Incontinence

If incontinence makes you nervous when you cough, sneeze, laugh or exercise, or if you sometimes have to rush to the toilet, this summary will help you understand the causes and how physiotherapy can help.

What is incontinence?

Incontinence is leaking of urine, wind or stools. Urinary incontinence is a particularly common problem that affects about one in 10 men and one in three women. Incontinence can be distressing and embarrassing, affecting work, travel, social activities, physical activity and intimacy. Many cases of incontinence can be successfully treated with physiotherapy.

The two most common types of incontinence are:

• Stress incontinence - leaking following a physical stress on your bladder, such as coughing, sneezing or running
• Urge incontinence - leaking unexpectedly as you rush for the toilet.

What causes the problem?

The main cause is weak pelvic floor muscles - the muscles that support the bladder, bowel, uterus, and form the floor of the pelvis. In men, incontinence is most common following prostate surgery, while in women it can be a problem during pregnancy, after childbirth and after the menopause, though it may occur at any time. A persistent cough, frequent constipation or being overweight can make things worse.

How can physiotherapy help?

Many of us do not use our pelvic floors properly. A physiotherapist can explain how to do this. Incontinence is often due to a weak pelvic floor (particularly in women). Where this is the case, physiotherapy should be the first treatment option before considering an operation.

What will happen when I see a physiotherapist?

The physiotherapist will conduct a confidential assessment of how your bladder and bowel are working and affecting your life. They will then create a programme for your specific problem. Treatment may include:

• pelvic floor exercises
• advice on eating and drinking habits
• electrical stimulation
• biofeedback.

It may take up to three months of exercising for your pelvic floor to strengthen and regain its endurance.

Are there physiotherapists with extra training in this area?

Some physiotherapists have special training, skills and experience in continence management. Many are members of the Association of Chartered Physiotherapists in Women's Health or the Chartered Physiotherapists Promoting Continence.

Meanwhile, how can I help myself?

• Try to engage your pelvic floor whenever you remember. (To do this, imagine that you are stopping wind escaping).
• Brace your pelvic floor before your laugh, cough or sneeze.
• Avoid caffeine, as for some people this can be a bladder irritant.

Where can I get more information?

Association of Chartered Physiotherapists in Women's Health

UK-based clinical interest group. Provides contact details of physiotherapists specialising in women's health.
W www.acpwh.org.uk

Incontact

Independent national charity that offers advice and support to people with bladder and bowel problems. Produces a range of information and helplines.
T 0870 770 3246 (counsellor helpline)
W www.incontact.org

Your pelvic floor website

Website produced by continence expert Professor Grace Dorey. Provides a range of information and exercises for men and women.
W www.yourpelvicfloor.co.uk

How to find a physiotherapist

See our section on access to physiotherapy.

Disclaimer

The content on this page is provided for general information purposes only and is not meant to replace a physiotherapy or medical consultation.