Objective: The purpose of this paper is to discuss the chiropractic management of stress urinary incontinence in a pregnant patient following a previously traumatic birth.
Clinical Features: The patient presented for chiropractic care during the second trimester of pregnancy with complaints of urinary incontinence of more than three years’ duration. History revealed a previous traumatic birth with severe perineal tearing immediately preceding the onset of incontinence. The patient was unable to hold urine beyond a self-reported approximation of about a half-full bladder, and would frequently urinate on themselves when sneezing or coughing even shortly after voiding the bladder. Examination included the Webster analysis, postural analysis, bilateral scale analysis and balance testing, as well as standard neurological and orthopedic tests. The patient was diagnosed with vertebral subluxation of the sacral and lumbar region, as well as incoordination and muscle spasms.
Intervention and Outcomes: Instrument-based chiropractic adjustments were utilized to correct sacral and pelvic dysfunction. Round ligament tension was addressed via Webster protocol. The patient was also instructed on corrective exercises to perform at home to augment their in-office treatments. After six office visits, the patient reported complete resolution of their urinary incontinence.
Conclusion: This case demonstrates the effectiveness of chiropractic care in addressing pelvic floor dysfunction resulting in urinary incontinence and the safety of this care during pregnancy.
Author Keywords: Chiropractic, Webster Technique, urinary incontinence, vertebral; subluxation, adjustment, spinal manipulation, pelvic floor dysfunction, postpartum, pregnancy
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