Stress Urinary Incontinence

03 Jul Stress Urinary Incontinence

Stress Urinary incontinence (SUI) is leakage of urine with any intra-abdominal force/pressure.

Unlike its name suggests it is NOT leakage of urine with stressful relationships, deadlines or emotional stress etc. It is about the physical stress imposed on the bladder directly. These stresses include coughing, sneezing, laughing, lifting, or exercising and for others laughing or intercourse.

Other causes of Stress Urinary incontinence include chronic cough, asthma, COAD, diabetes, obesity and constipation.

How the bladder works

In order to understand SUI it’s important to understand how the bladder works.

In a normal bladder, the kidney filters urine into the bladder/detrusor muscle. This muscle has stretch receptors such that when the muscle expands and stretches as it fills to ~400-600mls.  It sends a message up the spinal cord to the brain telling it that the bladder is full. The brain decides whether it’s appropriate to urinate or to hold off. If it decides to urinate, the brain will send a message to the detrusor commanding it to squeeze and another message to the pelvic floor muscles to relax.  The combined action of contraction of the detrusor and relaxation of the pelvic floor muscles allow us to urinate effectively.

With SUI – it bypasses this, and with any intra-abdominal pressure, it acts directly with a downward force upon the bladder.  If the sphincter and pelvic floor muscles aren’t quick or strong enough both women and men can experience urinary incontinence.

What can be done?

Continence and Pelvic Floor Physiotherapists will/may:

• Ask you questions about your pregnancy, surgery, and symptoms or causes for your urinary leakage. Your physiotherapist will differentially diagnose any red flags or serious causes to your bladder complaint(s).
• With your consent, do a pelvic floor examination or use real-time ultrasound to assess your pelvic floor muscle strength. They will check for any prolapse, and avulsion (the tear of the levator ani muscle) or perineal tears caused during labour.
• Ask you to do a bladder diary and or a 7-day accident diary.
• Do a pad weight cough and jump test on a bladder filled with 500mls water to gauge the quantity of urine leaked.
• Prescribe a specific individualised, progressive pelvic floor muscle training technique to help cure your leakage.
• Discuss the time it takes to cure your symptoms. This may range between 6-12 weeks maximum and up to 5-10 treatment sessions depending upon what other adjunctive therapies you  choose.
• Discuss adjunctive electrical stimulation, acquaflex, and/or contiform and pessaries, which also assist with the treatment and cure of Stress Urinary Incontinence.

The Pelvic Floor Physiotherapists working at Hoppers Physiotherapy have extensive experience and treated thousands of women and many males with Pelvic floor concerns. If you have any queries about the above please contact our Clinic on 9749 5110 and book an appointment with one of our Women’s Health Physio’s today!