Incontinence

Urinary incontinence is a symptom resulting in loss of control of the bladder contents. It is a common problem that increases in prevalence with age, and is more common in women than men.

It is important to report this condition to your doctor or health care provider, as a thorough evaluation can usually determine the cause of your incontinence.

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To better understand incontinence, it helps to understand the structure of the urinary tract. Urine is waste products and water removed from the blood by the kidneys. Urine flows from the kidneys downwards through a pair of tubes (the ureters) to the bladder.

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The bladder is a balloon-like structure that stores urine. Urine leaves the body through another tube (the urethra) at the bottom of the bladder. Urination is controlled by special muscles, called sphincters, located at the base of the bladder and the wall of the urethra. These normally control the flow of urine by contracting and therefore closing off the neck of the bladder and the urethra, like a tie around the bottom of a balloon, so that no urine is leaked.

When the sphincters relax, they open the passage for urine to pass. At the same time, the muscle of the bladder wall contracts (squeezes) and forces the urine out of the bladder. When the urination process is finished, the sphincters contract and the bladder itself stops squeezing and relaxes.

Incontinence during pregnancy

Your pelvic floor muscles are under considerate strain during pregnancy. They have to support the weight of your growing uterus, and cope with the changes caused by pregnancy hormones. A sharp increase in abdominal pressure – as happens when you cough or jump – may be momentarily too much for the muscles to hold back the flow of urine, with the result that a few drops may escape.

Stress incontinence may happen at anytime in pregnancy, but is more common towards the end. It is often worse for a few days following the birth, when the muscles of the pelvic floor and other structures are recovering. Women who give birth by caesarean section may also suffer from stress incontinence. Things should start to improve within 7-10 days.

What can I do about it?

The best remedy is regular and effective pelvic floor exercises, to keep the muscles toned. Although you may not make a full recovery during pregnancy, regular exercises now will minimise the problem and help you towards a full recovery after your baby is born.  Help is also available with adult diapers and it may be a good idea to for a mattress protector to ensure your bed stays dry and unstained.

Don’t let your bladder get overfull. If you need to go – go! At the same time, don't restrict your fluid intake. This may be harmful in other ways.

If stress incontinence does not get better after your baby's birth – in spite of six weeks of rigorous pelvic floor exercises , talk to your health visitor, practice nurse or doctor. They may be able to refer you to a specialist physiotherapist. You should not have to suffer long-term without help.

Stress incontinence may be an early sign of urine infection. If it suddenly happens to you for no obvious reason, have a word with your doctor or midwife – especially if you feel unwell or have other symptoms.  

If this page was of interest you may wish to view the following pages.  Incontinence Article, Incontinence Products, Pelvis Floor exercises.