Urinary incontinence can be quite embarrassing. Not knowing when you might experience your next accident may leave you feeling anxious if not act as a deterrent to leaving the home.
Up to 1/3 women will experience urinary incontinence during their lifetime. And it has been shown that in young female elite athletes (who have never been pregnant) the incidence of urinary incontinence ranges from 28 to 52% (Nygaard et al 1994, Thyssen et al 2002). This is most commonly experienced by gymnasts, ballerinas, basketballers, tennis players and track athletes (Nygard 1994).
If you’ve managed to get through your sporting endeavours and childbearing years without a leak, you then might find the menopausal period may be your undoing as estrogen levels start to decline. The point is, even if you haven’t given birth, depending on your lifestyle and other factors, you may leak.
Read on to learn more about the different types of Urinary Incontinence.
WHAT IS STRESS URINARY INCONTINENCE (SUI)?
SUI is any involuntary loss of urine during strain, effort or exertion. This is the most common and usually occurs as a result of weakness of the pelvic floor muscles or due to damage to the connective tissue supporting the bladder. Note, there is a population of women with hypertonic pelvic floor muscles who leak too (that’s why a pelvic floor examination is important to determine your contributing factors). Typically, women will complain of leaks with coughing, sneezing, jumping or running for example. During these situations, the support structures are unable to provide the required support to the urethra to stop the leak from occurring.
HOW CAN PHYSIOTHERAPY HELP MY STRESS URINARY INCONTINENCE SYMPTOMS?
Physiotherapy is the first line of treatment for SUI and is backed by research. Typically, treatment will involve:
- taking a detailed history and a thorough assessment to determine your contributing factors
- education and an individualised pelvic floor muscle training program
- advice on returning to activities or on exercises as your pelvic floor support improves
- in some instances, a pessary may be indicated as an adjunct.
WHAT IS URGE URINARY INCONTINENCE (UUI)?
Urgency- is the sudden uncontrollable desire to have to urinate (wee) that you can’t defer.
Urge Urinary Incontinence (UUI)- is the sudden uncontrollable desire to have to wee that results in a leak.
Urgency may be brought on by triggers such as running water or putting the key into the door as you arrive home. Please note that urgency may or may not be accompanied by urinary incontinence.
The term Overactive Bladder (OAB) is often used interchangeably with UUI. Women sufferers will typically complain of the following symptoms:
- difficulty in deferring the urge to pass urine with or without leaking
- going to the toilet frequently
- fear of urinary leakage, even though you may have never leaked
- going to the toilet more than 1x at night (nocturia)
WHAT CAUSES OVERACTIVE BLADDER (OAB) ?
Up to 40% of adult females will suffer from OAB. Causes of OAB include pelvic floor weakness or pelvic floor overactivity, chronic constipation, pelvic organ prolapse, low estrogen, bladder irritants (caffeine, artificial sweeteners, carbonated drinks) and too much or too little fluid intake.
HOW CAN PHYSIOTHERAPY HELP MY OVERACTIVE BLADDER SYMPTOMS?
Did you know that physiotherapy is the first-line treatment for OAB and Urge Urinary Incontinence and is supported by years of great research? You will be asked to complete a bladder diary so we can learn more intimately about your bladder habits (yes, you do have to measure your wee’s for 48 hrs). Once we have taken a detailed history and performed our assessments we may use some or all of the following strategies:
- Bladder education
- Bladder training
- Bladder retraining and calming
- Bladder drills
- Pelvic floor muscle exercises
- Transcutaneous Electrical Nerve Stimulation (TENS)
- Teach you how to respond when urgency strikes
- Breathing education
- Musculoskeletal treatment to treat other drivers we feel may be contributing to the urgency
- Liaising with your doctor regarding medications to assist the bladder calming process
WHAT IS MIXED URINARY INCONTINENCE?
Basically, it is a bit of SUI + UUI.
Whether it is a little or a lot, SUI, UUI or Mixed Urinary Incontinence (MUI) rest assured in most cases conservative physiotherapy management under the guidance of a Women’s Health Physiotherapist can help with urinary incontinence.
If you are suffering from urinary incontinence, please do call/WhatsApp on 9780 7274 or get in touch over email to discuss your concerns. Rest assured, help is available.
You can also visit our website to learn about other women’s conditions we treat through physiotherapy and how we can help you.
Nygaard IE, Thompson FL, Svengalis SL, Albright JP. Urinary incontinence in elite nulliparous athletes. Obstet Gynecol. 1994;84(2):183-187.
Thyssen HH, Clevin L, Olesen S, Lose G. Urinary incontinence in elite female athletes and dancers. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(1):15-17.