Incontinence is not a subject we like to talk about, yet, it is far more common than many of us realize. Men and women of all ages can develop the problem and even young fit athletes can experience episodes of incontinence when performing high impact activity.
More than 4.8 million Australians experience bladder or bowel control problems. The Continence Foundation of Australia’s vision is to have a community free of the stigma of incontinence.
Healthy bladder and bowel habits can help you avoid bladder and bowel control problems such as incontinence which can have a major impact on your quality of life.
There are several different types of incontinence but they all result in leakage of urine and sometimes from the bowel. The primary pelvic floor muscle forms a sling from the pubic bone to the coccyx and is the base of what we describe as the ‘core’. It helps to anchor the pelvic organs; the urethra, vagina, rectum and anus, into their correct position. When the pelvic floor weakens or is injured, these organs can shift causing problems such as incontinence or prolapse.
Do you recognise any of the following symptoms?
- The frequent feeling of a sudden and uncontrolled urge to go to the toilet.
- Leakage when coughing, sneezing, squatting, running down-hill or simply from standing up
- The feeling of a dragging or bulging sensation in the pelvic region
- Never feeling completely satisfied after going to the toilet, even if you go frequently
What is Urge Incontinence?
Urge incontinence is common in both men and women and is generally associated with over activity of the bladder which causes an overwhelming urge to go to the toilet at the most inconvenient times, day or night. There may even be a loss of urine while sleeping which can be very distressing.
Urge incontinence may be caused by a number of different things, for example; an infection irritating the wall of the bladder, a growth on the bladder wall, in women it may be due to a pelvic organ prolapse causing excessive pressure on the bladder wall or weak or injured pelvic or ‘core’ muscles.
What is Stress Incontinence?
Stress incontinence tends to be more common in women and associated with weakness of the pelvic floor due to;
- Injury of nerves, muscles and fascia from previous childbirth.
- Surgery such as a hysterectomy.
- Pelvic organ prolapse.
- A stroke.
- A general weakening of these muscles that occurs with menopause.
In men, stress incontinence occurs;
- Following surgery (eg. prostatectomy).
- After a prolonged illness.
- A stroke.
- Loss tone of the pelvic floor muscles associated with ageing.
In younger athletes stress incontinence can occur when;
- The abdominal muscles become over-active.
- There is an increase in intra- abdominal pressure during high impact exercise causing a ‘bearing down’ on the pelvic floor.
What is Overflow Incontinence?
This is more common in men who have enlarged prostates that block the normal flow of urine. The bladder becomes so full it simply ‘leaks’ urine when the pressure inside the bladder builds past a certain point. Overflow can also occur when the bladder has lost all tone and is unable to contract properly, again, resulting in leakage.
- A small trickle of flow.
- Difficulty urinating.
- A feeling of pressure in the abdomen.
- A feeling the bladder has not been emptied, often resulting in straining and overusing the abdominal muscles.
What is Mixed Incontinence?
This tends to be more common in women and symptoms demonstrate a mixture of both urge and stress incontinence such as the urge to rush to the toilet day or night and leakage when coughing or sneezing.
How Can Physiotherapy Help?
Research has shown that pelvic floor muscle training is less expensive and more effective than medication in treating incontinence and that intensive pelvic floor muscle training, plus lifestyle changes, is the most effective method for treating urinary and bowel incontinence. Physiotherapy directly aids in the recovery and training of pelvic floor muscles.
A specially trained physiotherapist will;
- Take a detailed history.
- Perform an appropriate examination.
- Identify the type of incontinence and likely causes.
- Provide a detailed explanation of the most appropriate intervention and treatment.
Dr Irmina Nahon is the president of the ACT branch of Continence Foundation Australia and we are extremely proud to be in partnership with her, and make available our practice for her very important services. She is an expert in this area and very passionate about her work – she can help you.
What to Expect at the First Appointment?
Your first session with a physiotherapist will include;
- A completely confidential, detailed assessment.
- Advice on how to improve your condition.
With diagnostic ultrasound, your highly trained physiotherapists may also include an internal examination and assessment of the area. This allows for a detailed understanding of how your pelvic floor muscles are working (or in some cases overworking!) but will only occur if necessary and with consent.
If any of these issues are affecting you, please don’t hesitate to contact us and make an appointment. With help, you can free yourself from the distress of incontinence.