Urinary incontinence

How does a normal bladder work?

According to the Continence Foundation of Australia, a normal bladder:

• can hold up to 600 ml of wee
• empties four to six times each day (every three to four hours) and up to once each night
• empties completely when you wee
• gives you enough time to get to the toilet
• doesn’t leak wee.

Types of urinary incontinence

There are different types of urinary incontinence, including:

• urge incontinence – you have a strong urgency to wee and can’t hold on long enough to get to the toilet, or you wee a lot during the night
• stress incontinence – wee leaks when you sneeze, cough, laugh or jump
  
• mixed incontinence – you experience urge and stress incontinence symptoms
• overflow incontinence – the bladder doesn’t empty properly and becomes overfull, causing it to leak.

Causes

The pelvic floor muscles (muscles that support the bladder, bowel and uterus) can stretch and weaken, leading to continence issues.

Incontinence can also happen when pelvic floor muscles are too tight (overactive).

Urinary incontinence can be caused by:

• pregnancy and childbirth
• prolapse
• constipation or regularly straining when going to the toilet
• repetitive lifting of heavy weights – at the gym, at work, in the garden or even when lifting children
• being overweight or obese
• coughing caused by smoking and chronic lung disease
• chronic sneezing (e.g. due to hay fever).

Urinary incontinence is also associated with:

• changes around the time of menopause (e.g. the pelvic floor becomes weaker and the bladder less elastic)
• diabetes
• pelvic or abdominal surgery
• certain medicines, such as fluid tablets (diuretics).

Diagnosis

If you have symptoms of urinary incontinence, it’s important to talk to your doctor or continence nurse specialist.

They will ask about your medical history and symptoms, including:

• how often you go to the toilet
• how often you have wee leakage
• how much wee leaks
• when the wee leaks
• whether there is a burning sensation when you wee
• whether your bladder feels empty after weeing
• how often you wee during the day and at night
• how much fluid you drink.

They may test a urine sample for a urinary tract infection (UTI) or refer you to a specialist to do a pelvic floor muscle assessment.

Prevention and management

There are many ways to prevent and manage urinary incontinence. For example:

• eat a balanced diet
• do regular physical activity and maintain a healthy weight
• do regular pelvic floor muscle exercises using the right techniques
• practise good toilet habits, such as only weeing when you need to, not ‘just in case’
• talk to your doctor about hormone treatment.

Visit the Continence Foundation of Australia website to learn more about Continence Foundation of Australia website to learn more about managing urinary incontinence.