Meredith Pfohl 
Urinary incontinence is the involuntary loss of urine and is a common (but not normal!) occurrence.
Urinary incontinence can occur when there is a sudden increase in abdominal pressure, such as with laughing, coughing, sneezing, running, jumping, lifting etc. This is referred to as stress urinary incontinence. Sometimes the incontinence is related to a sudden, strong bladder urge that can’t be contained – this is called urge urinary incontinence. Some people may have one type of incontinence only, whereas others may have a combination of stress and urge urinary incontinence – this is called mixed urinary incontinence.
Stress urinary incontinence occurs when the system responsible for keeping urine (wee) in the bladder isn’t strong or capable enough to withstand the forces on the bladder when the pressure in the abdomen increases. This may be because of poor pelvic floor function (e.g. a lack of strength, endurance or co-ordination, or even pelvic floor overactivity), a lack of bladder and urethral support (e.g. an anterior wall or ‘bladder’ prolapse), or issues with the closure mechanism of the urethra (e.g. damage to the urethral sphincter or a low oestrogen state). Effective treatment of stress urinary incontinence involves identifying which factors are contributing to your symptoms, and putting in place targeted management strategies. This may involve pelvic floor muscle training to improve your pelvic floor strength, endurance, co-ordination or resting level of tension, supporting the anterior (front) vaginal wall (e.g. with a pessary) and working with your medical team to ensure adequate oestrogen levels for the vaginal tissues.
Urge urinary incontinence occurs when the strong urge of the bladder overcomes our ability to keep urine in the bladder. Typically this is related to the bladder being overly active or irritated rather than our pelvic floor being inadequate (although there can be a contribution from both), and sometimes it has a strong learned component due to a history of poor bladder habits. Effective management of urge urinary incontinence involves identifying and addressing what is irritating the bladder and making it overactive, as well as addressing the function of pelvic floor. (See our blog on Overactive Bladder for more information.)
If you are experiencing urinary incontinence, our Physiotherapists trained in Women’s Health can help you regain your continence get back your quality of life.
