ARTICLES

The leaky bladder syndrome – just what is it anyway?

You probably have seen this problem advertised on TV. You may think that everyone only needs to put on a pad or diaper. BUT there is another solution for this problem. Contrary to popular belief, incontinence is not a natural part of aging for women or men and it is not a natural consequence of having children.

Urinary incontinence is a socially embarrassing problem that is rarely talked about or acknowledged but women, men, and children do not need to be held hostage by the condition. Education and proper treatment are the keys.

You may remember the “Everyone Loves Raymond” episode when it is discovered that Amy leaks when she laughs. This was looked on with shock and disgust. It was talked about in the family but not in front of Amy. Unfortunately, incontinence is not usually discussed. Society attaches shame to the problem which can result in people suffering in silence, becoming socially isolated, or just extremely unhappy. Amy was mortified when she learned that the whole family knew her problem. Everyone thought it was very embarrassingly funny. Amy’s problem could have been used as a way to educate the viewers in this social problem. Amy just needed to see a physiotherapist who treated urinary incontinence.

I am a trained and registered physiotherapist who works in Greater Halifax. I added the areas of urinary and pelvic problems to my practice over 10 years ago when I recognized how much of a problem this issue was for women and men. I was extremely fortunate to be able to learn about treatment for this problem in women and children when I worked in Canada, the UK, New Zealand, and Australia.

If you are suffering with this problem, you will need to find out what you can do or what help you need to do to get back the control of your bladder. I have given you a bit of an overview of the whole problem and what there is to do about it.

The bladder is a muscular organ which is hollow so that it can hold the urine produced by the kidneys. When full it then contracts and the urine is excreted, this is called urinating. You probably had bladder control around 3 years of age. From this age forward, you should have had no problems controlling your urine unless, you had tried to hold your urine for too long and could no longer control the need to go, had a bladder infection, had an injury that puts stress on the bladder making it not function properly, have a medical condition which affects the bladder or your mobility, or have just recovered from a total hip operation.

Women, men, and children can have different forms of urinary incontinence.

• Stress incontinence (weak or leaky bladder) - The involuntary loss of urine when a person is physically exerted with such things are lifting, coughing, sneezing, or laughing. Research shows that stress incontinence affects 12-50 % of women ages 19-55 and the rate increases with age. Although men can become incontinent, they usually do not have problems until age 65.
• Urge incontinence (the strong uncontrollable urge to void) - You may have experienced this when you really need to urinate but are not near a toilet. You are able to keep things controlled until you put the key in the lock at home or get to a toilet and are in the stall. Then, without warning, you start to urinate and there is no stopping the flow. This is the type of incontinence that most men develop. Research shows that 2-9% of men are affected by incontinence up to the age of 65. After 65, the rate increases from 6-22%. This is due to changes in the prostate.
• Frequency (having to urinate often) - If you need to go more than the normal amount which is every 3-4 hours during the day.
• Nocturia (needing to urinate at night) - Unless you are over 65, it is not normal to get up more than once per night and that should only be occasionally. After 65, 1-2 times per night is normal.
• Enuresis (bedwetting) – This can be quite an embarrassing problem for children.

There are a number of factors involved with this problem but they are solvable. Women may notice a change in the bladder control around the time of their periods. This is normal due to the hormonal changes but the control comes back during or just after the cycle. During pregnancy there will be changes as well but the control returns after first month post natal if the woman does her post natal exercises including the pelvic floor. Research shows a 100% correlation between women, who do not practice the exercises and have more than one child, developing bladder problems by their 50’s. It can occur even earlier.

Some women may also have the problem of pelvic pain. The pain may occur during the monthly cycle, sex, or urination. This pain can be assessed and treated by a physiotherapist who works in the field of women’s health. The physiotherapist can determine how involved the problem is and if further medical intervention is required. Treatment for bladder problems and/or pelvic pain often involves manual (hands-on) therapies to realign the pelvis, back, and/or hips, to release of restrictions in the pelvis and low back, and exercises (Keigel) to strengthen the weak pelvic floor muscles, lower abdominals, and low back. Machines may be used by some physiotherapists to help clients regain their pelvic floor muscle function.

The biggest thing to remember is that incontinence is not a natural part of aging or having children. Incontinence is a medical condition that should be treated with the same concern and respect as any other medical problem.

Janice Webber has offices in Dartmouth and Halifax to assist you in gaining control of your bladder and get back to enjoying your life. You can reach her at 240-7634.