Urinary incontinence

Urinary incontinence is perhaps the most wide spread, least known affliction of the general population. The overall estimated prevalence of urinary incontinence in women is 30%. It is most common in women who have had children but it can also affect children, men and women without children

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

    • bladder retraining
    • techniques to control overactive bladder symptoms
    • pelvic floor muscle rehabilitation
    • advice and education on normal bladder habits

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. 

Why bother with supervised pelvic floor muscle exercises?

Put simply, it’s easy to get them wrong. Learning how to perform pelvic floor exercises correctly is critical to their effectiveness. Your women’s health physiotherapist can accurately assess whether you are engaging the right muscles.

In a study in which most of the participants were physiotherapists, 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 urinary incontinence 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%.

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

Prevalence of urinary incontinence 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 urinary incontinence 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.

In a study of 144 elite female athletes who had not had children, 28% reported urinary incontinence.