» Introduction : Urinary Incontinence

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Introduction

Urinary Incontinence

Urinary incontinence affects approximately 200 million people around the world – mostly women. In fact, 26% of women between the ages of 30 and 59 have problems with urine leakage [1]. Urinary urgency or urge incontinence can be caused by common triggers such as certain foods, drinks, and medications.  It can also be caused by medical issues as common as a bladder infection, or due to more serious causes such as bladder or pelvic cancer.

The symptoms of urinary incontinence can range from leaking urine when you laugh, cough, sneeze or run to having a sudden need to urinate that is so overwhelming that you don't always make it to the bathroom in time. Some people find that they dribble urine, while others feel like they never really empty their bladder.

Many people with urinary incontinence tend to suffer in silence because they are too afraid or embarrassed to talk to their doctor. Many women with this problem also wrongly assume that the loss of bladder control is a normal part of aging or motherhood because it is so common. More than half of first-time moms and one in three women who have already had a baby experience some urinary leakage [2].  If urinary incontinence is affecting your daily life, you should definitely talk to a medical professional.
 
Your family doctor, nurse practitioner, urologist or gynecologist can do a number of tests to determine what type of incontinence you have and what might be causing it. This may include keeping a bladder diary for several days and having a urinalysis and/or blood tests.

Further specialized testing may be needed to provide more detailed information.

One potential, non-pharmaceutical intervention for urinary incontinence is physiotherapy.  In Balance Physiotherapy can work with you to design a customized program that will help address weakness and spasm, regular bowel and bladder emptying as well as exercises to prevent further injury. Three common techniques that In Balance Physiotherapy uses to help improve bladder control are:

Exercises – Many people simply need to strengthen and re-educate their pelvic floor muscles to dramatically improve their symptoms. Gaining greater control over the muscles deep in your lower abdominals can also help improve pelvic floor muscle function.  Rigid contractions of both the abdominal and pelvic floor muscles can actually make leaking or pain worse.

Biofeedback – Although many people have heard of Kegel exercises, more than half are not able to contract the right muscles based on verbal or written instructions [3]. Biofeedback can be used in combination with an exercise program to help make sure you are targeting the proper muscle groups. Biofeedback provides you information by a computer screen or a sound that tells you when you are contracting the correct muscles.  This enables you to learn how to control the muscles during functional activities in sitting, standing and lying down.  It also lets you know if you are fully allowing the muscles to relax.  This is a crucial function especially with clients with pelvic pain.

Muscle Stimulation – Sometimes pelvic floor muscles are so weak that doing exercises (even with biofeedback) isn't enough. The muscles need to be physically reminded how to work properly. To do this your physiotherapist will teach you how pelvic floor muscle electrical stimulation can assist your muscles to remember how to contract. As the muscles start to remember how to work properly, your physiotherapist will add strengthening exercises into your treatment program.

Behavioral modifications are lifestyle and dietary changes that can significantly reduce your symptoms and improve your overall health.  Combining behavioral modifications with pelvic floor strengthening techniques improves the effectiveness of your program. Your physiotherapist at In Balance Physiotherapy may include one or all of the following to help improve your control over your bladder:

Bladder Training – People with incontinence often get into the habit of going to the bathroom too often. There are a number of techniques you can use to gradually increase the amount of time between bathroom trips, including learning how to control the urge to urinate and learning how to empty your bladder more completely. A licensed physiotherapist can also give you advice on how to modify your daily habits to help you regain control of your bladder. Monitoring what and how much you drink, losing weight and doing regular exercise may also help reduce or eliminate your symptoms.

Relaxation Techniques – Stress, anxiety and tension only make bladder problems worse. Physiotherapists at In Balance Physiotherapy can instruct you in breathing, postural and relaxation techniques that can help put you back in control.

Many people with urinary incontinence tend to suffer in silence because they are too afraid or embarrassed to talk to their doctor. Many women with this problem also wrongly assume that the loss of bladder control is a normal part of aging or motherhood because it is so common. More than half of first-time moms and one in three women who have already had a baby experience some urinary leakage [2].  If urinary incontinence is affecting your daily life, you should definitely talk to a medical professional.
 
Your family doctor, nurse practitioner, urologist or gynecologist can do a number of tests to determine what type of incontinence you have and what might be causing it. This may include keeping a bladder diary for several days and having a urinalysis and/or blood tests.

Further specialized testing may be needed to provide more detailed information.

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