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Incontinence, or the accidental loss of urine from the bladder, or wind or faeces from the bowel, is a problem that affects over 4.8million women in Australia. It is a treatable problem that unfortunately is often shrouded in secrecy, and accepted as a normal condition post childbirth. It’s not and doesn’t have to be!

 

Working through a checklist, women can determine what is and what is not normal bladder function. They can then decide whether to seek professional advice.

 

It is NOT NORMAL to:

  • Leak urine when conducting normal daily life activities.
  • Have a sense of urgency to empty your bladder right there and then. You should always have time to find a bathroom.
  • Feel like there is some urine left in your bladder once you have finished urinating.
  • Have a stop start flow of urine, or to feel like you need to strain to go.
  • Pass urine more than 6-8 times per day and / or more than twice overnight.

Incontinence can present in a few different ways… it’s not a one size fits all, but the two more common types are:


  1. Stress incontinence
    This leakage of urine occurs when the pelvic floor muscles are put under stress, e.g. coughing, sneezing, jumping or running.

  2. Urge incontinence
    This is a sudden and uncontrollable urge to pass urine, that can’t wait. There are a number of contributing factors around the development of these types of incontinence. These include:
  • weak pelvic floor muscles
  • pregnancy and birth 
  • menopause
  • obesity
  • chronic constipation
  • other medical conditions

Pelvic floor muscles play a significant role in giving good control over our bladder and bowel function. These muscles span the bottom of our pelvis (see diagram below) and in women support the bladder, bowel and uterus.  It is through these muscles that the urine tube, vagina and back passage pass. The strength of these muscles is very important for women of all ages for good bladder, bowel and sexual function.


So how do we know if our pelvic floor muscles are in good shape? First we need to be confident that we know where they are, and how to contract them correctly.

  1. Sit or lie down with your knees bent up, letting your buttocks and tummy relax.  Now imagine you were trying to stop passing wind. You should feel a ‘drawing up’ sensation in your back passage. Now relax the muscles and repeat until you are confident you have found the right muscles. 

  2. When sitting on the toilet passing urine, try contracting your pelvic floor muscles.  You should be able to SLOW the flow down or even stop it, then start it again.   If you don’t feel that you tract the muscles, or are unable to slow the urine flow down then you should seek a review with your GP, Women’s Health Physiotherapist, or continence nurse.

Lifestyle factors can also have an effect on incontinence. There are simple things that you can do to help prevent incontinence.

  • Aim to drink 1.5-2 litres of fluid per day, unless otherwise instructed by your GP. If it is particularly hot weather,
    or you are exercising, you may
    need to increase this.
  • Limit carbonated, caffeinated and alcoholic beverages.
  • Eat a healthy diet with adequate fibre. Fibre maintains moisture within your stools, which makes them easier to pass, thus reducing the need to strain.
  • Exercise regularly and maintain a healthy weight. Excess body weight places additional strain on the pelvic floor.
  • If you are a smoker, seek help to stop! Chronic coughing associated with smoking can weaken your pelvic floor.

 

If you are experiencing any symptoms or issues with incontinence, you should speak to your GP, or contact the National Continence Helpline on 1800 33 00 66. This Helpline is serviced by trained professionals who are able to give advice.


Jo Davison is a Physiotherapist with 27 years clinical experience across all aspects of physiotherapy including sports physiotherapy, rehabilitation, women’s health and paediatrics. Jo is a mum to three children, a keen runner and an advocate for women’s health through all stages of life!


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