May 26th, 2020

 
Leaky water works - Incontinence
 
There are many myths about incontinence, which are not necessarily true.  For instance many people believe incontinence is an inevitable consequence of ageing or if you drink less it will improve the problem.  Neither of these beliefs is helpful.
 
Some facts about our Water Works:

• The bladder is an expandable muscular bag that gradually fills and once full it automatically contracts to force urine out.
• The bladder can hold 300-400 mls during the day and up to 800 mls overnight.
• We normally empty our bladder 5-7 times a day. 
• Your pelvic floor and urethra sphincter muscles are important in stopping leakage and we have control over these muscles.
• We need to drink 6-8 standard glasses of fluid a day.
• Caffeine, artificial sweeteners, alcohol, some fizzy drinks and medications, including diuretics, are known to irritate the bladder.
• Infection and inflammation of the bladder and urethra will cause pain, discomfort and urgency.
• We can train our bladders to empty before it’s full.

 
There are two types of incontinence – Stress and Urgency.
 
Stress incontinence
 
With stress incontinence there may be leaking when coughing, sneezing, jumping, lifting, pushing, laughing and pulling.  This is caused by weak pelvic floor and urethra sphincter muscles.  The trick is to strengthen your pelvic floor and urethral sphincter muscles and tighten your pelvic floor muscles before stressful activity occurs.
 
Urgency incontinence 
 
Urgency incontinence is the sudden need to go, for example, when opening the front door you generally get the urge. It’s caused by an overactive bladder, which has been trained to empty before it’s full. Typically small amounts of urine are passed more frequently -10 plus times a day.

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Preventing or fixing incontinence
 
For both types of incontinence strengthening your pelvic floor and urethra sphincter are important.  To do this:

• sit comfortably with feet and knees apart
• lean forward at the hips with your back straight
• breathe normally throughout
• find your pelvic floor by imagining stopping yourself from passing urine or wind
• tighten your pelvic floor muscles on the out breath 
• close the openings by squeezing and LIFTING inside 
• aim to hold for 3 -10 seconds, rest 5-10 seconds, repeat 5-10 times.  Do this three times a day.

Once you’ve mastered the pelvic floor exercises, practice regularly eg every time you stop at red lights.
 
Tips for managing and training urgency incontinence
 
When you experience the sudden urgency to pass urine, it is often associated with a feeling of panic.  The following may help:

• keep calm – don’t panic
• stand still or sit down
• remember the bladder is a large bag and you do not actually need to go
• let the tummy muscles relax
• KEEP BREATHING
• pull up the pelvic floor muscles hard ie PULL THE BRAKES ON!
• think of something else.
• wait until the urgency passes, usually about 10-30 seconds, and then carry on with activity or slowly make your way to the toilet.

 
If desperate:

• cross the legs, or
• press on the pelvic floor muscles by sitting on the arm of a chair or pressing with the hand.

 
If you are still struggling there is help:

• Consult your Doctor to rule out inflammation, infection or drug irritation
• Contact the Nurse Maude Continence Service
• Contact our friendly Physiotherapist who will be able to help you improve your pelvic floor and urethra strength.

 
You don’t have to suffer alone - contact us we can help
 
 
Ph:                   03 3775280
Email:              admin@tpl.nz
Web:                www.therapyprofessional.co.nz
 
 
 
Reference:     Women’s Waterworks – Curing Incontinence by Pauline E Chiarelli