PELVIC HEALTH CARE
URINARY INCONTINENCE
Urinary incontinence is any involuntary loss of urine. It is common, but it not normal. There are many different causes and types of urinary incontinence, and targeted Physiotherapy by a Womens Health Physiotherapist is highly effective in 60 – 90% of cases.
The two most common types of urinary incontinence include Stress Urinary incontinence and Overactive Bladder syndrome (OAB), or mixed urinary incontinence which is a combination of both.
Stress urinary incontinence (SUI)
SUI is the loss of urine on strain, exertion or effort. It is the most common type of UI, and usually occurs as a result of weakness in the pelvic floor muscles and or damage to the connective tissues supporting the bladder. In situations where there is increased load such as such as during exercise, coughing and sneezing the damaged or weakened tissues have an inability to provide the required support to the urethra and as a result urine leaks out.
TREATMENT
Physiotherapy is considered the first line of treatment for stress incontinence with 70 – 90% of women reporting their symptoms significantly improved or complete resolved following a targeted program.
Our Physiotherapists will do a thorough assessment to see what part of your pelvic anatomy is letting you down and educate you and create a specific program around this.
We may also assess and treat other contributing factors such as breathing technique, or abdominal, back, pelvic and ribs biomechanics.
In some cases, the use of Pessaries will be suggested as an adjunct to the treatment regime whilst working on other factors. Click here to read more about pessaries.
Overactive bladder (OAB)
OAB refers to urinary urgency and frequency, a sudden overwhelming desire to pass urine, which may or may not be associated with urinary incontinence. Sudden compelling urges are involuntary bladder spasms as the bladder is filling which is not normal. Urgency can worsen or come on with triggers such as running water, key in the door as you arrive home.
SYMPTOMS
Difficult to defer urge to pass urine
Going to the toilet more often than others
Urinary leaking associated with the urge
Fear of urinary leaking, even though may have never leaked
Needing to go to the toilet more than two times per night (Nocturia)
STATISTICS & CAUSES
Research tells us that OAB it affects up to 25% of adult males and up to 40% of adult females.
Causes of OAB include pelvic floor weakness and pelvic floor tightness/overactivity, chronic constipation, pelvic organ prolapse, low oestrogen, bladder irritants – including caffeine, artificial sweeteners, carbonated drinks, fluid consumption – too much or too concentrated urine.
PHYSIOTHERAPY TREATMENT
Physiotherapy is proven to be the best first line treatment for OAB, and at WIF we simply love helping women with their OAB as the results can be life changing.
In your initial treatment we will ask lots of questions about your bladder habits, assess your pelvic floor muscles, explain to you about your bladder function and how to start thinking about bladder retraining. We will ask you to complete a bladder diary to assess your bladder & urgency, do an abdominal ultrasound to look at your bladder Size, shape and emptying ability, as well as assess your pelvic floor muscles.
Based on our findings our treatment approach may include
Bladder retraining and calming
Bladder Drills
Bladder education
Pelvic floor training
Electrical stimulation and TENS
Breathing training
Musculoskeletal treatment to treat other drivers we feel may be contributing to the urgency
Liaising with Doctors regarding medications to assist the bladder calming process.