urinary incontinence

[sidney43]

I have recently seen a 73 yr old female with a 20 year history of urinary and faecal incontinence following a fall down stairs. No previous problems. Urodynamics are within normal limits slightly reduced bladder capacity only. No stress urinary incontinence with coughing, but has no sensation of wanting to void or of bladder fullness. She reports being unable to feel any pelvic floor contraction but can occasionally "hang on " long enough to get to the toilet without leaking. wears 2 to 3 pads a day. Cauda Equina lesion has been ruled out. Any ideas on how to manage her problem? she is seeing a urologist with a view to having bladder neck support surgery.

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[Hessa]

the source of the probem is neurlologocal
sice she felt on stair so she get lession in cauda equine
that means she lost the coordenation between nerve connection and muscle contraction
i advise you to use biofeedback , you can applu the cone in her vagina and rectus and ask her to contract her pelvis muscle and see the screen so this will help her to reeducate her pelvis muscle so she remmember when her pelvic floor muscle being contracted>
can give her pelvis floor muscle excercise
and electrotherapy like TENSE in her lowe back region