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Physiotherapy for Incontinence

Incontinence is a term that describes any accidental or involuntary loss of urine from the bladder (urinary incontinence), or faeces or wind from the bowel (faecal or bowel incontinence). There are 2 main subtypes of Urinary incontinence – Stress Urinary Incontinence (SUI) and Urge Urinary Incontinence (UUI). Alana Physiotherapy offers a comprehensive assessment and tailored treatment pathways for women experiencing this often embarrassing and activity-limiting issue.

Stress Urinary Incontinence

Stress urinary incontinence is a condition in which women suffer from leaking urine during ‘effort’ or activity.  Activities that commonly provoke leaking in women with this condition may include coughing, sneezing, lifting, running or jumping.  This type of incontinence can be multifactorial, and thorough assessment by your Alana Physiotherapist who is trained in pelvic floor dysfunction will correctly identify the leading cause.

What Causes SUI?

Stress incontinence is often caused by pregnancy, childbirth and menopause.  Pregnancy and childbirth can stretch and weaken the pelvic floor muscles that support the urethra causing incontinence during activities that push down on the bladder (e.g. coughing or running).  During menopause the reduction in Oestrogen can reduce the thickness of the urethra and lead to SUI.

Are there conservative (non surgical) treatments available for stress urinary incontinence?

Yes, there are several conservative options that can be effective in the management of this condition which include pelvic floor muscle strengthening, exercise technique correction exercise, and pessaries being a few.  However, the success rates of each option differ depending on the precise cause of your stress urinary incontinence. It is for this reason that a detailed pelvic floor assessment is required.

Urge Urinary Incontinence (UUI)

Urge urinary incontinence is a sudden and strong need to urinate which can be very distressing.  You may also hear it referred to as an unstable or overactive bladder (OAB), or detrusor instability.

What are the symptoms of UUI/Overactive Bladder (OAB)?

  • Urgency – a sudden and intense need to pass urine that is difficult to defer.  This may even happen when your bladder is not full. Sometimes you may have difficulty making it to the toilet in time and may suffer from urge incontinence (leaking urine on the way);
  • Frequency – a need to empty your bladder many times during the day that you consider to be bothersome (usually more than 7);
  • Nocturia – waking up more than once at night to go to the toilet.

What causes OAB?

The causes of OAB can be complex and multifactorial.  Essentially, the symptoms are due to the bladder muscle squeezing to empty urine either too often, sometimes without warning or when you do not want it to.  If you have had a previous surgery for stress urinary incontinence you may also be more likely to experience symptoms of OAB.

Can OAB be treated conservatively (non-surgically)?

Fortunately, there are many treatments that can be effective in reducing the symptoms of OAB.  Often simple first line treatments such as lifestyle changes can significantly improve symptoms.  In addition, your Alana Physiotherapist may suggest a bladder-retraining program, urge suppression techniques, pelvic floor strengthening, and/or the use of nerve stimulation to restore the normal messages being sent via the urinary system.  These treatments can be non-invasive and are often very successful.

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