1. What is urinary incontinence?
3. Who does urinary incontinence affect?
4. What is stress incontinence?
5. What are the treatments for stress incontinence?
7. What are the treatments for urge incontinence?
9. Where can I get help and advice?
Answers
1. What is urinary incontinence?
(A) Urinary incontinence occurs when you pass urine when you don’t mean to. This happens when there is a partial loss of control of the bladder. Urinary incontinence effects between 3 and 6 million people in the UK. Most people can control their bladder, even when it is full so they do not release urine until they get to the toilet. When you get to the toilet your brain tells your pelvic floor muscles and the opening at the neck of your bladder (the sphincter) to open. As your bladder muscle tightens, urine is pushed out.
When people have incontinence, either their muscles or nerve supply is not working properly causing incontinence. The two main types of incontinence are stress incontinence and urge incontinence.
2. What is the pelvic floor?
(A) The pelvic floor is a set of muscles in the shape of a sling, which stretch from side to side across the floor of the pelvis. These muscles hold the urethra and the bladder in place. They are used when we urinate, relaxing as the bladder contracts to release urine. The pelvic floor has other uses including supporting the contents of your abdomen and your pelvic organs (particularly when exerting yourself or standing) and supports your bladder by squeezing itself when sneezing or coughing to avoid leaking.
The pelvic floor muscles can become weakened through hormonal changes in women, through childbirth and through pregnancy. Inactivity and natural ageing can also weaken these muscles in the same way they do for other muscles in our body. However, issues such as ongoing constipation, pelvic surgery, being overweight and chronic coughs can place added pressure on the pelvic floor muscles.
3. Who does urinary incontinence affect?
(A) Urinary incontinence affects around 3-6 million people in the UK, twice more women than men. It is more commonly found in women who have had children, but also affects a wider range of people such as older people, the disabled, individuals with learning disabilities and people with health problems.
4. What is stress incontinence?
(A) Urinary stress incontinence is actually quite common after pregnancy and labour. It happens when the weight of the baby and the stress of labour cause the female pelvic floor to weaken. The female pelvic floor is a broad sling that holds the bladder, bowel and uterus in place and once it has weakened it can cause these organs to drop putting pressure on your bladder and causing it to leak urine when you cough, laugh, sneeze or exercise.
Research has shown that 41% of women experience a weak pelvic floor causing them to leak urine spontaneously. Although this is embarrassing and sometimes stressful it is a common side effect of pregnancy and can be improved by strengthening your pelvic floor muscles through exercise and with the help of pelvic floor exercise aids.
5. What are the treatments for stress incontinence?
(A) Research has shown that pelvic floor muscles respond to regular exercise. Simple exercises include contracting and releasing the pelvic floor muscles, known as the kegel exercise. A therapist or doctor is usually required to ensure you recognise and exercise only the pelvic floor muscles. Most women who carry out regular exercise, reduce or even completely overcome the symptoms of a weak pelvic floor. No matter what the age, it is never too early or late to begin exercising the muscles of the pelvic floor.
Pelvic floor muscle exercise systems can be used to aid the strengthening of the pelvic floor muscles. Aquaflex, the most widely used piece of pelvic floor equipment in the UK has been specifically designed for women who accidentally leak urine when they exercise, laugh, cough or sneeze.
6. What is urge incontinence?
(A) Urge incontinence, also known as having an overactive or unstable bladder, is the second most common form of incontinence. Urge incontinence is caused when the brain and the bladder do not communicate correctly. The bladder thinks it is full when it isn’t and so tells the brain, which leads to the bladder muscles to involuntarily squeeze too early and empty, releasing a large amount of urine.
Urge incontinence can happen during most activities, and even when the individual is sat still. It is quite often triggered by a sudden change of position, stress or during sex. People with urge incontinence often find themselves going to the toilet often during the night
7. What are the treatments for urge incontinence?
(A) There are a number of ways to treat urge incontinence: -
- Retrain the bladder. Through specific techniques the bladder can gradually be stretched so that it can hold more urine and give you more time to get to the toilet. Speak to your doctor, nurse or incontinence advisor about bladder retrain exercises.
- Medicines. Medicines can be taken which block certain nerve impulses by relaxing the bladder. Some medicines may have side effects so it is advisable that your doctor is consulted to establish which medicine will suit your body best.
According to NHS Direct, a combination of bladder training and medicines is often the most effective form of treatment. - Garments and pads. Incontinence pads and clothing are available; many of them look like normal briefs and are washable. Speak to your doctor, nurse or incontinence advisor to find the nearest suppliers of these products.
- Prostate gland enlargement. There is the option for men to have an operation which removes part of the prostate and relieve the outflow obstruction. Consult your doctor, nurse or incontinence advisor for the advice on this procedure.
In addition to the above treatment methods you should always ensure you have quick and easy access to a toilet. Some people find it more helpful to have a commode in their bedroom for during the night.
8. Hints for Pregnant women
(A) Pregnant women should start an exercise programme as soon as pregnancy is confirmed. Exercises to strengthen the pelvic floor muscles will not make delivery more difficult despite the myth! Healthy muscles are strong and resilient and so are able to cope with the stretching involved in delivery and spring back into place almost straight away. Those who stop the pelvic floor from deteriorating through exercise actually achieve a big improvement. However, you may not notice this until your baby has been delivered.
9. Where can I get help and advice?
(A) A doctor, nurse or incontinence advisor will be able to offer you advice, exercises and treatment methods. There are also a variety of links to websites where you will find additional information on stress incontinence, women's health and mother and baby.