Urge Urinary Incontinence

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Suddenly busting to go to the toilet resulting in an involuntary loss of urine? You may be suffering from Urge Urinary Incontinence.
 

Normally, as the volume of urine in our bladder increases, the wall of our bladder stays relaxed and should stretch, triggering a reflex and giving us a gradual urge to pass urine. Roughly, when the bladder is half full, we get a mild urge to go. The bladder will continue to gradually fill, increasing the pressure and telling you that it is time to empty your bladder. When convenient, we then sit on the toilet and the bladder contracts and pushes the urine out.
 

With Urge Incontinence, the bladders sense for signalling ‘fullness’ is misfiring and the bladder contracts, or ‘spasms’ too early, (despite not being full) and there is a strong desire to go to the toilet.  

There are many reasons why a person may experience a sudden urge to go, some of these include:

  • Overactive Bladder
  • Bladder sensitivity – eg. infection
  • Triggers eg. hearing running water or key in the door when you get home.
  • Diet – caffeine, alcohol, fizzy drinks.
  • Neurological disorders increasing bladder sensitivity eg. Parkinsons disease or MS.
  • Poor bladder habits – eg. Not emptying properly

Treatment – As women’s health physio’s we are trained in understanding bladder spasms and neurological reflexes, hypersensitivity, and of course specific pelvic muscle training. Here are some treatment options used to suppress the bladder and regain control to avoid accidents.
 

1.Diet

  • Reduce caffeine intake as caffeine is a bladder irritant
  • Reduce artificial sweetener – also a bladder irritant
  • Take note of fluid consumption

2. Bladder Retraining

  • Teach the bladder to hold more urine before signalling a need to go.
  • Use a Bladder Diary: measuring fluid intake vs fluid output along side the time you have used the bathroom. This is used as a diagnostic tool and also a treatment tool. Commonly, bladder training involves urinating at a set time and extending the amount of time between voids, with a goal of 3 hours between going to the toilet.
  • Avoid ‘just in case’ visits. This may cause your bladder to become even more sensitive.
  • Ensure your bladder is empty after each visit to the bathroom. Your physiotherapist can use ultrasound to measure pre and post voids to determine if you are emptying correctly.

3. Suppress the Urge

  • Activating various reflexes in the body to help the bladder spasm pass.
  • Relaxed breathing
  • Toe curls in your shoes
  • Calf raises
  • Sitting down on the heel of your foot and putting pressure on the genital region
  • Counting backwards

4. Pelvic Floor Muscle Training

  • Bladder spasms can overwhelm a pelvic floor and muscle training is important. Coordination of the muscles is vital. It must be noted that some people have urgency due to an overactive pelvic floor – its best to be assessed by a women’s health physio.

Urge Urinary Incontinence and Overactive Bladder unfortunately affects around 20% of women in Australia. Determining the cause of the overactive bladder and urge incontinence is a key component to understanding which treatment strategy is used.

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