Incontinence Q & A

Stopping the Leaks

Do you fit the picture?

• At the back of the aerobics class
• Watch sport instead of joining in
• Housebound or decreasing social outings
• Know every toilet in town
• Can’t sit through a film

What is urinary incontinence?

Any unwanted or involuntary leakage of urine, no matter how small.

The two most common types of incontinence are:

stress incontinence - leakage with activities such as coughing, laughing, sneezing or playing sport and

urge incontinence - leakage occurring when you urgently need to go but don’t get there in time.

Urge incontinence often occurs with urinary frequency, a need to pass urine very frequently during the day or night. Someone with frequency knows every toilet around!

Any tips on preventing incontinence?

Firstly, keep your pelvic floor muscles strong especially during and after pregnancy, around menopause and if you are having gynaecological, abdominal or spinal surgery.

Keep within your healthy weight range.

Don’t do anything that strains the pelvic floor muscles: avoid repetitive heavy lifting and don’t get constipated…. fibre, fluids and general exercise help this.

If you have back problems, keep your pelvic floor strong as well as your abdominals….your physiotherapist will help you with this.

If you have respiratory problems and have prescribed prevention medication, use it! Stop that cough!

Check with your GP if any medication you are on may contribute to your incontinence.

Isn’t it a normal part of having children or getting older?

At these times in our lives, incontinence is certainly more common. One out of every three women who have ever had a baby will experience some incontinence.

Fortunately, everyone can be helped and, in many cases, cured and the sooner you seek assistance the better. Also, don’t ever think it’s too late to get help.

What is normal then?

It is normal to:

• Go to the toilet around 4 to 6 times per day, and no more than once overnight.
• Pass more than a cupful each time
• Get to the toilet without having to rush
• Have no trouble starting the flow of urine and have a strong stream
• Have no need to strain to pass urine
• If I just go to the toilet more often and drink less, won’t that help me to leak less?

No! The bladder is like a reservoir and should be encouraged to store good amounts of urine…at least a cupful. If you drink less and practise going more, you may make it even harder for the bladder to hold on when you want it to. Avoid going to the toilet “just in case”…only go when you really need to.

Drink 6-8 cups or glasses of fluid each day unless you have been advised otherwise but keep an eye on the caffeine…no more than 3 per day.

When you do go, take your time. Sit down on the toilet rather than hover over it, take your time and never push to empty.

How can physiotherapy help?

Some physios have extra training in treating incontinence. Your physio can help you to find one of these.

A pelvic floor physiotherapist will firstly ask you questions about your particular problem

and work out a plan for your treatment. This will always involve strengthening the pelvic floor muscles and improving their endurance and coordination.

In addition, you may be taught bladder retraining techniques to help your bladder hold on better.

Any program will involve some general exercise, for example walking as well as strengthening other muscles that are around the pelvic floor.

But I’ve done pelvic floor exercises before and they didn’t help!

There can be many reasons for this.

Some women are unable to contract the pelvic floor muscles correctly on their own, even though they try very hard.. A pelvic floor physiotherapist will help you to identify the right muscles.

Working our muscles from time to time is not enough to increase strength which may be needed to cure a problem….your program needs to be performed regularly.

As your strength improves, your exercise program will be increased to reflect this.

If muscles are very weak, your physiotherapist may suggest use of muscle stimulation to help in the initial stages of training. Various forms of biofeedback may also be used to help you to identify and strengthen the right muscles.

Does physiotherapy help everyone?

Some people may need to be referred to their GP or a specialist for further assistance or assessment. Physiotherapists are trained to know when to refer you to another professional.