Incontinence is defined as accidental or involuntary loss of urine from the bladder (urinary incontinence) or bowel motion, faeces or wind from the bowel (bowel incontinence).
This can happen at any age, and many people experience this at some point of another in their lives. The good news is that physiotherapy can help with this condition, it can help you to understand and manage incontinence.
Types of incontinence:
- Stress incontinence This is the most common. It is caused by a physical stress on your bladder It often happens when you cough, sneeze or exercise. This is commonly caused by poor control of already weak pelvic floor muscles. Other problems, such as constipation, lack of fitness, a persistent cough, surgery or being overweight may make it worse.
- Urge Incontinence This is when there is a sudden need to go to the toilet immediately and a leak takes place on the way, meaning that you are unable to hold it in, even for a short period of time. It can be due to lost or reduced control of the bladder muscle.
- Overflow Incontinence This is likely due to blockage or obstruction of the urethra, for example by a tumor or stones.
- Mixed Incontinence is a mixed of the above. Physiotherapy will help you to overcome your need to rush to the toilet by helping you regain control of your pelvic floor muscles.
- Anal Incontinence This is leakage of stool (faeces) or difficulty with controlling wind. It may be caused by weak anal muscles.
Possible causes of incontinence:
- Pregnancy. Hormonal changes which cause laxity and the increased weight of the baby can lead to stress incontinence.
- Childbirth. Vaginal delivery can weaken or cause trauma muscles, damage bladder nerves and supportive tissue, leading to a dropped (prolapsed) pelvic floor. The prolapse may lead to incontinence.
- Changes with age decreases the bladder’s capacity to store urine. Additionally, involuntary bladder contractions increase with age which may cause a leak.
- Menopause. With menopause less estrogen is produced, Estrogen is important to maintain a healthy bladder and urethra lining. Deterioration of these tissues can aggravate incontinence.
- Hysterectomy. Any surgery around a woman’s reproductive system, including removal of the uterus, may damage the supporting pelvic floor muscles. Direct trauma may result in incontinence. Additionally, hysterectomy also causes changes in hormone production which is also likely to cause incontinence
- Obstruction. A growth in the urinary tract can interrupt normal flow of urine, leading to overflow incontinence. Urinary stones could also cause urine leakage.
- Neurological disorders such as Multiple sclerosis, Parkinson’s disease, a stroke, a brain tumor or a spinal injury can affect nerve signals involved in bladder control, causing urinary incontinence.
- Skin problems. Rashes, skin infections and sores can develop from constantly wet skin.
- Urinary tract infections. Incontinence increases your risk of repeated urinary tract infections.
- Impacts on your personal life. Urinary incontinence can affect your social, work and personal relationships.
Treatment and Prevention
- Pelvic floor exercises
- Maintain a healthy weight
- Avoid bladder irritants, such as caffeine, alcohol and acidic foods
- Healthier diet to prevent constipation
- Stop smoking