What is Incontinence?
Incontinence is a complaint of leakage of urine and the inability to hold it in! It happens when there is a break in the working relationship of the bladder and pelvic floor muscles.
What are the different types/causes of incontinence (leakage)?
Stress Incontinence – is leakage due to high-level physical exertion such as jumping, running, heavy lifting, coughing and sneezing.
Urgency Incontinence – when you feel a sense of needing to go for a wee but you can’t delay; so you leak on your way to the toilet.
Mixed Incontinence – a mix or urgency and physical exertion, for example during exercise you feel a little leak and a sudden need to go for a wee but you leak further before you make it to the toilet.
How Common is Incontinence? (Leaky bladder)
Stress Incontinence 1 in 3 women – usually younger women (before menopause).
Mixed Incontinence 1 in 3 women, worsens after menopause most common in your 70’s.
50% of elderly people in hospital/nursing home have severe incontinence.
Women Suffer in Silence
With over 1 in 3 women suffering with incontinence, surveys show that most wait 1-5 years to ask their doctor for help. They resort to wearing pads, going to the toilet more frequently to avoid accidents, drinking less, wearing dark clothes and avoiding sports.
Many women are too embarrassed to discuss the problem with friends or their doctor and continue to live with incontinence in silence. Some women avoid social situations; avoid sex and even leaving their house.
Why am I Suffering with Incontinence?
The bladder stores waste liquid in the body with an average capacity of 600mls. There is always some liquid remaining in the bladder – so even if you go frequently and some wee comes out, that is normal because there will always be urine remaining.
Once the fluid in the bladder reaches a certain pressure the urethra (pipe for urine) triggers a sensation of needing to go for a wee. The sphincter muscles open and close the urethra. The pelvic floor/fascia holds part of the urethra in place and keeps the neck of the bladder stable.
If the pelvic floor is not doing its job properly, it will allow the flow of some urine out of the bladder. Hormones can also effect the action of the urethra so during pregnancy and menopause incontinence is more common.
Weakness of the Pelvic Floor
Often compared to a sagging trampoline. Weak pelvic floor muscles cause less stability in the pelvis, do not support the bladder, urethra and vagina – prolapse.
There is less sphincter muscle activity (open and closing urethra) and a feeling of less sexual arousal.
Overactive (High Tone) Pelvic Floor
When the muscles of pelvic floor are too tense, this causes problems with urgency (rushing to get to the toilet) and frequency (going to the toilet very often).
Also, women with too much tension in their pelvic floor will complain of pelvic pain and pain during sex too.
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