Incontinence management

There are three main types of incontinence: stress continence, urge incontinence and overflow incontinence.

The most common form of urinary incontinence is stress incontinence. It is characterised by the involuntary loss of urine with exertion (eg. while coughing, sneezing, laughing, lifting heavy objects or during physical activity). The amount of urine loss in stress incontinence is generally small.

Urge incontinence is the most common type of incontinence experienced by older people. It consists of a sudden and urgent desire to urinate and the inability to hold the urine until a toilet is reached. Urge incontinence is caused by an overactive bladder muscle, and is characterised by involuntary contractions. Urge incontinence is sometimes also referred to as overactive bladder or detrusor instability.

Overflow incontinence occurs when the bladder cannot empty completely. This results in an bloated bladder and eventually the muscles near the urethra and anus will open causing urine to leak. Women with overflow incontinence may only have a weak dribbling stream of urine or feel that they need to empty their bladder but cannot. The residual urine in the bladder can cause recurrent bladder infections.

Although common, urinary incontinence is not normal and should be addressed in the same way as other health problems by consulting a health professional. It is important that women recognise they do not have to endure this condition and are made to feel comfortable about obtaining help.

Pelvic floor exercises are designed to strengthen the pelvic floor muscles through actively tightening and lifting them at intervals. Strong, well activated pelvic floor muscles help support the bladder, uterus and bowel and allow the system to function properly. The exercises are designed to work three different parts of the pelvic floor muscles: the muscles that control urine flow; the muscles that control muscles around the anus and the muscles that surround the urethra and vagina. The exercises also interact with the deep abdominal muscles.

There are a number of steps that can help to reduce the chance of incontinence occurring.

• Drink between 1.5 to two litres of fluid every day, the majority of which should be water. An adequate fluid intake helps keep the urine diluted (causing less irritation to the bladder) and maintains the bladder's ability to hold urine. It also reduces the occurrence of constipation.
• Limit caffeine and alcohol intake.
• Maintain good bladder habits by only going to the toilet when the bladder is full. Avoid going "just in case".
• Adopt a good toileting position. Women should avoid 'hovering' over the toilet seat, a common behaviour when using public toilets.
• Learn how and when to perform pelvic floor exercises (eg. when coughing, sneezing, lifting). Perform them regularly, especially during pregnancy, following childbirth and into menopause. In conjunction, strengthen deep abdominal muscles.
• Treat the cause of any chronic coughing or sneezing (ie. manage asthma, hay fever).
• Hold a firm abdomen while walking and standing as this maintains pelvic floor support.
• Maintain a healthy weight and avoid smoking.

For more information on incontinence, you can talk to:

• your local doctor
• your local sexual health clinic
• your local family planning clinic
• Women's Health Queensland Wide.

Related Content

Queensland Health Sexual Health information