Conquering Incontinence: A New and Physical Approach to a Freer Lifestyle
By Peter Dornan
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Conquering Incontinence - Peter Dornan
CONQUERING
INCONTINENCE
Peter Dornan has been a physiotherapist in the fields of sporting injuries and manipulative therapy for the past 35 years, working with many international sporting teams, including the Queensland rugby team, the Wallabies and the Kangaroos. Peter has also been an Olympic advisor and Commonwealth Games physiotherapist. He is a fellow of Sports Medicine Australia, and has written two successful books on sporting injuries. In 2000 he was awarded the Commemorative Australian Sports Medal for achievement in sport.
In recent years Peter’s interests have turned to men’s health and the treatment of incontinence patients, and in 2000 he was awarded the Duncan Travelling Fellowship to study aspects of prostate cancer in the United States. In 2002 Peter was appointed as a Member of the General Division of the Order of Australia (AM).
Peter Dornan has published two previous books with Allen & Unwin, The Silent Men and Nicky Barr, An Australian Air Ace.
Peter has been married to Dimity, a speech pathologist, for more than 35 years, and they have two children, Melissa and Roderick.
CONQUERING
INCONTINENCE
A new and physical approach
to a freer lifestyle
Peter Dornan
First published in 2003
Copyright © Peter Dornan 2003
All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without prior permission in writing from the publisher. The Australian Copyright Act 1968 (the Act) allows a maximum of one chapter or 10 per cent of this book, whichever is the greater, to be photocopied by any educational institution for its educational purposes provided that the educational institution (or body that administers it) has given a remuneration notice to Copyright Agency Limited (CAL) under the Act.
Allen & Unwin
83 Alexander Street
Crows Nest NSW 2065
Australia
Phone: (61 2) 8425 0100
Fax: (61 2) 9906 2218
Email: info@allenandunwin.com
Web: www.allenandunwin.com
National Library of Australia
Cataloguing-in-Publication entry:
Dornan, Peter, 1943–.
Conquering incontinence: a new and physical approach to a freer lifestyle.
Bibliography.
Includes index.
ISBN 1 74114 144 3.
1. Urinating disorders. 2. Urinary incontinence—Treatment.
I. Title.
616.62
Set in 12/14.5 pt Granjon by Midland Typesetters, Maryborough, Victoria Printed by McPherson’s Printing Group, Australia
10 9 8 7 6 5 4 3 2 1
I dedicate this book to my wife, Dimity Dornan. Besides being my primary support system, my tireless cheer squad leader when problems seemed insurmountable, and my critical life editor and coach, she is my inspiration and muse, the well-spring of all creativity.
Never give in, never give in—never—in nothing, great
or small, large or petty—never give in except
convictions of honour and good sense.
—Winston Churchill
Contents
Figures
Acknowledgments
Glossary
Introduction
Part I Anatomy and physiology: The bladder and the lower urinary tract
1 How it all works
Part II Incontinence: Causes and treatments
2 What causes incontinence?
3 Conventional treatments for stress incontinence
Part III Behavioural intervention: A new and physical approach
4 A new approach: Taking control
5 Urge incontinence and bladder training
Part IV Cancer and incontinence: The psychological and social effects
6 Dealing with the demons: Cancer, depression and beyond
7 Erectile dysfunction: The meaning of manhood
Appendix: Pilot study results
Bibliography
Figures
1.1 Male and female pelvic organs
1.2 Pelvic floor muscles
1.3 The dorsal vein of the penis complex
1.4 The abdominal muscles
1.5 Nerve supply to the bladder and urethra
3.1 Bulking injections
4.1 Basic crunch exercises
4.2 Obliques (rotators) and transversus
4.3 Cycling and trunk rotation
Acknowledgments
Abook of this nature relies heavily on the support of not only members of the medical profession, but also on the many sufferers, survivors and patients who have shared their problems and experiences with me.
I would particularly like to acknowledge the role of my friend and urologist, Dr Les Thompson, for his consistent encouragement, countenance and direction over the last seven years. I am also extremely grateful to the many other urologists, oncologists and doctors who have assisted me to further my understanding in this area.
I am indebted to the members of the Queensland branch of the Continence and Women’s Health Special Group of the Australian Physiotherapy Association. There were many special people within this group who assisted me with advice and ready back-up. In this regard, I would like to give particular thanks to Dr Ruth Sapsford for her continuing championship. I would also like to pay tribute to physiotherapists Prue Ryan and Jackie Lander.
I am also obliged to the dedicated staff at the Queensland Cancer Fund who have encouraged and assisted me in so many marvellous ways. I would especially like to mention psychologist Suzanne Steginga for her perspicacity and sound judgment relating to psycho-social concerns.
On matters relating to mountaineering, I would like to give particular thanks to Drs Alan Frost and John Taske, as well as to Jim and Marianne Drapes of Peregrine Travel.
A special accolade also goes to my dedicated office manager, Carol Jackson, whose patience and assistance in both typing and compiling the many drafts of this manuscript have been invaluable.
Finally, I wish also to express my gratitude to the many caring friends I have met both internationally and locally, especially through the now wide network of the Australian Prostate Cancer Foundation. In particular, I am obliged to the members from my own affiliated Brisbane Prostate Cancer Support Group. The collective courage, humility and support demonstrated by individual members continues to inspire me.
I will never underestimate the power of the human spirit.
Peter Dornan
Brisbane 2003
Glossary
after-dribble annoying dribble that exists after urination has finished
anti-cholinergic agents drugs which block the contraction of the bladder muscles
anticipatory reflex the reflex which prepares postural muscles for movement
benign prostatic hyperplasia enlarged prostate
biofeedback/electrical stimulation a system to assist pelvic floor muscle training
bladder container which stores urine
bladder augmentation