Urinary incontinence (UI) is essentially unwanted leakage of urine, whether it be a few drops or a total loss of bladder control. Don’t worry, you’re not alone in this. Up to half of adult women and 1 in 10 of adult men experience UI. Further, up to 64% of women who are pregnant will experience a type of UI and this may or may not resolve after delivery. The different sub types of UI relate back to their cause. Stress UI, Urge UI, Mixed UI, Nocturnal UI and are all examples.
UI is primarily caused by changes in pressure in the abdomen – this is called intra-abdominal pressure (IAP). This pressure increase could be brought on by sneezing or coughing, impact exercise such as jumping, running or crunches, or when experiencing the urge to urinate. Activities that cause physical exertion such as jumping or sneezing and coughing is Stress UI.
Specifically, for women who have had a child, variables that increase your risk of developing a UI include having a vaginal birth, forceps, pre-existing UI, a higher number of births/children and having an epidural. During vaginal birth, there are four main mechanisms that may occur that can lead to Stress UI: damage to the pelvic nerves, direct harm to the urinary tract, damage to the connective tissues (including pelvic floor muscles) or compression of the blood vessels. If any of these occur, this affects how the whole urinary tract sits in your body and how it is supported. If this system is affected when IAP (explained above) is applied, this can lead to unwanted urinary leakage!
Due to the varied types and causes of UI, your treatment plan needs to be individualised by your Allied Health professional – a Physiotherapist or Exercise Physiologist. Aside from exercise, they may recommend some products to use to assist in the rehabilitation process, for example, a pessary ring. These are inserted into the vagina to support the bladder and/or compress the urethra. Again, depending on your specific needs, it may be recommended to be used every day or maybe only during exercise. Speaking of exercise, majority of the time this is what a lot of the rehabilitation process will focus on.
A common focus with the exercises prescribed is to strengthen and activate the pelvic floor muscles. These muscles are often weak (underactive) which can be a leading cause of UI. An example of an exercise to target your pelvic floor is explained in the video inserted in this blog post.
Please do not hesitate to book an assessment with your Allied Health professional to get a treatment plan. UI is common but it is NOT normal!