1 in 3 women have symptoms of urinary incontinence but many are too embarrassed or too frightened about surgery to seek help. The most common time for women to experience these symptoms are during pregnancy, postnatally, during the menopause and in later years of life, however it can affect all ages.
Women often start to restrict their fluid intake if they know they are going out, start to say no to exercise classes with friends, start to avoid sexual intercourse with their partner and frequently become reliant on continence pads such as TENNA or carrying a spare change of underwear.
The Government recommends that most women should see a Women's Health Physiotherapist as first line treatment, although you should always discuss this with your GP first. Treatment is highly effective and most patients that attend physiotherapy will be cured of their problems, or reach a point where the symptoms have very little impact on their quality of life.
There are several different types of incontinence, although you may have a combination of these listed below.
1. Stress urinary incontinence is leakage of urine when coughing, laughing, sneezing, running, jumping, exercising, sit-stand, walking, lifting and during sexual intercourse
2. Urge urinary incontinence is rushing to the toilet and not quite getting there in time. These symptoms can be aggravated by the sound of running water, undressing as you approach the toilet or whilst trying to get your key into the front door lock.
3. Void frequency - needing to go to the toilet very frequently, more than 8 times per day.
4. Nocturia - night time weeing, being woken by your bladder and getting up more than once per night.
5. Incomplete/difficulty emptying is not feeling empty after going to the toilet, needing to go back minutes later or even pushing and straining to empty the bladder
Pelvic floor muscles
Physiotherapy for these problems will focus on re training the pelvic floor muscles and teaching them to squeeze and close the bladder tube, thus stopping the urine leakage.
Drinks which contain caffeine, for example tea, coffee, green tea and coke a cola, can irritate the bladder and make symptoms of urgency and void frequency worse. If you have these symptoms try to reduce your intake to a maximum of two caffeinated drinks per day.
Many ladies think that their bladder symptoms will get better if they drink less. This can actually make symptoms worse as concentrated urine is more difficult for the bladder to store. Aim to drink 1.5-2 litres per day, evenly spaced throughout the day, with your last drink 2 hours before bed if you have night time symptoms.
During your physiotherapy session we can review and analyse how your bladder behaves at it fills with urine. If we notice that the bladder is not behaving normally we can teach you techniques to help re-train your bladder function. These techniques require patience and practise to correct the messages sent between the bladder and brain.
Women can experience times in their life when they need to use continence pads, but most hope to return to being pad free! Continence pads are readily available in most chemists and supermarkets. It is important to use pads which are designed for urine loss rather than pads designed for menstrual blood loss. Try different brands and sizes to see which suit you the best - you need to feel both comfortable and confident that the pad will contain leakages.