The joys of long sunny days and summer holidays means playing with the kids and grandchildren in the garden. Running around after them, bouncing on the trampoline….If the picture above has you making excuses for not getting on the tramp, you are not alone!
Stress Urinary Incontinence (SUI) is the involuntary leakage of urine on when there is a sudden increase in pressure in your abdomen. That dreaded moment when you jump, laugh lots, cough, sneeze or do some star jumps and you feel the leakage occur. Even yelling at the kids, your husband or the dog can cause leakage. According to Continence NZ 1.1 million New Zealanders suffer from urinary incontinence and 1 in 3 women who have ever had a baby will have some form of urinary incontinence.
That’s a lot of leaking! Two-thirds of women who experience leakage do not seek help as it is portrayed as a normal especially after childbirth and they think nothing can be done about it. According to the adverts on TV all you need to do is put a liner on for LBL (light bladder leakage) and your life will be right again………….em no!
Bladder control problems are COMMON but NOT NORMAL. This sounds like a lot of doom and gloom, but women can become dry or experience significant improvement with the right treatment, including physiotherapy.
There is a lot of misconception about who gets SUI and why. It’s all about risk factors. The more risk factors you have, the greater than chance you have of developing SUI.
The biggest risk factor = GENETICS
You are 1.3 times more likely to develop SUI is your mum or older sister has it! We think it’s due to connective tissue make up.
SUI can start in childhood and is very common among athletes who do high impact sports. The sport does no cause the SUI, but shows up who might be at risk of developing it later. Pregnancy, labour, chronic cough and increased BMI (body mass index) significantly increase your chances of developing it…but not everyone with these risk factors will develop SUI.
The mechanism behind why you leak plays the biggest role in what you treatment may involve. We now know the issue could be due to:
weakness in pelvic floor muscles or urethra (wee tube)
connective tissue that supports the bladder and urethra being damaged
changes in the stiffness of the connective tissue due to hormonal changes (this is what symptoms can appear at different times of the month or appear during the menopausal years…remembering perimenopause starts around 35 and lasts until about 65!)
some more complicated reasons but us physios can figure it out!
How do you know if you are at increased risk with no symptoms? How can you tell what is causing your SUI? A detailed assessment with an expert physio with advanced assessment and treatment skills. I can take a detailed history, complete an advanced pelvic floor exam to determine why you have SUI and the best treatment plan.
Will physiotherapy work for you? We can get about 50% of women cured or a significant improvement with a pelvic floor exercise programme. Will pelvic floor exercises work for you? They can be magic for the right type of SUI. I am training to use ultrasound to help me figure out which patients will benefit from physio and those who won’t. Very exciting!
A support device called a pessary can also work wonders. Will you need surgery and will it work? …..I can talk through all of this with you and give you the most up-to-date evidence based advice.
There is so much more that can be done other than ignoring it or wearing a pad. Sometimes it’s as easy as learning to breath better, contract or relax your pelvic floor to become dry. Physiotherapy can help with the breathing and core mechanics, changing how your exercise or move and of course strengthening (or relaxing…this is just as important) the pelvic floor. Don’t forget that rehab and exercise after bladder surgery is just as important as after knee or shoulder surgery!