Urinary Incontinence

Urinary incontinence ranges in severity from just a small leak to complete loss of bladder and bowel control. 

It affects women more than men, and although the chances of becoming incontinent increases with age, it can affect people of all ages and is not a natural part of ageing. 

It is a misconception that it is normal to experience urinary leakage after childbirth, that it happens as you age, and that there is nothing you can do about it. Without treatment, urinary incontinence can affect social and physical activity, leading to decreased self esteem, isolation and depression.

Incontinence can be very well managed, and in most cases it can be completely overcome with conservative management.

There are 3 main types of Urinary Incontinence: Stress Urinary Incontinence, Urge Incontinence & Overflow Incontinence.

Stress Urinary Incontinence

This is when a small amount of urine leakage occurs during activities that increase pressure in the abdomen and push down on the bladder, e.g. coughing, sneezing, laughing, jumping. Stress urinary incontinence is often due to a weakness and/or stretch of the pelvic floor tissues. 

It is often associated with pregnancy, vaginal delivery and menopause. It is also prevalent in athletic women, particularly women involved in high impact sports or weight training activities.

The good news is that there is significant evidence showing that, with the correct pelvic floor muscle training, stress urinary incontinence can be completely overcome. 

Urge Incontinence

This is when you have a sudden and strong urge to urinate. As it often involves small bladder volumes, it can also be referred to as an overactive bladder. It can also be associated with leaking on the way to the toilet, but not always. There can be a small amount of urine loss or a complete emptying of the bladder.

Urge incontinence is often caused by overactivity of the bladder muscle, weak or tight pelvic floor muscles or an unregulated sympathetic nervous system.

Several factors can cause your bladder to become overactive: small bladder capacity, nerve damage, caffeine, anxiety & depression.

It can often be successfully overcome by treating the weak or tight pelvic floor, alongside education and cognitive behavioural strategies for learning to manage the urgency.

It is not uncommon for someone to suffer from both stress and urge incontinence.

Overflow Incontinence

Overflow incontinence is when the bladder is unable to empty properly and frequent leakage of small amounts of urine (dribbling) occurs as a result.  Signs of overflow incontinence include straining to urinate, slow urine stream/flow, feeling that the bladder never feels empty and regular urinary tract infections.

Overflow Incontinence can be caused by a variety of factors, and your treatment will depend on this. Pelvic Organ Prolapse, tight pelvic floor muscles, poor bladder emptying techniques and some medications can lead to Overflow Incontinence.

To determine which type of Bladder Incontinence you may have, a detailed history will be taken, along with postural observation and assessment and an internal pelvic examination to determine overactive, tight or weak pelvic tissues.