Incontinence

The bladder is a hollow muscular organ that collects and stores urine from the kidneys. The bladder muscle is called the detrusor muscle and it remains relaxed while the bladder fills. Tightening the pelvic floor muscles when you have an urge to void, inhibits contraction of the detrusor muscle and assists the urethral sphincter to prevent urinary incontinence.

Urinary Incontinence (UI) is the involuntary loss of urine. There are 3 main types of incontinence: Stress Urinary Incontinence (SUI), Urgency Urinary Incontinence (UUI) and Mixed Urinary Incontinence (MUI) which is a combination of SUI and UUI.

SUI – Involuntary loss of urine with effort of physical exertion such as when you strain, cough, sneeze, laugh hard, jump on a trampoline etc. There is no contraction of the bladder (detrusor muscle). There is simply leaking due to increased abdominal pressure (IAP) bearing down on the bladder causing urine to leak through the closed urethral sphincter. Proper contraction of the pelvic floor muscles reinforce this sphincter and help to prevent leakage. Changes in how the abdominal muscles are sequenced during activity can also reduce IAP alleviating stress on the bladder.

UUI – Loss of urine associated with urgency/inability to get to the bathroom in time. Urgency is caused by an overactive bladder muscle and it is much worse when the pelvic floor muscles are not functioning optimally to prevent leakage. Bladder irritants such as caffeine can make the situation worse. Prevalence of this condition increases with age.

Treatment varies according to individual needs. Real-time Ultrasound is used both to assess and to teach proper pelvic floor contraction as well as abdominal muscle function. Attacking the problem on two fronts: (a) reducing downward pressure on the bladder and (b) improving pelvic floor muscle function provides optimal results. Other treatment approaches include changes to diet and toileting patterns to assist in regaining bladder control.