Is your bladder taking the P? ........... You are not alone!!

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Is your bladder taking the P? ........... You are not alone!!

29th October 2015 02:51 PM

Author: Emily Sturt

"don't make me laugh I'll wet myself" (nervous laughter); "let me just pop to the loo before I leave" (hmmmm I better had just in case); "eeeeeek where on earth are the toilets" (cue feelings of total panic); "you're going again? ..... but you have only just been!" (ok, so everyone is counting my trips!)

Let's break the taboo and shed some light on this 'embarrassing little secret'. If you are familiar with the above words and scenarios, having uttered them more times than you care to admit, then don't worry, you're definitely not alone.

Urinary incontinence is surprisingly common. The Bladder and Bowel Foundation estimate that one in four of us will have a problem with bladder control at some point in our lives. The NHS estimates that between 6 and 8 million people in the UK currently have some degree of urinary incontinence. Incontinence can have a major impact on your quality of life.......but the good thing to know is that it is a manageable and treatable condition. You really don't have to suffer in silence.

Urinary incontinence is a term that describes any accidental or involuntary loss of urine from the bladder. It is commonly associated with pregnancy, childbirth, surgery, menopause, obesity and a range of chronic conditions such as bronchitis, diabetes and spinal/nerve problems.

There are two different types of incontinence with a number of possible causes. The most common types are stress incontinence and urge incontinence.

Stress urinary incontinence (SUI) is defined as the sudden unintentional loss of urine during normal day to day activities. You hear it commonly referred to as a 'weak bladder'. It is estimated that approximately one third of women in the UK suffer from SUI. If you suffer with a weak bladder you may notice leakage if you laugh, cough, sneeze, exercise, change positions or lift something heavy. It can also be associated with obesity, having a chronic cough or diabetes. Have you ever wondered why this may be the case for you? Or have you lived with the problem assuming that is is 'normal for a woman', 'all part of ageing' or 'what is to be expected after childbith'. I can tell you it is indeed common, but it certainly isn't 'normal' or something you have to accept and live with.

The situations I described above are all activities that increase pressure inside your abdomen, thus forcing pressure down onto your bladder, womb, bowel (pelvic organs) and the layers of pelvic floor muscles beneath. Pregnancy (weight of baby and hormonal changes); childbirth (especially prolonged deliveries, forceps/suction assisted deliveries, episiotomies, larger babies); surgery (C-sections, hysterectomies, prolapse repairs); chronic constipation, an increased BMI and other trauma can stretch, damage and weaken the pelvic floor muscles that support your pelvic organs and their associated tubes/passages. Under this stress, your pelvic floor muscles and bladder sphincters are too weak and therefore do not work fully or react quickly enough to stop the burst of urine, hence the wetness you experience.  Strong, healthy and well contracted pelvic floor muscles act like a taut trampoline and provide lift to your pelvic organs and, allong with the sphincters help too keep the openings of the urethra, vagina and anus shut, thus preventing weakness.

During menopause, certain times of the menstrual cycle, or after some gynaecological surgeries, the pelvic floor becomes weaker following hormonal changes within the body. Oestrogen (a female hormone) is produced in lower quantities or stopped completely. Oestrogen helps to maintain the thickness of the lining of the urethra, to keep the urethra sealed after passing urine (much like a washer seals water from leaking from a tap). For some women this loss of Oestrogen causes SUI.

 Urge incontinence is a sudden, strong and intense need to go to the toilet, often having to rush to get there. You hear it commonly referred to as an overactive bladder. Severity may range from experiencing 'key in the door syndrome', increasing frequency of visits to the toilet day and night, planning your daily activities around the proximity of toilets, or staying home for fear of not making it to the toilet in time when out and about. Many women experience leaks on the way to the toilet, as they pull down their underwear, or total loss of control at any point. It can leave you feeling worried, side-tracked, embarrassed and simply fed-up. More than anything it becomes extremely inconvenient and interruptive to your life.

In a properly functioning bladder, the bladder muscle (detrusor) remains relaxed as it gradually fills up. As it stretches to about half full we get a feeling of wanting to pass urine. Most people can hold on after this initial feeling until a convenient time to go the toilet arises. With an overactive bladder the bladder may feel fuller than it actually is, it contracts too early and gives you a strong urge to empty its contents. If your pelvic floor muscles and sphincters are weak they can't withstand the force of the bladder contracting, which then pushes out its contents before you are ready. The bladder can be irritated by infection, concentrated urine or caffeine. If the bladder is emptied more and more often then over time it becomes smaller, holding less and less. Urge incontinence is commonly the result of a long history of poor bladder habits linked to pregnancy and childbirth, stress and anxiety, sedentary lifestyles, high intake of caffeine, smoking and alcohol intake. It can also be linked to stroke, parkinsons disease, MS and other chronic health conditions.

Can you relate to any of the above? Are you worrying and struggling on alone? Do you laugh with your friends about it whilst actually wishing things could change? All is not lost. You are not expected to know why, or how to help yourself........but I can! As briefly described above, your pelvic floor muscle health and strength, and indeed your buttocks and abdominals, play a fundamental role in controlling and maintaining your continence. Through seeing a specialist physiotherapist, like myself, and with the support of your GP, we can identify the right course of treatment for you.

The pelvic floor muscle is a group of muscles and like all other muscles in your body it needs specific training to activate it, strengthen it and make it fit for purpose. I can guide you on where to start, how and what to do, what treatment options are available and support you on your journey to continence. There are many ways to treat urinary incontinence from pelvic floor exercises to healthy bladder training, diet and lifestyle advice, medication and some surgical options.

So chat with your GP and come and see me. Please don't continue to suffer - us women have to put up with a lot so let me help you with this burden and give you back control.

I look forward to working with you.

Emily x


Coming soon: Top Tips for a Healthy Bladder

Tags: stress incontinence, urge incontinence, urinary incontinence

Treatments: Women's Health Physiotherapy

Practitioners: Emily Sturt

The views expressed in these blogs are those of the blog authors and do not necessarily reflect the views of The Bridge Centre for Natural Health.

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