Coughing and leaking.

In a very logical study, researchers assessed the prevalence of urinary incontinence in those patients suffering from chronic obstructive pulmonary disease (COPD). Because COPD can cause chronic coughing, and we know that one of the classic mechanisms of stress urinary incontinence is coughing, we might deduce that folks who cough more might leak more.

This study aimed to address such a prevalence in men and women aged 50-75 years. Over 700 men and women diagnosed with COPD were surveyed and 66% of them returned an evidence-based incontinence assessment tool. In women, 49.6% reported urinary incontinence (UI), in men, 30.3% experienced urinary leakage. 52.4% of the women described stress UI, whereas 66.3% of the men reported post-micturition dribble. Other differences noted between the genders in this study include that women were more likely to seek help for UI, had increased levels of bother from UI, and more women refrained from physical activities than men due to leakage.

The study concludes that patient management for those who care for patients with COPD must include assessment and appropriate treatment of UI. Depending upon the environment in which you treat patients (wouldn't it be fantastic if every skilled nursing facility, hospital, and outpatient center had a provider who can treat urinary incontinence?) you may meet patients of both genders who are dealing with COPD as a co-morbidity. Perhaps this information can be included at your next team or staff meeting. Are non-pelvic rehab providers aware of the relationship between coughing and leaking? Between leaking and avoiding social outings? Have you met the providers who serve the patients who seek treatment for COPD?

One of the amazing things about pelvic rehabilitation from a marketing standpoint is that you may have singular access to some medical care providers that other therapists do not access. Many medical providers are thrilled to learn that 1) their patients have broader treatment options than previously known, and 2) you can provide the services to the patient. Who markets to the pulmonologist? You can look at this from either a financial (cannot be ignored) or a humanitarian (where we like to live) standpoint. You might also remind the person who controls access to funds for a biofeedback unit that pelvic rehab therapists have the expertise and the power to reach patients and care providers who are not readily on many general practice's radar. A large and important part of our work is helping the public understand the treatment options that pelvic rehab specialists can provide.