and depressing to resign oneself to a fate of eternal leaking.

 

If you or someone you know stands to benefit from a pelvic floor uptraining program, please contact us at Revitalize Physical Therapy. We specialize in treating men, women, and children experiencing urinary incontinence, and we can offer you a personalized treatment plan and home exercise program. We look forward to helping you along your healing journey!

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Planting a Seed

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While it may not be self-evident, NOT all bacteria are created equal. Like good cop-bad cop, there are good bacteria and bad bacteria. In fact, this discussion has recently become relevant to a different conversation, namely, the pros and cons of vaginal delivery vs. cesarean section (c-section) delivery. Vaginal delivery introduces the newborn to vaginal fluids which help develop a healthy newborn microbiome (the collection of microscopic organisms which live on and in us).

These microorganisms exist on the skin, in the mouth and saliva, in the eyes, and in the gastrointestinal (GI) tract. It is believed that many of these organisms, especially ones in the GI tract, contribute to healthy gut flora and function. In other words, exposure to the mother’s vaginal fluid, bacteria and all, helps develop a healthy newborn microbiome. Furthermore, it helps develop the neonatal immune system, prevents growth of negative bacteria, and produces certain vitamins.

Babies delivered via c-section are deprived of the maternal vaginal fluid along with its corresponding health benefits. Furthermore, c-section delivery is often accompanied by antibiotic usage which may also interfere with healthy infant microbiome development.  In fact, it has been hypothesized that the recent rise in childhood asthma, immune diseases, and obesity may be associated with the increased rate of c-section, which nowadays is approximately one in three births nationally.

This has led researchers to explore the field of vaginal seeding, the artificial introduction of maternal vaginal fluid to the infant’s mouth, nose, or skin. This exposes the baby to the same bacteria he or she would have encountered through a vaginal delivery. This progressive and creative solution is still in its initial stages, and the American College of Obstetricians and Gynecologists (ACOG) is recommending, “Ladies, don’t try this at home.” In fact, they only recommend undergoing the process as part of an IRB approved clinical trial. The reason for this is because they still lack adequate research to support this procedure routinely. It is still unclear if the benefits outweigh the risk of exposing the infant to pathogens or other dangerous maternal bacteria.

However, it won’t be long before we have more data, and clinical trials are well underway. In fact, microbiologist Dr. Maria Gloria Dominguez-Bello’s pilot study compared the microbiomes of infants born vaginally with those of infants who were delivered via c-section followed by vaginal seeding. Dominguez-Bello found that the microbiomes of both groups appeared very similar after one week. This is promising, and longer-term studies with larger sample sizes will determine if vaginal seeding will become par for the course within the c-section community.

To learn more about this fascinating research, I encourage you to listen to Dr. Aviva Romm’s interview of Dr. Dominguez-Bello. Dr. Romm is a physician, a midwife, and an herbalist with over thirty five years of experience. She has an amazing website replete with valuable information, including her blog and podcasts. This is the link to her website, and this is the link to her interview. I hope you find this information as exciting as I do!

 

Dominguez-Bello MG, De Jesus-Laboy KM, Shen N, Cox LM, Amir A, Gonzalez A, et al. Partial restoration of the microbiota of cesarean-born infants via vaginal microbial transfer. Nat Med 2016;22:250–3.