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As many as 1 in 3 people have problems with continence at some stage in their adult lives. Incontinence can have many causes. Most people can be easily treated and all incontinence can be managed.

Anatomy

The pelvic floor muscles form a hammock like structure to cover the base (or floor) of the pelvis. They support the bladder, bowels, and in women the uterus. These muscles work to assist in closing off the outlet of the bladder and bowels, helping to prevent any leaking.

Common types of incontinence

Stress urinary incontinence (SUI) is when leakage occurs following a sudden increase in pressure on your bladder - such as when you cough, sneeze or exercise. This is the most common type of leakage experienced. It occurs more commonly in women, especially during pregnancy and after childbirth as the enormous strain on the pelvic floor muscles can leave them significantly weakened. Changes that occur after menopause can also exacerbate the problem as can other problems such as a persistent cough, constipation and being overweight.

Strengthening your pelvic floor muscles can be a simple and effective solution to this problem. You will need to persist with them for many weeks - probably months before a substantial improvement results, and ideally continue them for life. There are also medications available that can help SUI (including an relatively new drug called Duloxetrine [Yentreve ™]). They are thought to work by assisting the tightness in the bladder valve. As there can be side effects it is best to discuss the options with your GP. Sometimes surgery is required, which when undertaken is usually highly successful.

Urge Incontinence refers to when people leak as their bladder gives them so little warning they have difficulty making it to the toilet on time. There are several reasons why this can happen. Some medical conditions can cause these symptoms (such as Multiple Sclerosis or following a stroke). Loss of control of you bladder muscle or infection or irritation of the bladder can also lead to urgency and urge incontinence. It can be made worse by certain lifestyle habits, including diet and drink. The main form of treatment for urgency and urge incontinence involves bladder retraining (to normalise the pattern of going to the toilet), pelvic floor exercises (if the muscles are weak), and drugs to help reduce overactive contractions of your bladder.

Mixed incontinence is when the symptoms of both Stress and Urge Incontinence are experienced. A specialist physiotherapist can discuss and assess your individual problems and discuss the best treatment for you. Treatments may include individualized pelvic floor muscle exercises, and advice on techniques that can facilitate the strengthening of these muscles. There may also be changes to your diet, bladder and lifestyle habits that they can advise you on to help reduce your symptoms.

Useful Tips

• Drink at least 2 litres of water a day.
• Avoid emptying your bladder too frequently as this can reduce its capacity. (Aim to hold on for at least 2, but no more than 4, hours)
• Cut down on caffeine (found in tea, coffee and many fizzy drinks)
• Completely empty your bladder each time, without straining.
• Perform you pelvic floor exercises at least 3 times a day (LINK)
• Tighten your pelvic floor muscles prior to sneezing /coughing etc

Support Groups and further information can be found from The Continence Foundation, click here to be taken to their website.