Understanding Urinary Incontinence

From leaks to laughter – understanding Urinary Incontinence

By By Winnie Wu, Pelvic Health Physiotherapist and Director of Papaya Clinic & Movement Laboratory

Winnie Wu, Pelvic Health Physiotherapist image courtesy of Papaya Clinic

Bringing a new life into the world is an incredible experience, but it also brings unique challenges. As a pelvic health physiotherapist and Founder of Papaya Clinic, a multidisciplinary women’s health clinic in Sydney, I see the effects of motherhood every day with our patients. One of the most prominent challenges is urinary incontinence, a common yet often misunderstood or undermanaged condition that many new mums face.

Let’s explore what urinary incontinence is, the different types, common myths, and how you can manage symptoms while navigating motherhood.

PREVENTION OVER CURE

Urinary incontinence is surprisingly common, affecting up to 50% of pregnant women and about one-third of new mums even a year after giving birth. Only 14.8% of pregnant women seek professional help (Wang et al, 2022). Early intervention and preventive care can make a significant difference. Women who perform pelvic floor exercises during and after pregnancy can reduce their risk of incontinence by up to 50%. (Woodley et al, 2017)

WHAT IS URINARY INCONTINENCE?

Urinary incontinence is the involuntary leakage of urine, where the body is unable to generate the pressure to close the urethra when needed. There are multiple types of UI, the most common ones we see in clinics are the three below.

1. Stress Urinary Incontinence (SUI): This happens when you leak urine during activities that put pressure on your bladder, like coughing, laughing, sneezing, or exercising.

2. Urge Incontinence: this happens when there’s a sudden, strong urge to pee, followed by involuntary leakage. Normally associated with a high frequency of pees, and can happen even if your bladder isn’t full. Also known as overactive bladder.

3. Mixed Incontinence: This means that you experience symptoms of both.

Pelvic floor anatomy demonstration, image courtesy of Papaya Clinic

COMMON MYTHS ABOUT URINARY INCONTINENCE

❓ Myth 1: It Will Get Better on Its Own

Many women believe that urinary incontinence will resolve itself over time. While some may experience improvement, many need specific interventions like pelvic floor exercises or pessary use for significant and lasting relief.

❓ Myth 2: My Pelvic Floor is Fine if I Had a C-Section

Weight contributes to incontinence. Connective tissues are softer and more stretched than usual during pregnancy and postpartum phases. Nine months of childbearing puts significant loading on the pelvic floor and surrounding tissues, which can lead to pelvic organ prolapse and incontinence is a symptom of prolapse.

❓ Myth 3: It’s only for older women

Urinary incontinence can affect women of all ages, especially during and after pregnancy. It’s not just an issue for the elderly. Some women are more prone to it, and that is because of their sporting background and lifestyle, not due to age.

❓ Myth 4: There’s Nothing You Can Do About It

This is perhaps the most harmful myth. There are many effective treatments available, including pelvic floor exercises, lifestyle modifications, and pelvic health physiotherapy.

Interior of Papaya Clinic, image courtesy of Papaya Clinic

WHAT CAN YOU DO TO MANAGE SYMPTOMS?

🌟 Pelvic Floor Muscle Training aka Kegels

Pelvic floor muscle training is one of the most effective ways to manage urinary incontinence. Supervised Kegels after an individualised pelvic floor assessment results in significant improvement for those with leakage. We recommend a minimum of three months (NICE 2019) of Kegels to see significant improvement.

🌟 Lifestyle Changes

Simple changes in your daily routine can help manage urinary incontinence:

Fluid Management: Keep an eye on what and how much you drink. Try to limit caffeine and alcohol, which can irritate your bladder.
Weight Management: Keeping a healthy weight can reduce the pressure on your bladder and pelvic floor muscles.
Exercise Modifications: If you notice leakage during exercise, a pelvic floor physiotherapist can help you adjust your workout to be kinder to your bladder.

Woman stretching, image courtesy of Jonathan Borba, Pexels.com

YES… THIS IS ME. WHAT’S NEXT?

If urinary incontinence is bothering you or not improving, it’s time to visit a pelvic floor physiotherapist. A vaginal internal assessment is often performed to examine your pelvic floor baseline pre and postpartum. A thorough assessment can give a comprehensive treatment plan. If you’re in Sydney, Papaya Clinic is a multidisciplinary clinic that can help improve your symptoms and more.

To learn more about managing urinary incontinence and improving your pelvic health, check out the following resources:

References

NICE Guidelines (2019). Urinary incontinence and pelvic organ prolapse in women: management. Retrieved from NICE guideline NG123
Woodley, S. J., et al. (2017). Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews.
Australian Commission on Safety and Quality in Health Care. (2017). Stress Urinary Incontinence Guide

Want more? Papaya Clinic are hosting a Japanese Yoga and Transformational Breathwork session on 31 August to help women release stress, realign, and connect. Find out more here.

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Understanding Urinary Incontinence