Urinary Incontinence

What is Urinary Incontinence

“Generally, when we hear the word incontinence, we think primarily of urinary incontinence (loss of bladder control),” said Char Challenger-Smith, a physical therapist, certified athletic trainer and sports specialist with Rehab and Sport Medicine at Northern Nevada Medical Center. “It is important to know incontinence can be both urinary and/or fecal. We most commonly think of women, especially post-partum, suffering from urinary incontinence. Though women are more predisposed to urinary incontinence, men are also very commonly affected.”

Urinary incontinence is common amongst athletes, walkers, runners and powerlifters. It can be a common cause of people not exercising, especially if the exercises include walking, running, jumping or squats, anything that pressures the pelvic floor.

For some people this happens when they cough, laugh or sneeze, others may not know they suffer from incontinence until they commence an exercise program and physically stress their pelvic floor muscles. This can be really embarrasing for the athlete.

Urinary incontinence is something that is not generally discussed because of the potential stigma.

When you look at the high incidence of urinary incontinence it is reasonable to assume that one in three women suffer from urinary incontinence and also a high percentage of men.

What Can I Do About It – For Women

The kind of treatment you have will depend on:

• the type of urinary incontinence you have
• how severe it is
• your age, health and medical history.

Your doctor may refer you to a women’s health physiotherapist or a doctor who specialises in women’s pelvic floor problems (called a urogynaecologist). They may recommend one or more of these treatment options: 

• Lifestyle changes such as losing weight, quitting smoking, eating more fibre, drinking more water or lifting less. 
• Medication to help relax the bladder muscles, which play an important role in urge incontinence. 
• Physiotherapy to strengthen the pelvic floor, which supports your bladder. A physiotherapist can design a special pelvic exercise program for you. 
• Surgery to support or ‘hold up’ your bladder or urethra (the tube that links your bladder to the outside of your body). Surgery is usually only considered if medication or physiotherapy have not been successful. 
• The success of treatment can vary. While treatment may not ‘cure’ your incontinence, it can still help you live more comfortably with it.
• Choose a well fitting garment or or incontinence pad to protect you while you are going about your daily activities or exercising.

Why Kegel exercises matter

Many factors can weaken your pelvic floor muscles, including pregnancy, childbirth, surgery, aging, excessive straining from constipation or chronic coughing, and being overweight.

You might benefit from doing Kegel exercises if you:

• Leak a few drops of urine while sneezing, laughing or coughing (stress incontinence)
• Have a strong, sudden urge to urinate just before losing a large amount of urine (urinary urge incontinence)
• Leak stool (fecal incontinence)

Kegel exercises can also be done during pregnancy or after childbirth to try to improve your symptoms.

Work out a plan to do your Kegal Exercises at least three times a day. These exercises can be done while you are sitting at the computer or while you are standing in the kitchen preparing a meal. There is no preparation just to remember to do them.

How to do Kegel exercises

To get started:

• Find the right muscles. To identify your pelvic floor muscles, stop urination in midstream. Once you’ve identified your pelvic floor muscles you can do the exercises in any position, although you might find it easiest to do them lying down at first.
• Perfect your technique. To do Kegels, imagine you are sitting on a marble and tighten your pelvic muscles as if you’re lifting the marble. Try it for three seconds at a time, then relax for a count of three.
• Maintain your focus. For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises.
• Repeat three times a day. Aim for at least three sets of 10 to 15 repetitions a day.

Don’t make a habit of using Kegel exercises to start and stop your urine stream. Doing Kegel exercises while emptying your bladder can actually lead to incomplete emptying of the bladder — which increases the risk of a urinary tract infection.

What Can I Do About It – For Men

Benefits of Kegel exercises for men

Male pelvic floor muscles

Many factors can weaken your pelvic floor muscles, including the surgical removal of the prostate (radical prostatectomy) and conditions such as diabetes and an overactive bladder.

You might benefit from doing Kegel exercises if you:

• Have urinary or fecal incontinence
• Dribble after urination — usually after you’ve left the toilet

How to do Kegel exercises for men

To get started:

• Find the right muscles. To identify your pelvic floor muscles, stop urination in midstream or tighten the muscles that keep you from passing gas. These maneuvers use your pelvic floor muscles. Once you’ve identified your pelvic floor muscles, you can do the exercises in any position, although you might find it easiest to do them lying down at first.
• Perfect your technique. Tighten your pelvic floor muscles, hold the contraction for three seconds, and then relax for three seconds. Try it a few times in a row. When your muscles get stronger, try doing Kegel exercises while sitting, standing or walking.
• Maintain your focus. For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises.
• Repeat 3 times a day. Aim for at least three sets of 10 repetitions a day.

What are Pelvic Exercises

I have included a YouTube video by Pelvic Exercises’ presenter Michelle Kenway, Michelle is a health professional (Physiotherapist), internationally renowned author and exercise instructor for women. 

Pelvic floor exercises or Kegels involve contracting and relaxing the pelvic floor muscles in a controlled manner. This is an excellent short video that describes the muscles you are targeting, how to do the exercises and the desired frequency of the Legal exercises.

This training can improve the function of your pelvic floor muscles and help you recover and maintain your pelvic health and fitness. Scientific research tells us that pelvic floor exercises provide evidence-based treatment for a range of pelvic floor problems including muscle weakness and bladder leakage (stress incontinence).

Protective Underwear

There are several brands of discreet incontinence pads and underwear on the market now. Choose a brand that suits your confirmation and you will be able to regain your confidence knowing that you are protected from incontinence leakage when you are walking, running and at the gym. This also includes those who need protection because of more sever leakage.

Causes of Stress Incontinence

Urinary incontinence can be caused from medical and physical conditions, it is important to have a medical assessment to exclude any medical condition and also to identity what will be the most effective management of the condition.

It may be that a referral to a physiotherapist or an incontinence professional will assist you and give you the best initial management and treatment. Most importantly give you the support and confidence to achieve your goals, whether it be an exercise program or managing an issue that is impinging on your quality of life.

Pregnancy

Hormonal changes and the increases weight of the baby during pregnancy can lead to weakening of the pelvic floor muscles

Childbirth

Vaginal delivery, particularly if you have a difficult birth experience, can weaken muscles needed for bladder control and damage nerves and supportive tissue. This can also lead to prolapsed (dropped) pelvic floor.

Changes with Age

Aging of the bladder muscle can decrease the bladders capacity to store urine. The involuntary contractions of the bladder become more frequent as we age.

Menopause

After menopause women produce less oestrogen, a hormone that helps keep the lining of the bladder and urethra healthy. Deterioration of these tissues can agrivate incontinence.

Enlarged Prostate

For men stress incontinence can often stems from prostate gland issues. Again as men age the prostrate can become enlarged for various reasons and applies pressure to the bladder.

Obstruction A tumour along your urinary tract can block the normal flow of urine leading to overflow incontinence. Urinary stones, the hard stone like masses that form in the bladder can also cause urinary leakage.

Neurological Disorders

Multiple sclerosis, Parkinsons disease, stroke, spinal injury can interfere with nerve signals involved in bladder control and cause urinary incontinence.

Types of Urinary Incontinence

Stress Incontinence

Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.

Urge Incontinence

You have a sudden urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night. Urge incontinence may be caused by a minor condition, such as infection a more severe condition such as a neurological disorder or diabetes.

Overflow incontinence

You experience frequent or constant dribbling of urine because the bladder does not empty completely, or has no muscle tone to fill and empty.

Functional Incontinence

This is due to a physical condition for example not being able to get to the toilet because of a physical ailment.

Mixed Incontinence

This is experiencing more than one type of urinary incontinence and most often refers to a combination of stress incontinence and urge incontinence.

When to Contact Your Doctor

You may feel uncomfortable discussing incontinence with your doctor. But if incontinence is frequent or is affecting your quality of life, it’s important to seek medical advice because urinary incontinence may:

• Cause you to restrict your activities and limit your social interactions
• Negatively impact your quality of life
• Increase the risk of falls in older adults as they rush to the toilet
• Indicate a more serious underlying condition

A doctor may be able to help treat your urinary incontinence by resolving the health issue that’s causing it. Or, they may be able to help you manage the condition through behavioral therapy, bladder training, medication, or other treatments.

Don’t Quit Exercising

Though it occurs more often as people get older, urinary incontinence isn’t an inevitable consequence of aging. If urinary incontinence affects your daily activities, don’t hesitate to see your doctor. For most people, simple lifestyle and dietary changes or medical care can treat symptoms of urinary incontinence.

Check out the discrete incontinence gear that is available and choose one that is right for you. Discuss your problems with a health professional and this will give you the confidence and support you need to manage this common problem.

This can be a temporary issue, such as one caused by an infection, or a more persistent one that may be caused by another health condition, such as an enlarged prostate or pelvic floor weakness.

Even if the cause is not serious, urinary incontinence can affect your quality of life. It is important to talk with a doctor to discover the cause and find a treatment option that works for you.