I love Shaun Micalef. For all our international readers he has a hilarious show on the ABC called ‘Mad as Hell’. It’s a satirical look at politics in Australia- it’s sharp, cutting and makes me laugh out loud – which doesn’t happen very often unless I’m showing patients one of my prescriptions for recovery from chronic pain – funny cat and dog videos – after all sometimes laughter CAN be the best medicine.
So it struck me while I was watching Mad as Hell tonight that that’s how I felt every time I read an article – usually written by pad manufacturers- with the terminology ‘LBL’ – or light bladder leakage. Now the Continence Foundation of Australia has shared a great article on it’s Facebook page debunking this trivializing of a serious and very treatable condition called Stress Urinary Incontinence (SUI- the correct acronym for it).
Giving it a nice little acronym sort of de-medicalizes it….LBL….LOL….OMG….WTF!!! (excuse the French).
Now if the answer to a little bit of LBL is to pop on a micro-thin panty liner with magic material in it to hardly make you aware that it’s even on, or worse still that you may have leaked urine, well who needs to waste time seeking help/advice from your GP, local Continence and Women’s Health Physiotherapist or specialist Urogynaecologist if conservative strategies have not been successful.
Now the article previously mentioned above has nicely summarized the fact that conservative strategies are very successful at treating stress urinary incontinence, and urge incontinence for that matter, and you have read in many of my previous blogs about those treatment strategies. But what makes me ‘mad as hell’ is that urinary incontinence can be a red flag for other medical conditions- so if our message to the customer is LBL, no big deal, pop on a liner – then some more serious issues might be overlooked.
Urinary leakage can be a sign of:

• poor urethral closing pressure such as with sphincter insufficiency (often due to an atrophic uro-genital region post menopause helped by local oestrogen pessaries twice a week)
• a urinary tract infection (UTI)- it doesn’t have to be that you have blood, feel like you are passing razor blades or feel unwell to have a UTI- urinary urgency and leakage can be the only sign sometimes
• from over-distending your bladder (if perhaps following childbirth your bladder sustained an overstretching injury-say if you couldn’t void post delivery and it took a while to recognize that before a catheter was inserted to empty your bladder)
• diabetes- so if the woman leaking doesn’t seek assessment then the diagnosis of diabetes may be missed compromising the proper early treatment
• a fistula post vaginal delivery or gynae repair surgery
• urinary obstruction
• spina bifida occulta with tethering of the spinal nerves
• multiple schlerosis
• spinal cord neoplasms

Yes exactly!
Now most likely the cause of your incontinence is due to stress incontinence or urge incontinence- so don’t freak out.
But at the same time don’t just assume that you have no time to seek help for this condition; that you are too busy and it’s only LBL; and especially don’t just slip on a panty liner and get on with life. Talk to your GP; look up the APA Find a Physio directory for a Continence and Women’s Health Physio near you; ring the Continence Foundation of Australia Continence Helpline 1800 330066 and they will give you the name of a person trained to help you.
And of course reading my books will certainly give you plenty to go on with – if you have had surgery you need Book 1 Pelvic Floor Recovery: Physiotherapy for Gynaecological Repair Surgery and if you haven’t had any surgery, but have some early bladder signs (frequency and urgency); or you are leaking with exercises; or you are pregnant; or you have just had a baby; or anytime after that through your lifetime…it’s never too late!) then you need Book 2 Pelvic Floor Essentials.