Urinary incontinence is perhaps the most wide spread, least known affliction of the general population. It can affect as many as 40% of the female population.

It can be mild (occasional leakage of small amounts) or severe (daily leakage, wearing pads and avoiding normal activities/sports).

Symptoms can include:

• Increased frequency of urination
• urgency (sudden and uncontrollable desire to go to the toilet)
• urge incontinence (leaking before you can get to the toilet)
• stress incontinence (leaking associated with activity, change of position, coughing, sneezing)

People are often reluctant to seek help but there is a great deal of help available

(physiotherapy/specialist nurses, medications, life style changes, surgery)

Some improvement in symptoms is possible for nearly everyone with incontinence. Check out our other information on this site

It is most common in women who have had children but it can also affect children, men and women without children.

Physiotherapy treatment involves assessment (you may be asked to complete a bladder diary) and depending on your symptoms:

• bladder retraining
• pelvic floor muscle rehabilitation (this takes motivation and patience, and can take
• weeks to notice improvement)
• advice and education on normal bladder habits

Why care about pelvic floor muscle function?

Poor tonic muscle support of the pelvic floor is likely to be a factor in the following conditions:

• Urinary frequency
• Urinary urgency
• Urinary seepage
• Vaginal prolapse

2. Inadequate tonic muscle support and strength of the pelvic floor contributes to the following:

• Stress urinary incontinence
• Urge urinary incontinence
• Obstructed defaecation due to lack of rectal support.

Pelvic floor muscle rehabilitation can help in many of these cases:

• Conservative management of stress urinary incontinence by rehabilitation of the pelvic floor muscles is advocated as a primary intervention.  This approach has no adverse effects and has been shown to be effective in mild-to moderate cases of urine loss [1.].

Why bother with supervised Pelvic Floor Muscle Exercises?

In normals (most of whom were Physios) when asked to perform a pelvic floor lift 65% performed the correct procedure but 35% bore down (not good if you’ve got a prolapse or incontinence problem).

How common is Urinary Incontinence?      – Quite!

Among younger women, the prevalence of any urinary incontinence (UI) ranges from 9% to 31%, depending on the survey.  In a Norwegian survey of 34,000 women, the prevalence of any leakage in women between the ages of 20 and 24 was 9% to 11.7%.  [2.]

A cross-sectional survey of Australian women found a prevalence of nearly 13% in those 18 to 23 years of age.  [3.]

Prevalence of UI increases as women age.  It ranges from 21% to 58% in middle-age women, defined here as the period between the ages of 40 and 60.  In the Norwegian survey, the prevalence of any UI in women between the ages of 50 and 54 years was 28.5% to 31.9%.

In another study of 541 healthy women aged 42-50, 58% reported urine loss at some time, 30% reported regular incontinence but only 25% sought help. [4.]
Off 144 elite nulliparous athletes 28% reported incontinence of which:

Patients that might be missed:

• Athletes: especially parous women
• Respiratory problems: especially parous women
• Neurological conditions: men and women
• Back problems: men and women

The overall estimated prevalence of Urinary Incontinence  in women is 30%.

What about prolapse?

Swedish women (n=487) aged 20-55

• Any prolapse at all on clinical assessment           30.8%
• Women 20-29 yrs                                     6.6%
• Women 50-59 yrs                                     55.6%
• Prolapse to introitus                                              2.0%

So can bladder training and pelvic floor training help?
Here is the evidence!

Evidence for Bladder Training to Treat Urinary Incontinence

2.  Evidence for Pelvic Floor Training to Treat Urinary Incontinence

3. Evidence for Pelvic Floor Training in Prevention of Pregnancy and Birth-Related Urinary Incontinence