Urinary incontinence is the involuntary loss of urine at an inappropriate time or place – this can vary from just a few drops every now and then to full bladder leakage.
Treatment can only be truly effective when the correct dysfunction is identified. So, if you have tried to self treat incontinence, and haven't been successful, don't despair! There's a good chance you haven't tried everything yet. And with a thorough assessment, we can come up with a treatment plan designed to address your dysfunction.
Incontinence can also refer to anal incontinence. To read more on this disorder, please see Anorectal Dysfunction.
This is defined as "involuntary loss of urine on effort or physical exertion, or on sneezing or coughing"
The approach to treating stress incontinence is very much defined by the dysfunction leading to the incontinence; do you have a weak pelvic floor? Poor urethral closing pressure? Pelvic organ prolapse causing a loss of support to the bladder, or pressure of a prolapsed rectum on the bladder? Chronic constipation or a large cyst putting pressure on the bladder? Or have you perhaps simply lost the coordination of contracting to brace against a cough? The effectiveness in treating stress incontinence is determined by how effectively and specifically we are addressing the cause of the dysfunction.
This is "involuntary loss of urine associated with urgency"
Again treatments will vary greatly depending on the presentation and cause. Frequently there are some lifestyle or behavioural changes that can have a significant effect on this symptom of urgency, sometimes there is an anatomical or structural reason contributing to or causing the urgency, and the treatments can vary greatly here too.
A pelvic health physiotherapist can diagnose which type of incontinence you have and treat accordingly – 70% of women with incontinence will get significant improvements with appropriate treatment! The art is in identifying the underlying causes (or causes), and applying the right treatment options.
A full assessment of the pelvic floor can identify not only general muscle weakness, but also the co-ordination and timing ability of the muscles to contract when there is increased pressure (such as a laugh or cough). Research has shown that up to 50% of women perform a pelvic floor contraction incorrectly if they are only given verbal cues. An internal pelvic floor examination is used so the therapist can ensure a correct and effective pelvic floor contraction can be achieved, but also to look for changes to structural support which may be contributing. Following this assessment, your diagnosis will be discussed, along with a range of treatment options to see what will be most comfortable for you. An individualised pelvic floor retraining programme (if appropriate) can also be commenced.