Urinary Stress Incontinence
Stress incontinence is a result of the inability to manage pressure changes in the body, and refers to the involuntary loss of urine due to an increase in abdominal pressure from physical exertion such as a sneeze, cough, laugh, jump, run or lift. This leak occurs in the absence of a detrusor (bladder muscle) contraction.
For an individual to remain continent during exertion, the pelvic floor muscles and the sphincter muscle around the urethra work to clamp around the bladder neck, and the supporting pelvic fascia (ligaments) must be intact to maintain normal position of the urethra. If there is a deficiency in any of these systems, the pressure from exertion may be higher than the pressure generated from the pelvic floor and sphincter, causing urine to leak.
Stress incontinence can occur due to a number of reasons, such as childbirth, chronic constipation, chronic cough, repeated heavy lifting and obesity.
Conservative management of stress incontinence may involve pelvic floor muscle training and / or the use of a pessary (link to treatments), as well as a programme of exercises to manage pressure changes in the body more effectively.
Urinary Urgency / Urge Incontinence
OAB occurs when the muscle that makes up the wall of the bladder (detrusor muscle) contracts when it should be relaxed during the bladder filling phase.
There can be a number of reasons for urinary urgency, including high fluid intake, constipation, urinary tract infections such as cystitis, pregnancy and hormonal changes associated with the menopause, neurological / other medical conditions, or certain medications such as diuretics. It is always best to see your GP to rule out any medical reason for your symptoms, before embarking on physiotherapy treatment.
Urinary Urge incontinence is the involuntary loss of urine as a result of the inability to overcome that strong urge to urinate. If the contraction force of the detrusor muscle is stronger than your ability to hold on, urge incontinence occurs. Physiotherapy treatment (link to treatments)can be very effective in improving the ability to ‘hold on’ (strengthen the pelvic floor muscles), and retrain the bladder.
Faecal urgency refers to an intense urge to open your bowels. There can be a number of reason for this including an insufficient pelvic floor/anal sphincter, dietary, neurological / medical conditions, or certain medications. It is always best to speak to your GP regarding your symptoms, before embarking on physiotherapy treatment.
Faecal urge incontinence refers to the passing of stool (liquid or solid) as a result of a strong urge that you are unable to overcome. This can be highly embarrassing for the individual and is often revealed during a consultation for bladder concerns. It is estimated that major faecal incontinence effects 1.4% of the UK population over 40 years old, but it is likely that the number is much higher.
Some individuals may also experience passive soiling where the passing of stool occurs without an urge.
Constipation can be defined as the passing of less than 3 bowel motions a week, with these often being dry, hard or lumpy and difficult to pass. Obstructed defecation refers to the inability to effectively evacuate the bowels, often due to a structural change in the pelvic floor such as prolapse, or constipation.
As a result of constipation many individuals experience abdominal discomfort and bloating. In addition, the congestion in the rectum, sometimes coupled with straining can lead to anal fussures and haemorrhoids. There are many different factors that can influence constipation including diet, fluids, level of exercise, medication, toileting habits and stress levels.
Physiotherapy can be very effective in treating bowel conditions by improving pelvic floor and anal sphincter function, improving defecation dynamics (the process of emptying the bowels), working on abdominal discomfort through various massage techniques and providing advice on lifestyle adaptations. Our clinicians can also speak to your GP for prescriptions or make onward referrals to appropriate specialists if needed.
Mixed Urinary Incontinence
Many women notice a prolapse after childbirth. Sometimes the symptoms don’t occur until later in life, generally around the menopause when oestrogen levels decline and vaginal tissues weaken in the absence of oestrogen.
Chronic constipation, chronic cough, persistent heavy lifting and obesity can also contribute to vaginal prolapse.
Physiotherapy can help by strengthening the pelvic floor muscles to help support the pelvic organs. Your physiotherapist can also teach you strategies to manage the prolapse better.
Pessaries can also help support a prolapse and our specialist physiotherapists are trained to be able to offer trails of several different types if you are suitable for this treatment (link to treatments).
It is best to seek advice from your GP before starting physiotherapy for a prolapse.
Pelvic Pain / Dyspareunia
Our physiotherapists offer a sensitive, confidential and professional service, where you can discuss your concerns in confidence, and the most appropriate assessments and treatment options are provided.
Call Church Lane Physiotherapy Clinic Ltd in Newcastle-under-Lyme on
01782 719 232 for more information on our women’s health treatments.