How do you deal with urinary incontinence?

What is Urinary incontinence ?

Urinary incontinence is involuntary loss of urine.

The symptoms are vary : some has occasional dribbles, some has complete loss of bladder control, resulting in fully wetting their pants.


Common types of Urinary incontinence

Involuntary loss of urine during physical activities that put pressure on the bladder

Involuntary loss of urine associated with urgency

Mixed symptoms of Stress urinary incontinence & Urgency urinary incontinence


Stress Urinary Incontinence

Involuntary loss of urine during physical activities that put pressure on the bladder, such as coughing, laughing, or running.

In more severe cases, even simple movements like standing up or rolling over in bed can trigger leakage.


Urgent Urinary Incontinence

Involuntary loss of urine associated with urgency

Urgency= sudden strong desire to urinate with, inability to defer

ex. leakage that occurs when a person experiences an overwhelming desire to void but can’t make it to the toilet in time.


Less common types of Incontinence

When a person is unaware of the leakage until it has already occurred

Involuntary leakage of urine that happens right after urination is completed.

Also known as bedwetting, it involves involuntary urination during sleep.

This occurs specifically during or after sexual intercourse.


What are the Causes of Urinary Incontinence?

The Causes of Stress Urinary Incontinence

The cause of Stress urinary incontinence is Insufficient Uretheral Close pressure during increase in Internal Abdominal pressure.

It could be due to issues with the urethra itself or problems with surrounding structures, such as the pelvic floor muscles.

uretheral issues

  • Weak uretheral sphincters
  • Poor blood supply in uretheral area
  • Scarring of uretheral wall. etc.

surrounding issues

  • Poor bladder neck support due to
  • Pelvic floor muscle – strength weakness, poor endurance, poor co-ordination
  • Poor Pelvic floor fascial support of urethra

These issues could be triggered by pregnancy, childbirth, gynecological surgeries, abdominal surgeries, hormonal changes from menopause, aging, and other factors. Additionally, poor urethral closure function can be worsened by obesity and hormonal changes.


The Causes of Urgent Urinary Incontinence

The most common cause of Urgent urinary incontinence is Detrusor overactivity.

Overactive Detrusor :

  • The detrusor is a muscle in the bladder wall. The primary function is to contract and help expel urine from the bladder during urination.
  • An overactive detrusor muscle contracts even while the bladder is filling with urine
  • Uretheral relaxion Incompetence : Leakage happens due to urethral relaxation the bladder is filling with urine, in the absence of raised intraabdominal pressure or a detrusor contraction.

Does incontinence go away its own?

Since the causes of incontinence can vary, the potential for self-improvement depends on the specific factors involved.

Temporary incontinence, such as that caused by childbirth, a urinary tract infection (UTI), or the acute recovery phase after abdominal or gynecological surgeries, may improve on its own.

Chronic incontinence usually requires more sustained treatment based on a proper diagnosis. Treatment options may include lifestyle changes, pelvic floor exercises, and bladder training, among others.


How to Treat Incontinence?

Once you understand the types and causes of your incontinence, you can begin treatment.

  • Stress Urinary Incontinence : Pelvic floor exercise >= 3 months, supervised pelvic floor muscles training is strongly recommended. Research suggests that supervised pelvic floor exercises result in significantly better outcomes compared to unsupervised exercises. Additionally, it’s important to understand whether your pelvic floor needs relaxation exercises, contraction exercises, strengthening exercises, endurance exercises, or functional exercises
  • Urgent Urinary incontinence : bladder retraining lasting a minimum of 6 weeks. Training correct patterns of frequent voiding, Improve control over urgency and reduce incontinence episodes, Increase bladder capacity, Restore patient confidence to leave the house.
  • Fluid adjustments , Caffeine adjustment,
  • Constipation management
  • Other life style intervention : ie weight loss

When do you need to see a Pelvic health professionals?

  • When incontinence persistent or getting worse despite the pelvic floor exercise or life style intervention
  • When the pain or discomfort are combined, (should visit a health professional as early as possible)
  • Nontonal incontinence (should visit a health professional as early as possible)
  • 6 weeks post partum
  • Post Gynecological surgeries or abdominal surgeries.
  • If you feels difficulties in daily living or basic exercises

 

Jewel OH
Physiotherapist | Director | pppclinic.com.au



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