Urinary incontinence is the involuntary leakage of urine, often associated with sneezing, coughing, or physical exertion. In Canada, the prevalence of urinary incontinence is estimated to be 1 in 3 women and 1 in 9 men. However, 74% of people do not seek professional help because of common misconceptions.
Contrary to popular belief, urinary leakage after childbirth and/or associated with aging are NOT normal. There are many ways to manage and even cure incontinence with conservative treatment, including pelvic health physiotherapy.
Anatomy 101: The Bladder
A general awareness of bladder function and anatomy helps with understanding the symptoms of urinary incontinence. The bladder is a storage reservoir that can expand and contract as it continuously receives urine.
It sits within the pelvis and is supported by the activity of pelvic floor muscles beneath it (they act like a sling!). The walls of the bladder are compromised of three layers of muscle; they contain stretch receptors that are stimulated with filling.
Continence – What is required for full control of the bladder?
1. Healthy Nervous System
When the volume in the bladder reaches a certain point, stretch receptors signal the brain a need to urinate. In response, the brain sends a signal back to the detrusor muscle to contract and expel urine. Fortunately, a healthy nervous system allows us to perceive the need to urinate and allows us to control it until the time is appropriate.
2. Coordinated Pelvic Floor Muscle and Bladder Function
Urine exits the bladder through a tube called urethra. The opening of this tube is located within the second layer of the pelvic floor muscles, and therefore the relationship between the pelvic floor and bladder muscles is important for control of urination.
As the brain signals the bladder to contract to void, the pelvic floor muscles must relax to allow urine to pass through the urethra. During the storage phase, these muscles also work in opposition: the bladder relaxes and stretches to accommodate fluid, and the pelvic floor contracts to prevent leakage.
Different causes of incontinence include:
- Aging process (weakening of bladder muscles)
- Childbirth: Damage to the pelvic floor muscles during vaginal delivery or with added weight of growing baby; Organ prolapse; Hormonal changes
- Neurological dysfunction (impaired function of the brain, spinal cord and/or spinal nerves to and from the bladder)
- Other: Side effects of medication or pelvic/low back/hip surgery, bladder cancer, birth defects, behavioral, etc.
Daily Tips to Improve Bladder Health:
1. Visit the washroom 6-8 times over 24 hours.
- It is NOT normal to go every 30 minutes or during the night (*1visit/night is considered normal if over 55 years old).
- Avoid going to the washroom “just in case” as this can lead to a reduction in the bladder’s storing capacity.
2. Practice pelvic floor exercises to increase structural support to the bladder.
- Remember: stronger pelvic floor muscles = stronger force of bladder/urethra closing to prevent unwanted leakage!
- Do NOT practice these exercises on the toilet as it can interfere with the important brain reflexes!
- Do NOT hold your breath or squeeze surrounding muscle groups (buttocks).
3. Ensure good toilet posture.
- Feet flat on the floor, lean forwards with elbows on knees.
4. Avoid or minimize bladder irritants including alcohol, caffeine, tea, spicy foods, artificial sweeteners and carbonated beverages.
5. Drink adequate water to improve bladder control.
- Many people with bladder control issues decrease water intake. This decreases the volume of urine, BUT the smaller amount is often highly concentrated and irritating to the bladder lining.
- Sip water throughout the day (avoid guzzling).
6. Visit a Pelvic Health Physiotherapist if you are suffering from bladder urgency, frequency or incontinence symptoms. They can assess your bladder habits and pelvic floor function to assist you in making changes to improve your overall health and wellbeing!
Our pelvic health physiotherapists provide professional, compassionate and evidence-based care in the assessment, diagnosis and treatment of women and men experiencing pelvic pain and incontinence.
We treat women and men of all ages with a wide range of urinary incontinence symptoms. Contact SEMI to schedule a consultation with one of our qualified pelvic health physiotherapists today!