Physical Therapy Management in Recurrent Urinary Tract Infections: A Case Report

Abstract

Supplemental Digital Content is Available in the Text. Background: Pelvic floor dysfunction is linked to urinary incontinence (UI) and urinary tract infections (UTIs). Recurrent UTIs can affect an individual's quality of life, especially emotionally. Literature examining the conservative management of recurrent UTI is mostly in the pediatric and neurologic populations, not the general adult population. Therefore, the purpose of this case report is to describe the physical therapy (PT) management of a patient with a 10-year history of uncomplicated UTIs and UI. Case Description: This case describes the management for a 50-year-old woman referred to PT for UI, UTIs, urinary urgency/frequency, and pelvic pain. PT interventions included bladder retraining, surface electromyography biofeedback, electrical stimulation, therapeutic exercises, patient education, and a progressive home exercise program. Outcomes: Following 6 PT sessions over a 6-week period, the patient reported decreased urinary symptoms and resolution of UI. The Urinary Impact Questionnaire (UIQ) improved by 18% and the Focus on Therapeutic Outcomes Pelvic Floor Dysfunction Questionnaire (FOTO PFDI) improved by 8%. The patient reported no recurrence of UTIs at 3 months post-discharge. Discussion: A PT program designed to improve pelvic floor strength and coordination may have contributed to a decrease in UTI frequency and elimination of UI within a 3-month time frame. PT could provide a conservative treatment option for uncomplicated recurrent UTI and UI to improve the social/emotional impacts of symptoms and reduce antibiotic use. Future studies are needed to see the long-term effects of PT on UTI frequency. Informed Consent: This study was approved and exempt from a local intuitional review board. A video abstract for this article is available at: http://links.lww.com/JWHPT/A39.