URINARY INCONTINENCE

Urinary incontinence can be devastating. Here are some facts:

• Millions of people in the UK suffer from incontinence
• It can affect up to one in three women and up to one in ten men
• It affects people of all ages
• Due to the associated embarrassment, it can lead to a number of other mental and emotional health problems (including anxiety, depression and social isolation) not to mention a loss of dignity
• It also leads to urinary tract infections, which can cause confusion and falls in an ageing population, resulting in avoidable hospital admissions
• It is the second main reason why women are admitted into care homes
• It is expensive: incontinence pads or so-called ‘containment products’ are not cheap, and it has huge social and healthcare cost implications for the NHS
• It is often treatable and/or preventable.

Below are descriptions of the main types of incontinence which can affect men and women.

Stress urinary incontinence

Caused by a rise in intra-abdominal pressure (eg. on coughing, sneezing, shouting, laughing, lifting, bending or standing up from sitting).

Urgency and/or urge incontinence (also known as ‘overactive bladder’)

A sudden compelling urge to pass urine, and maybe leaking on the way to the toilet.

Mixed urinary incontinence

A combination of stress urinary incontinence and urge incontinence.

Faecal urgency and/or incontinence

A sudden strong urge to open one’s bowels, and/or not making it to the toilet and losing stool.

Functional incontinence

Where disability, reduced mobility or problems with manual dexterity limit one’s ability to make it to the toilet or to remove clothing in time.

Given the profoundly negative impact it can have on people’s lives, why don’t more people seek help? Evidence suggests that only 20% of women sufferers will be treated actively (and that figure is based on the number of women who actually come forward). Often they think it’s normal (it may be ‘common’ but it’s not ‘normal’) or they blame themselves, for example, for not doing their pelvic floor muscle exercises. (The problem is, often women who do their exercises are doing them incorrectly, as they may only have been given a leaflet telling them what to do.) Or they simply don’t know what their treatment options are. Evidence shows, for example, that two thirds of women who suffer from stress urinary incontinence can be cured by following a course of supervised pelvic floor muscle training. The research is also favourable regarding outcomes for men.

National health guidelines identify physiotherapy as the first-line course of treatment for urinary incontinence. It’s non-invasive and can be highly effective. Yet how many people know what women’s health physiotherapists really do, or how pelvic floor muscle training can help men with bladder problems? Unlike continence nurses, physiotherapists don’t manage ‘incontinence’: the aim of treatment is to get their patients dry. That’s why specialist physiotherapy should consist of a lot more than just pelvic floor muscle training. Ideally it should include bladder re-education, dietary and fluid intake advice and advice on bowel habits and exercise. It should focus on functional use of the pelvic floor muscles to regain bladder control and should educate patients about how to avoid bad habits which weaken or damage the effect of those muscles.

If you would like to discuss any of the above, in confidence, please contact the clinic and speak to Charlotte Pearson.