Urinary incontinence, the involuntary loss of urine, is not a disease, but a common set of symptoms, the treatment of which is unfortunately often neglected. Nearly half a million people in our country suffer from urinary retention problems! Fortunately, more and more of those affected are seeking help, but there are still many who do not reach a specialist. Reasons for this include embarrassment, lack of knowledge about treatment options, and the belief that urinary incontinence is a normal and inevitable process with age. However, this is not the case! The pelvic floor training mastered and led by a physiotherapist, and the additional conservative (non-surgical) treatment options are considered first-line therapy in the treatment of stress and mixed urinary incontinence!
What are the predisposing factors for urinary incontinence?
- general connective tissue weakness
- overweight
- pregnancy
- childbirth
- menopause (decreased estrogen levels)
- old age
- smoking
- diseases with strong coughing fits
- intensive practice of high impact sports, and sports with shaking, jumping (running, aerobics, ball sports, etc.)
- pelvic surgeries (e.g. prostate surgeries)
- side effects of some medicines
Who can we turn to in case of urinary incontinence complaints?
- to a GP
- to a urologist
- to a gynecologist/li>
- to a urogynecologist
- pelvic physiotherapist
By all means, talk to your GP about your symptoms so that you can go to a specialist as soon as possible who can help you if you have more serious complaints. Urinary incontinence should not be treated by drinking little liquid, this is not healthy in any way. Using pads is not mean as treating urinary incontinence, it can only improve the quality of life.
Types of urinary incontinence:
- Stress incontinence (SUI)
HInvoluntary loss of urine due to increased abdominal pressure or physical exertion, which is not accompanied by an urge to urinate. It can be triggered by coughing, sneezing, jumping, lifting, running and other physical activities. It is usually caused by weakness of the pelvic floor muscles. It occurs more often among women. It is mainly treated with pelvic floor training.
- Urge incontinence (UUI)
Involuntary loss of urine with a sudden, urgent urge to urinate. Those affected often cannot reach the bathroom without dripping or leaking urine. In the background, there may be overactivity and involuntary contraction of the bladder’s urination muscle, the detrusor muscle. It occurs more often among men. It can be treated with pelvic floor training, bladder training or toilet training and medicine.
- Mixed incontinence (MUI)
Stress and urge urinary incontinence are present together. It can be treated with pelvic floor training, bladder training or toilet training and medicine.
Untreated conditions lead to a depravation in the quality of life, in case of failure of conservative therapies and the presence of very serious complaints, surgical solutions may be used.
More information about stress incontinence can be found on the website of the International Urogynecological Association:https://www.yourpelvicfloor.org/media/stress-urinary-incontinence-RV2-1.pdf
Overactive bladder syndrome (OAB)
- with frequent urge to urinate
- with a sudden urge to urinate
- with nocturnal urges to urinate
- and can also be accompanied by urge incontinence
It is mainly treated with bladder training, pelvic floor training and medication.
More information about overactive bladder syndrome (OAB) can be found on the website of the International Urogynecological Association: https://www.yourpelvicfloor.org/media/Overactive_Bladder_RV2.pdf
Pelvic Organ Prolapse (POP)
Pelvic prolapse is the insertion of the pelvic organs – uterus, bladder, rectum – into the vagina. Its background is the weakening and damage of the pelvic floor muscles and suspensory ligaments that support the pelvic organs. Vaginal birth and labor are the most common causes of prolapse. It is treated with pelvic floor training, pessary therapy, electrotherapy if necessary and surgery in more severe cases.
Symptoms may include:
- vaginal foreign body sensation
- a palpable lump in the vagina
- urinary incontinence
- wind and faecal incontinence
More information about pelvic prolapse and pessary therapy can be found on the website of the International Urogynecological Association:
https://www.yourpelvicfloor.org/media/Pelvic_Organ_Prolapse_RV3.pdf
https://www.yourpelvicfloor.org/media/Vaginal_Pessary_for_Pelvic_Organ_Prolapse_RV2.pdf
Conservative, non-surgical treatment options
1. Lifestyle changes
- lose weight, quit smoking, avoid caffeine-containing drinks and foods, eat a high-fiber diet, control fluid intake
- Squeezing due to frequent constipation is a proven risk factor for the appearance of complaints of sagging.
- It is worth continuing a diet rich in fiber, a glass of lukewarm water in the morning to help the metabolic processes.Never squeeze on the toilet, relax your sphincter muscles when urinating and defecating, don’t rush the process, by using abdominal breathing and assuming a slightly forward body position, you can create a more natural position for relaxing the pelvic floor muscles.
- Distribute the liquid evenly throughout the day, drink at least one and a half liters of liquid per day.
2. Pelvic floor training
- In case of complaints, intensive pelvic floor training under the guidance of a physiotherapist must be carried out for at least 12 weeks in order to achieve significant results!
- The training doesn’t stop even after 12 weeks, after that you still have to do the exercises to maintain your level!
- Pelvic floor training can be done together with biofeedback training, which promotes the conscious function of the pelvic floor muscles.
3. Bladder training, toilet training
- It must be practiced for 6-12 weeks in order to achieve significant results!
4. Correct posture
- In the case of forward shoulders and careless posture, more pressure is placed on our abdominal and pelvic organs, if we are able to use the right muscles to achieve the correct posture, we deal with strengthening the core muscles, and we can spare our abdominal and pelvic organs as well.