Stress Urinary Incontinence
Today, I want to talk about a specific type of bladder leakage called Stress Urinary Incontinence. One in 3 women will experience bladder leakage at some point in their lifetime and although it is common, it is not normal. Let me reiterate that…
Bladder leakage is not normal. Not when you exercise. Not when you sneeze. Not after you have had a baby. Not when you laugh. Not when you are post-menopausal. Not when you lift. Bladder leakage is never normal. It is a sign of dysfunction in our core support system.
Stress incontinence happens when physical movement or activity — such as coughing, sneezing, running or heavy lifting — puts pressure (stress) on your bladder. Stress urinary incontinence is often a result of weakness or poor recruitment patterns of the pelvic floor muscles.
With stress incontinence you may experience urine leakage when you:
- Stand up
- Get out of a car
- Lift something heavy
- Have sex
Amount of leakage can vary from a few drops to a complete emptying of bladder. Some people experience the bladder leakage with many different activities and for others it is limited to a single activity type.
Treatment for Stress Urinary Incontinence
Stress urinary incontinence is probably one of the most common things that I see here at my practice. The good news is that it respond really well to conservative treatment and simple changes that you can make in your daily routine.
Contrary to what the Poise commercials want us to believe, the treatment for stress incontinence is not buying the latest, greatest absorbent pad or diaper. Instead, most people report a significant improvement in their leakage with training for their pelvic floor muscles. Many times stress incontinence is a result of weak pelvic floor muscles.
Not sure if your pelvic floor muscles are weak? See if you can stop the flow of urine mid stream. When you contract your pelvic floor muscles (AKA Kegel exercise) you should be able to get the stream to stop completely. If you can’t, then this is a sign that your pelvic floor muscles may be weak.
Word of caution… do not repetitively start and stop your flow of urine as a exercise. This can mess up the normal mechanisms for completely emptying your bladder.
One of the tips I tell people to do if they are having leakage with a cough or sneeze is what we called “The Knack.” It is a little precontraction of the pelvic floor to brace for the load of that is going come from the pressure of the cough or sneeze. If you have warning that a cough or a sneeze is going to happen then stop where you are and contract your pelvic floor to brace for the load.
If you are experiencing stress incontinence, know that you are not alone and there are things that you can do to make a difference. Partnering with a pelvic physical therapist can be a great option. They can help you identify your pelvic floor muscles and come up with a rehabilitation program specific to your individual needs and goals.
Do you go to the bathroom when you don’t need to “ just in case,” hoping you won’t have to when it is inconvenient? Just in Case peeing or JIC’ing can cause havoc for your bladder. By JIC’ing you are actually training your bladder to empty more frequently and often prematurely. This can lead to bladder issues such as urgency, frequency, and leakage.
To break yourself of this habit, before you JIC trying asking yourself “Do I really have the urge to go to the bathroom now or am I going because it is convenient?” If the answer is the latter then do not go to the bathroom. Instead wait until you feel an urge to urinate.
Working with a pelvic physical therapist can be a great way to help you break this bad habit and retrain your bladder if you have already developed symptoms of urgency, frequency, or leakage. Check out Legacy Physical Therapy for information on how physical therapy can help and call us today for your FREE screening 636-225-3649.
Bladder control issues are not a normal part of aging and they are definitely not something that you just have to live with!!!! Take this short quiz courtesy of the American Urogynecologic Society to find out if it is time for you to do something to take back control of your bladder.
YES NO Are you using the bathroom so often it disrupts your day?
YES NO Do you find yourself making a mental note of where all the bathrooms are when you enter a building?
YES NO Do you find it hard to make it to the bathroom, maybe even having accidents sometimes?
YES NO Are you using pads or other forms of protection to absorb bladder leakage?
YES NO Are you worried that you will leak with sneezing, coughing, lifting heavy objects, laughing, exercising?
YES NO Have tampons become too uncomfortable to use or do they fall out?
YES NO Are you experiencing pressure or bulging in your vagina, especially after you stand for long periods of time?
YES NO Has your urine stream become weak or turned into spray?
If you answered YES to one or more of these questions, consider talking to your physician about your symptoms and available treatment options. To learn more about physical therapy as a treatment option for bladder control issues visit the Legacy Physical Therapy website or call us at 636-225-3649 to set up your free screening appointment.
If I had a dime for every time I hear a woman say, “Yes I leak a little when I laugh or sneeze, but I just deal with it,” I would be a very rich woman! Let me start this article off right by dispelling this myth once and for all: bladder leakage when you cough, laugh, or sneeze is not a normal part of aging, and you do not have to just deal with it.
The National Institute of Health reports that 50 percent of all women having occasional urinary incontinence, with about 20 percent of women over the age of 75 experiencing daily urinary incontinence. Unfortunately these numbers are just estimates, because the sad fact is that many women never report their bladder control issues because of the social stigma associated with it. One study found that women wait an average of 7 years before talking to their doctor about bladder control issues, and that only 1 in 5 ever get help at all!
This is not just your grandma’s problem! Women of all ages may experience urinary incontinence. Leakage can be caused by weakening of the pelvic floor muscles, which form a sling around the vagina (birth canal), the urethra (tube from the bladder), and the rectum. Weakened pelvic muscles can be caused by aging, pregnancy, child birth, chronic constipation, and chronic coughing. Urinary incontinence is often a socially debilitating condition, which causes many women to have to give up activities they love. The good news is that most cases of incontinence can be cured or improved with proper diagnosis and treatment.
Types of Incontinence
1. Stress Urinary Incontinence: SUI may occur because of weak pelvic floor muscles and/or a deficient urethral sphincter, causing the bladder to leak during exercise, coughing, sneezing, laughing, or any body movement which puts pressure on the bladder.
2. Urge Urinary Incontinence: Urge urinary incontinence and overactive bladder is the urgent need to pass urine and the inability to get to a toilet in time. This occurs when nerve passages along the pathway from the bladder to the brain are damaged causing a sudden bladder contraction that cannot be consciously inhibited.
3. Mixed Incontinence: Mixed incontinence is very common and occurs when symptoms of both stress and urge types of incontinence are present.
If you experience incontinence, getting a prescription from your doctor to see a physical therapist trained in pelvic floor therapy is a great place to start. The truth is, pelvic muscle weakness can contribute greatly to urinary incontinence because of the lack of support and control. The therapist will provide a thorough musculoskeletal evaluation, assessing your posture, flexibility, core strength and alignment. From there the therapist will develop an individualized treatment plan that may include: pelvic floor muscle strengthening, bladder retraining, lifestyle modifications, biofeedback, and gentle electrical stimulation of the pelvic floor muscles.
Physical therapy is an appropriate conservative treatment option for urinary incontinence, but in some cases treatment for incontinence may include medication or surgery. The good news is that there are many effective treatments available and you do not have to live with the life-limiting problem of incontinence.
To learn more about physical therapy treatments for incontinence, please call Legacy Physical Therapy at 636-225-3649 to set up a free 15 minute screening.