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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.