Urinary incontinence is the unwanted leaking of urine. There are 3 types of incontinence. Stress incontinence which is leaking with a certain activity such as jumping or sneezing. Urge incontinence which is an uncontrollable and sudden urge to pee. This may come on with a certain activity or a certain time, for example, unlocking the front door. And mixed incontinence which is a combination of the two. Urinary incontinence can affect both men and women.
In women we typically see an increase in incontinence post partum and post menopausal. There are several changes that occur to the muscles of the pelvic floor while pregnant and after delivery. These changes can affect muscle strength and endurance and affect her ability to control urine. During and after menopause there are changes in estrogen in the body as well as water content of the muscles. This can affect both the strength and elasticity of the pelvic floor.
In men, we may see an increase in incontinence with changes in the prostate or after prostate surgery. There may be difficulty voiding or dribbling after urinating. Getting up to go to the bathroom at night or the inability to control their bladder during everyday activities are other common problems.
The role of the pelvic floor physiotherapist is to assess and treat the reason for the incontinence that is occurring. Treatments may include a combination of manual therapy, exercise, behaviour modification and a home exercise program tailored to your needs.
Urinary incontinence statistics
- There is Level 1, Grade A evidence (Wilson, 2005, 2009 ICS conference, Cochrane collaboration 2010) that supports pelvic floor muscle training with a trained physiotherapist should be the 1st line of defence for the treatment of stress and mixed urinary incontinence in women
- Urinary incontinence costs Canadians $11.5 billion dollars/year (Canadian Urinary Bladder Survey 2003)
- 30-40% of women have urinary incontinence (UI) either during pregnancy or after delivery (Morkved 2003)
- Symptoms can persist 2-3 decades following the first vaginal birth (Dolan et al 2006)
- 40% of first time pregnant women experience UI during pregnancy and 15% develop new symptoms after delivery (Glazener et al 2006)
- Urinary incontinence is reported by 78% of women with LBP (Eliasson et al 2008)
- Urinary incontinence is common, but it is not normal and can be treated
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