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URINARY INCONTINENCE – LEAKAGE – WHAT IS HAPPENING? WHAT TO DO?

1 in 3 women in the world would have experienced chronic urinary leakage in their lives. If you are struggling with this issue, you are more likely to ask Dr Google about it first, instead of talking to someone. So, it’s a good thing that this post is up online, so you can have a read and find out more about what urinary incontinence (UI) is, and which type of UI you are experiencing.

The most common type is stress urinary incontinence. The “stress” comes from the forces around the bladder that causes it to be squeezed down. These forces happen when there is an increased pressure inside your abdominal / stomach. When you are coughing or sneezing, your body acts so that you can push air out of your lungs forcefully. As you lift heavy objects, your core will have to be switched on to stiffen up (thus stabilising) the spine momentarily. Both of these actions can increase intra-abdominal pressure.

In order to treat or prevent UI, such forces must be equally met with the ligaments and muscles that form your pelvic floor to keep the urethral sphincter (shown on diagram below) closed. However, when this fails, you might experience leaking of your urine. This is what we call stress urinary incontinence. Check out my previous blog on pelvic floor activation exercises here.

Stress-Urinary-incontinence-diagram

Figure 1. https://urolon.com/urolon-for-women/stress-urinary-incontinence/

The other type of UI is urge urinary incontinence. It results from ‘urgency’, which is when you feel like you need to go to the bathroom. In urge incontinence, you may have an urgency but it does not necessarily mean that your bladder is full. The cause of this urgency is actually the overactivity of your detrusor muscle (shown in diagram) that lines your bladder wall. As muscle activates, it shortens, and in the case of your bladder, the activation of your detrusor muscle means your bladder will ‘compress’ to push urine out. Urge incontinence is not to be confused with polyuria, where your body is secreting large volumes of urine (urinating >3L/day) due to an underlying condition such as diabetes, or excessive drinking of coffee / alcohol.

overactive-detrusor-muscle

Figure 2. https://atlanticurologyclinics.com/conditions/overactive-bladder-oab/

The management of urge UI would still be strengthening your pelvic floor muscles to prevent leaking. There are other measures you can take to definitely try to prevent urgency by limiting consumption of bladder irritant food/drinks. That means no more consuming large amounts of coffee. Consuming just the right amount of water would be great. So instead of large amounts in 1 go, have your water in small amounts more frequently.

Bladder behaviour training is important to manage urge incontinence. The main aim is to increase the intervals between bathroom visits. Try avoid going to the bathroom until the next urge comes. When you are having an urge to go, tighten your pelvic floor muscles and focus on your breathing. Distracting the nerve that feeds your detrusor muscle would be helpful, too. You can achieve this by curling your toes and pointing your feet down as far as you can. Also, you can try sitting on the corner of a table. You may urinate when the next urge that comes. Keep practising until you achieve maximum bathroom visits of around 6 per day.

I really hope this blog has been helpful. Recommend this blog to anyone who you know is struggling with incontinence. Get the word out there. There are many other women’s health issues that I hope to cover bit by bit and share with you my knowledge. And, of course, if you have any questions, contact us at (02) 7226 3432, or book online for an appointment. Thank you for reading!

 

Stay fit, stay healthy!

 

 

References

Australian Institute of Health and Welfare 2013. Incontinence in Australia. Cat. no. DIS 61. Canberra: AIHW.