There are many different types of urinary incontinence and being a good detective for your physiotherapist is important to sort out what is the best treatment that is required to solve your problem. Research tells us that between 60-80% of stress urinary incontinence problems can be improved with conservative measures. Urgency, frequency, urge incontinence and nocturia can also be significantly improved with conservative management such as pelvic health physiotherapy. The earlier you are aware that you have a small amount of bladder leakage, the more that can be done to prevent this from getting worse and perhaps requiring surgery in the future. Your physiotherapist will ask you to do a 2 day bladder diary after your first appointment and you will recive a specipan to make this easier to do.
Pelvic floor muscle training and learning the knack or bracing (tightening the pelvic floor muscles before increased intra-abdominal pressure due to cough, sneeze, lifting, pushing trolleys, getting in and out of bed, going from sit to stand and bending); understanding good bladder and bowel habits; learning the correct position for defaecation; and understanding the importance of pelvic floor friendly exercising will help treat urinary leakage and prevent it from worsening.
Pessaries of various forms such as the Contiform® pessary, a ring with knob, the Continence dish, Marland and even a CPOP (this is a prolapse pessary but has been showing results with light bladder leakage with both urge and stress incontinence) can all be helpful for incontinence. A pessary fitting is usually a month after the initial appointment when all the other strategies have been implemented by the patient. (The pessaries vary in price but start at $40 and range up to $80 on top of the pessary fitting price). All our physios fit pessaries. You need to make an hour and 15 minute appointment (dressed in a skirt or dress and joggers/walking shoes) so you can trial the different pessaries and find the one that does the best job of helping your leakage. You will be taught how to self manage the pessary (put it in and out).
Marland pessary Ring with knob
Continence dish Contiform