Pelvic Health: Incontinence
Incontinence is a condition that affects millions of people worldwide. It is defined as the involuntary loss of urine or faeces, which can be both embarrassing and debilitating. Incontinence can impact an individual's quality of life, social interactions, and self-esteem. There are different types of incontinence, and it can be caused by various factors. In this blog, we will discuss the different types of incontinence, causes and contributing factors of incontinence, treatment options, and the role of physiotherapy in managing incontinence.
Types of Incontinence:
There are five types of incontinence:
Stress Incontinence: This type of incontinence is the most common, affecting women more than men. It occurs when there is an increase in intra-abdominal pressure that overcomes the strength of the pelvic floor muscles. Stress incontinence can be caused by activities such as coughing, sneezing, laughing, jumping or lifting heavy objects.
Urge Incontinence: This type of incontinence is characterised by a sudden and intense urge to urinate, followed by an involuntary loss of urine. Urge incontinence can be caused by overactive bladder muscles, which can be due to neurological conditions, infections, or medications.
Mixed Incontinence: This type of incontinence is a combination of stress and urge incontinence.
Overflow Incontinence: This type of incontinence occurs when the bladder does not empty completely, causing urine to leak out continuously or intermittently. Overflow incontinence can be caused by an obstruction in the urinary tract or weak bladder muscles.
Functional Incontinence: This type of incontinence occurs when a person has difficulty reaching the toilet in time due to physical or cognitive impairments. Functional incontinence can be caused by conditions such as arthritis, dementia, or mobility issues.
Causes and Contributing Factors of Incontinence:
Incontinence can be caused by various factors, including:
Age: As we age, our muscles and tissues weaken, including those that control the bladder and bowel.
Pregnancy and Childbirth: Pregnancy and childbirth can cause damage to the pelvic floor muscles and nerves, leading to incontinence.
Menopause: Menopause can cause changes in hormone levels, leading to changes in the pelvic floor muscles and urinary tract.
Neurological Conditions: Conditions such as multiple sclerosis, Parkinson's disease, and stroke can affect the nerves and muscles involved in bladder and bowel control.
Obesity: Being overweight or obese can put pressure on the pelvic floor muscles, leading to incontinence.
Medications: Certain medications, such as diuretics and alpha-blockers, can cause incontinence.
Treatment Options:
Treatment options for incontinence vary depending on the type and severity of the condition. They include:
Behavioural Therapy: This includes bladder training, pelvic floor exercises, whole body strength and dietary modifications.
Medications: Medications such as antimuscarinics and beta-3 agonists can help manage incontinence.
Medical Devices: Devices such as pessaries and urethral inserts can help manage incontinence.
Surgery: Surgery can be an option for some types of incontinence, such as stress incontinence.
How we can help:
An individualised assessment helps us to tailor the strategies that might be most helpful for you.
Our treatment and advice might include:
Keeping a bladder diary
Deferral strategies to help with urgency
Diet modification & toilet tips to improve constipation
Pelvic floor muscle training to improve your strength, endurance and neuromuscular coordination
Pressure management - altering how you breathe and lift
Manual therapy to address musculoskeletal factors that may be playing a role - scar mobility, rib & diaphragm motion, thoracic mobility etc.
Whole body strengthening. Recent research has shown that hip strengthening exercises can also help decrease urinary incontinence. In a study conducted by Sapsford et al. (2008), women who performed hip strengthening exercises had a significant decrease in stress urinary incontinence episodes compared to the control group.
If you have any incontinence symptoms and would like to discuss in detail what treatment options might be best for you, book a pelvic health consultation, click here.