Urinary Incontinence

Urinary incontinence can range from occasional small leaks to a complete loss of bladder and bowel control. It affects women more than men and, while the likelihood increases with age, it can affect people at any stage of life. Importantly, it is not a natural part of ageing.

Many misconceptions exist around incontinence, such as:

  • It is normal after childbirth

  • It happens as you get older

  • There is nothing you can do about it

Without treatment, incontinence can impact daily life, limiting social and physical activities and leading to reduced self-esteem, isolation, and even depression. However, the good news is that incontinence can be effectively managed, and in most cases, completely overcome with conservative treatment.

There are three main types of urinary incontinence:

Stress Urinary Incontinence

This occurs when urine leaks during activities that increase abdominal pressure and push down on the bladder, such as coughing, sneezing, laughing, jumping, or running. It is typically caused by weak or stretched pelvic floor muscles.

Common causes include:

  • Pregnancy and vaginal delivery

  • Menopause (hormonal changes affecting tissue strength)

  • High-impact sports or weight training (often seen in athletic women)

The good news is that with the correct pelvic floor training, stress incontinence can be completely resolved.

Urge Incontinence (Overactive Bladder)

This is characterised by a sudden, intense urge to urinate, sometimes leading to leakage before reaching the toilet. It is often linked to small bladder capacity, bladder overactivity, or pelvic floor dysfunction.

Potential causes include:

  • Bladder muscle overactivity

  • Weak or tight pelvic floor muscles

  • Nervous system imbalance

  • Triggers like caffeine, anxiety, or stress

Treatment typically involves pelvic floor retraining, bladder control techniques, and cognitive behavioural strategies to manage urgency and regain control.

It is not uncommon for individuals to experience both stress and urge incontinence.

Overflow Incontinence

This occurs when the bladder does not empty properly, leading to frequent small leaks or dribbling. Symptoms may include:

  • Straining to urinate

  • Slow urine stream

  • Feeling like the bladder is never fully empty

  • Frequent urinary tract infections (UTIs)

Common causes include:

  • Pelvic organ prolapse

  • Tight pelvic floor muscles

  • Poor bladder emptying techniques

Diagnosis & Treatment

To determine the type of incontinence, we conduct a detailed history, postural assessment, and internal pelvic examination. This helps us identify whether the pelvic tissues are overactive, tight, or weak.

With specialist treatment, education, and lifestyle modifications, many women regain full bladder control and significantly improve their quality of life.

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