If you have difficulty controlling you bladder, or difficulty emptying your bladder, it is important to tell your GP about this symptom.
Urinary urgency
The bladder may not be full, yet the rush to get to a toilet is very urgent.
Sometimes the bladder won’t wait and you may experience wetting as you rush to the bathroom or whilst undressing once you get there. This is urge incontinence. It can happen to men, women, teenagers and children.
Urinary urgency may be provoked by arriving home from an outing, hearing running water, having wet hands, or may come upon you for no apparent reason. Urgency can greatly impact a person’s quality of life, leading to anxiety, loss of confidence, and even social isolation.
How can physiotherapy help?
Urinary urgency (with or without loss of urine) can occur when the pelvic floor muscles are too weak. It can also occur when these muscles are overactive and tense at rest. This makes expert assessment really important. An exercise program can be devised to help you achieve correct muscle function.
Pelvic floor muscle function is not the only thing to consider with urinary urgency. Urinary urgency (with or without incontinence) can be a complex disorder for your health care providers to unravel, and a team approach is often required. It is important to tell your doctor that you have this symptom.
Some people require guidance with bladder retraining, which helps them to achieve better ability to store greater volumes of urine, and better control. The goal is for people to regain their confidence over their bladder control.
Stress urinary incontinence
This is nothing to do with emotional stress!
When the pressure in the abdomen goes up, that pressure is also felt by the bladder and bladder outlet. If the bladder outlet is not well supported urine can escape when you cough, sneeze, lift, bend, run, laugh, yell or blow your nose. These are all activities or events that make the pressure in your abdomen increase suddenly.
How can physiotherapy help?
Stress incontinence can mean that the pelvic floor muscles are weak, and not supporting the bladder outlet properly. There can be weakness in the urinary sphincter muscles, and/ or changes to other pelvic structures associated with childbirth, prolapse, lifestyle, other health conditions, or surgery. You may have tried pelvic floor exercises yourself, but not achieved the desired result – staying dry! In some people muscles are held very tense at rest, but lack control.
If you have had no success with pelvic floor exercises, then it is time to consider having a physiotherapy assessment. These muscles can be hard to locate by yourself, and exercise technique is often not ideal if you have had no instruction. For some people, performing pelvic floor strengthening exercises is unhelpful, and could even make their incontinence worse. This is where a pelvic health physiotherapist can tell you exactly how your muscles are performing…and how to improve control.
Children
Children who wet during the day may have trouble storing urine, trouble responding to the usual cues that the bladder needs to empty, or may not empty the bladder well when they do go to the toilet. Often these children are constipated too, and this has a big effect on bladder control. Even a child who passes a bowel motion every day can have a level of constipation that influences bladder control.
Urinary incontinence is one of the many conditions that can be treated by a suitably trained Pelvic Health Physiotherapist.