Bladder Incontinence & Frequency
Difficulty with bladder control is common in women (estimated to be a minimum of 1 in 3 women!) but many women don’t seek help for it. However, research shows that 70% of women with this problem can completely cure or significantly improve their symptoms with the right treatment.
WHY DOES IT HAPPEN?
There are many reasons why bladder control issues can occur, including:
- Pelvic Floor Weakness/ Injury from pregnancy and childbirth
- Respiratory conditions causing a chronic cough
- Prolonged constipation/ straining to empty bowels
- Hormonal Changes (during peri-menopause/ post-menopause)
- Urinary Tract Infections (UTIs)
- Some medications
- Being overweight
- Underlying neurological disorders (e.g. Multiple Sclerosis; Parkinsons)
TYPES OF BLADDER CONTROL ISSUES
There are different types of bladder control issues which is very important to understand because each type has a different underlying cause and have very different treatment recommendations.
Stress Urinary Incontinence
Leaking urine with activities that put pressure on your bladder such as running, walking downhill, sudden movements, lifting, coughing, sneezing or laughing.
Bladder Urgency/ Overactive Bladder
A frequent, strong desire to urinate, even when the bladder isn’t very full. It can sometimes be accompanied by bladder pain and can happen during the day or at night. It can often come on suddenly and can be triggered by things such as running water, feeling cold or arriving home (known as “key in the door syndrome”).
Urge Urinary Incontinence
Loss of urine associated with Bladder Urgency. This can happen immediately when feeling the strong urge to urinate or can happen on the way to the toilet or entering the bathroom.
When more than one type of incontinence occurs. Often, this is a combination of Stress Urinary Incontinence and Urge Urinary Incontinence symptoms.
Occurs when you are unable to empty your bladder properly, so it becomes very full and unable to hold anymore urine. This is usually experienced as a constant dribbling of urine. It’s important to see your GP asap if this is happening.
Functional Urinary Incontinence
Occurs when a physical or cognitive impairment prevents you from being able to get to the toilet on time e.g. difficulty walking to the toilet. If this is happening, see your GP to discuss options to help with this.
WHAT CAN I DO TO IMPROVE MY BLADDER CONTROL?
There may be some underlying medical reasons for your Incontinence (e.g. UTIs, neurological conditions) as mentioned above so it’s always a good idea to check this with your GP. Once they have been ruled out, the type of treatment that will work best for you depends on the type of incontinence you have.
For Stress Urinary Incontinence the treatment usually consists of some form of Pelvic Floor Muscle Training. Devices, such as the Pelvic Floor Educator, can help with learning how to contract your pelvic floor muscles correctly. Vaginal Weights such as Aquaflex, or E-stim machines such as a Neurotrac Continence, can help to improve the strength and endurance of your pelvic floor muscles. There are also devices such as a Contiform you can use when exercising which are designed to support your bladder/ urethra and stop leaking.
For Urgency/ Overactive Bladder your treatment will likely start with some basic advice and bladder retraining. Nerve stimulation using a device such as a Neurotrac Continence, applied to your tibial nerve (lower leg), lower back (sacrum) or vaginally, has also been shown to improve bladder Urgency. Sometimes, if your Pelvic Floor muscles are too tight (yes, this can happen too!!), this can cause frequent urination and bladder urgency so you may need to learn how to relax your pelvic floor muscles properly. The Pelvic Floor Educator can help to teach you how to relax your pelvic floor muscles.
For Urge Urinary Incontinence or Mixed Incontinence you may need to incorporate a few different treatment options. A Pelvic Health Physiotherapist can help with working out where to start.