Urinary Incontinence affects men, women and children. Urinary Incontinence occurs in:
- 1 in 4 Women
- 1 in 10 Men
- 1 in 10 Children
Incontinence can be very embarrassing and unfortunately, can lead to people becoming socially isolated as they avoid leaving the house in fear of having an "accident" in public.
2 Main Types of Urinary Incontinence:
- Stress incontinence is leaking from the bladder with increased pressure such as coughing, sneezing, laughing and exercise.
- Urge urinary incontinence is leaking from the bladder associated with a sudden urgency to empty the bladder that in uncontrollable, it is associated with having an overactive bladder.
Factors Contributing to Incontinence:
- Pregnancy and Childbirth
- Ageing, Obesity, Chronic Coughing associated with Chronic Lung Disease
- Neurological Conditions, side effects of Medication, Lifestyle Factors such as Fluid Intake, excessively heavy lifting with poor technique and Bladder & Bowel habits.
What Can We Do?
1. Ensure Adequate Containment of Leakages:
It is important to note that incontinence pads are not a long term solution to urinary incontinence. Pads can allow people to socialise and continue daily activities without the fear of leaking through their clothes. Pads also prevent skin irritation by absorbing the urine.
2. Ensure Healthy Fluid Intake:
Aim to drink 1.5-2 litres fluid per day, gradually throughout the day. Some people limit fluid intake in the hope of reducing leaks. This can cause dehydration and bladder irritation which may increase urgency to empty and can thereby worsen incontinence. When you are well hydrated, your urine show be a pale straw colour. Yellow, strong smelling urine can indicare dehydration. Also be careful with regards to Caffeine and Alcohol intake as these can irritate and stimulate the bladder. You should also stop drinking 2 hours before bed where night frequency also called Nocturia is an issue.
3. Maintain Healthy Bladder Habits:
Normal bladder emptying frequency is every 3-4 hours with fluid intake of 1.5-2l per day. It is not advised to urinate more frequently in order to reduce the chance of having a leak. This will not prevent leaks as it can cause the bladder to shrink and reduce capacity thereby leading to increased need to void more frequently. It is also important not to completely ignore bladder signals to empty as delaying voiding for a prolonged period of time will cause the bladder to overstretch and may reduce the bladders ability to give signals to the brain to empty at the appropriate time.
4. Avoid Constipation and Straining on the Toilet:
How to pass stool - Ideal position is squatting, with a straight spine in a forward lean position. A small step or stool under the feet will bring the knees higher than the hips creating the squatting position. This provides the most ideal position of the rectum to empty correctly.
5. Weight Loss:
There is a strong association between increased weight and BMI and incontinence, particularly stress incontinence. Weight is a modifiable risk factor for incontinence. For everything 5-unit increase in BMI, there is an associated 20-70% increase in the risk of daily incontinence. Research has shown that a weight loss of as little as 5-10% in overweight and obese women, can reduce the frequency of weekly incontinent episodes by 50-60%.
6. Strengthen the Pelvic Floor Muscles:
The pelvic floor muscles are a group of muscles which form a diamond shape at the base of the pelvis. The pelvic floor muscles attach from the tailbone at the back to the pubic bone at the front and to the sitting bones on either side of the pelvis. Pelvic floor muscles close around the back passage to prevent leaking of wind and faeces from the bowel, and close around the front passage to prevent leaking from the bladder. The pelvic floor muscles also form part of our core stabilising muscles connecting the spine to the pelvis and to help support the pelvic organs (Bladder, Womb and Bowel), thereby, helping prevent prolapse of the organs. Strong pelvic floor muscles can also lead to a more enjoyable sex life.
7. Seek Professional Help:
Speak with your GP who may prescribe medications to help with an overactive bladder, refer you to a gynaecologist or advise a review by a physiotherapist specialising in women's health. Women's physiotherapists offer a detailed assessment which includes an optional internal pelvic floor examination. The physiotherapist can also provide "Bladder Training Programmes" to help reduce urinary frequency and treat urge incontinence.