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Today I attempted my first video blog. I now have new respect for reporters, for actors and for Obama. Talking ad-lib to a camera without an autocue and to get it right the first…fifth……seventeenth time – is not an easy thing to do. So I thought I would write a blog on the Overactive Bladder to back up the video on Youtube.
Incontinence is a big deal in Australia. I have written previously of the prevalence (in 2011 4.8million Australians over the age of 15 suffer urinary and faecal incontinence 1) and cost ($42 billion per year 1) to Australia. The amazing thing is that it is very treatable…and it’s NOT rocket science.
Here are three simple ways I believe we can decrease the cost and decrease the prevalence and therefore the burden to Australia.
1. DISPEL THE MYTHS
Our mothers can be responsible for many myths and beliefs surrounding the bladder which are wrong!
Belief 1: Just in Case voids: Always go before you leave the house, when you arrive at the doctor’s surgery, before the movies. Wrong! Teach your adult bladder to hold to 350-500 mls. Go with a bouncy full bladder not that first urethral sensation. Check out what yours is by doing a simple bladder diary. Measure your wees out and drinks in, recording the time and types of fluids you drink.
Belief 2: You’ll get kidney stones if you hold onto urine. Wrong! The bladder is designed to store urine and if you drink 2 litres of fluid you should be able to hold 350-500 mls of urine before needing to go. This means you should be able to go roughly 3-4 hours between wees depending on what you drink(watch that caffeine.
Belief 3: Never sit on a public toilet, always hover or perch or you’ll catch germs. Wrong! You are more likely to get a urinary tract infection from not emptying your bladder properly when you hover than from the toilet seat. Always sit with good posture (see below) and relax your tummy and pelvic floor prior to voiding.

© Sue Croft Physiotherapist 2012

© Sue Croft Physiotherapist 2012

2. TEACH BLADDER RETRAINING UTILISING URGE CONTROL STRATEGIES
 Bladder retraining is the technique used to try to increase the capacity and decrease the sensitivity of the bladder. By teaching your bladder how to store more urine without leaking or giving uncomfortable spasms you will have more time between voids (wees) and more freedom to go out without constantly seeking the nearest toilet. Bladder retraining is safe, inexpensive and side-effect free!
Urge control strategies assist with this bladder retraining: –

  • Perineal or clitoral pressure hand pressure over the perineum, clitoris or urethra.
    • Sitting on the edge of a chair or table.
    • Sitting on a rolled up towel when in the car on a long trip.
    • Sitting on the edge of bed prior to getting out of bed in the morning.
  • Crossing your thighs in standing or sitting.
  • Buttock tightening and toe curling.
  • A gentle pelvic floor muscle hold or low tummy draw-in.

3. BREAK THE ADDICTION TO CAFFEINE
Caffeine is addictive, it irritates the bladder and in large quantities is a diuretic. It increases anxiety, increases heart palpitations and affects your sleep. Yes it tastes nice and can give you a kick-start in the morning but really if you ask for a (naturally) decaffeinated coffee/tea any bladder symptoms you have plus your poor sleep, anxiety and heart flutters should improve. Go on give it a go! But come down slowly or you may get a withdrawal headache.
1. Deloitte Access Economics report 2011