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Useful resources for women dealing with urinary incontinence.
Information about the author, Kelli Berzuk.
I laughed so Hard in the Press
I laughed so Hard Book Reviews
How do you prevent bladder control problems? What can be done to treat bladder control difficulties? How do you cure bladder control problems?

Book Review

August 2004
Journal of the Section on Women's Health
American Physical Therapy Association (APTA)
Volume 28, Number 2

Book Reviews

By K. Lynne Odom, PT, MOMT

I Laughed So Hard I Peed My Pants! A Woman’s Essential Guide for Improved Bladder Control. Berzuk, Kelli. Winnipeg, Manitoba, Canada: IPPC-Incontinence & Pelvic Pain Clinic (division of Nova Physiotherapy & Sports Fitness Clinic); 2002, Soft cover, 208 pages, $29.99.

I Laughed So Hard I Peed My Pants! Written by Physiotherapist, Kelli Berzuk, is an easy to read, self-help guide for women ages 16 and over. It is divided into 29 brief and informative chapters. Each chapter concludes with a summary of key points and a “Did You Know?” section. Chapter 1 briefly introduces the signs of incontinence and also addresses common fallacies about this condition such as “incontinence is a normal consequence of childbirth…and aging… and something you have to live with”. Chapter 2 describes the epidemiology of incontinence. Chapters 3-5 review the anatomy of the urinary and nervous systems. The role of the pelvic floor muscles is also presented in those chapters in easy-to-understand terminology. Good illustrations support the information presented in those chapters. Chapters 6 and 7 discuss types of urinary incontinence and pelvic organ prolapse. Chapter 8 covers the role of the pelvic floor in sexual function. Chapter 9 reviews the factors contributing to incontinence such as pregnancy, vaginal delivery, diastasis recti, aging, medications, and recurrent urinary tract infections. Chapters 10-13 contain self-help instructions on how to control incontinence including detailed exercise progressions. Chapter 13 also covers information on how to be sure exercises are performed correctly. Chapter 14 discusses the Red Dot Program as an assisted way to remember when to do the exercises. Chapters 15-16 cover bladder irritants and bladder diaries with a bladder diary that is easily followed and copied. Chapter 18 discusses urgency and urge delay techniques including a brief mention of pediatric urinary incontinence. Chapter 19 emphasizes the importance of relaxation techniques as an important part of calming the nervous system. Toileting postures are reviewed in Chapter 20. Chapters 21 and 22 cover pelvic floor exercise progression and the importance of progressing to accessory muscle exercises. Chapter 23 educates women on how to recognize when they have regained bladder control including a detailed check list of improvements to look for and why the exercises should be continued after continence is achieved. The remaining chapters cover available treatment options including physical therapy, pharmacological treatment, bladder function testing, and surgical intervention. The book includes an extensive list of references and resources including the books own website, .

I Laughed So Hard I Peed My Pants! does a good job of covering detailed information about the urinary system and role of the pelvic floor in a format that is easy to understand. It provides clear explanation of exercise progression as well an overview of diet and lifestyle modifications often used in incontinence management. Some chapters include helpful client examples. Overall the book is a good self-help tool that can assist in empowering women with incontinence , and also be beneficial as a source of information for preventative health of the pelvic floor. Physical therapists will find this book a useful adjunct to their clinical management of incontinence.

K. Lynne Odom, PT, MOMT
Nashville, TN

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