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Bev Killick for CFA

With World Continence Awareness Week (WCAW) looming on the horizon, I thought in this blog, I should set the scene with a brief overview of some quick things you can think about if you have urinary incontinence (for both women and men) and some of the first things to try to improve your continence state. But first a bit of introduction into this year’s WCAW. The Continence Foundation of Australia (CFA) are continuing this year with their theme of using humour to spread the message about treating incontinence.

This idea of using humour was first disseminated on a public forum by Elaine Miller, a Scottish Women’s Health Physio, who has performed for many years at the Edinburgh Fringe Festival and has made huge headway into getting incontinence into mainstream media and even into Parliament in Great Britain!

Elaine Miller

CFA have their own comedian, Bev Killick (tasked with the same job), who has recorded quite a few 15 second video grabs that are streaming on social media with the message of ‘doing regular pelvic floor exercises over your lifetime in order to treat any urinary incontinence’ needs to be a learned behaviour. But there is more to treatment of urinary incontinence than simply doing pelvic floor exercises.

Let’s look at some quick things to try in readiness for improving (and let’s hope for a cure for) your urinary incontinence.

Screening for a Urinary Tract Infection (UTI) should be a first step and this involves a trip to the GP for a request for a microurine (and the doctor can often get you to provide a midstream sample there and then and have it sent off). Many times increased urinary urgency and urge incontinence can be worsened if there is an infection. It also helps to check for the clarity of the urine (cloudy urine can signal infection) and colour (it should be pale yellow- the more concentrated the urine the more irritating for the bladder). If your urine is clear, a nice pale yellow, there is no odour and no stinging when you void or blood in your urine, then it is unlikely there is infection. 

Performing a 48 hour bladder diary to see what you can hold in your bladder is also important detective work to undertake with measured volumes preferably being between 350-500mls for the adult bladder. When we see our patients at Sue Croft Physiotherapy, we give everyone a container (which I call a witch’s hat but is technically called a speciman collector) to make measuring each urine void easier and since doing this many years ago I can honestly say we have about 95% return rate on the completed diary.

This bladder diary gives us an amazing amount of information – the capacity of the bladder; the degree of urge with each void (from nothing to busting); the spacing of the voids throughout the day; the number of urinary leaks and at what volume of the bladder; the number of voids at night and the amount of fluid voided through the day versus the night; the balance of your fluid input versus your fluid output; the types of fluid that you are drinking; the total volume of your intake; the times you are drinking etc.

Getting an ultrasound to see if you empty your bladder fully with voiding. Many times women believe they have urinary frequency when in fact they are not completely emptying their bladder fully which is why they have frequency. If you have a large residuals this can also lead onto recurrent urinary tract infections.

As we work through the weeks to WCAW, we will look at the different types of incontinence and some of the strategies you can employ to improve and ultimately cure urinary incontinence. If you have urinary incontinence, it can change how you feel about so many things: you can stop exercising; you can feel a whole range of emotions: shame, anxiety, sadness, depression; you stop socialising; you over-think about outings in general because you may be unsure about the location of the next toilet (did you know there is such a thing as a Toilet Map which actually locates where toilets are located?)

If you are suffering in silence with urinary incontinence, now is the time to seek help. The strategies we teach you are simple and easier than you think to implement and let’s face it – most pelvic health physios get into doing this work because of their own birthing experience and are actually living the dream of #pelvicfloordysfunction so they are empathetic, understanding and kind.

If you want to make a headstart on things prior to making an appointment with a pelvic health physio these things are comprehensively covered in my two books Pelvic Floor Essentials (if you haven’t had or not intending to have surgery) and Pelvic Floor Recovery: Physiotherapy for Gynaecological and Colorectal Repair Surgery (the surgical book). You can check them out on my book website.