“I’m not incontinent, I just leak a bit”
Approximately 3.5 million Canadians experience incontinence and not NEARLY enough people talk about.
It is a word that can create many emotions for many different people but it's not something to shy away from or ignore. Though it occurs more often as people get older, urinary incontinence isn't an inevitable consequence of aging. In fact, as many as 50% of the population will experience incontinence at some point in their life. It's not unique to women. It's not unique to women who've had children. And in fact, men and women throughout the world, suffer from incontinence.
Types of incontinence
1. Stress incontinence – also called stress urinary incontinence This is not caused by emotional stress or being nervous. This is when any form of stress on the human body causes a leak of urine or fecal matter. So this can be a cough, a laugh, a sneeze or run a jump. For some people it's simply sitting to stand, or walking upstairs. We see this a lot in pregnancy. And in fact, as many as 85% of women in the later stages of pregnancy will experience it. That doesn't mean they should put up with it.
2. Urgency urinary incontinence – also called urge incontinence or overactive bladder This type is the loss of larger amounts of urine with little or no warning. This is often caused by infections, bladder irritants, or brain diseases such as Alzheimer’s or stroke. It is the overwhelming need to go to the bathroom with little to no warning. It can lead to leaks or simply frequency. So sometimes incontinence isn't itself isn't the leak itself, it's the need to go to the bathroom on a regular basis.
3. Passive incontinence – this is a frequent dribble of small amounts of urine and the inability to completely empty the bladder. This is often a complication of diabetes and is more common in men due to prostate problems.
4. Mixed incontinence – this is a combination of the above types It is mostly a combination of stress and urgency urinary incontinence.
Research has suggested that the number one treatment for incontinence is pelvic health physiotherapy. It should involve a pelvic exam to assess the pelvic floor muscles then following through with an individualized exercise program. Also as a pelvic floor physiotherapist, we would assess the hips, lower back, core, and any other injuries or medical conditions that might be presenting.
This should be done before going on medication, before having surgery, or before even being seen by a surgeon. The surgery itself (supportive slings for the bladder or urethra) will still require post operative care involving learning how to control the muscles around the pelvic floor and parts of your core. And in many cases, the wait time to see a Urogynecologist is upwards of six to eight months. More importantly, in that time, a patient could be seen by a physiotherapist and enjoy significant improvement and quite possibly complete resolution of their symptoms that could mean surgery not having to be necessary.
I myself have suffered from incontinence. It's not fun. It's embarrassing. It limits your ability to live your life. Even though a great resource to prevent people from feeling embarrassed are pads (Tena , Depends , Always ), if you were using them on a daily basis, changing them two to three times per day, you're probably spending somewhere in the region of $1000-$1400 dollars per year on those pads. I would highly recommend you consider investing that money in Pelvic Health physiotherapy. Go to Pelvic Health Solutions and look up someone locally in Canada, Pelvic Guru , which has international listings and find someone local to you, who can help you on your road to recovery.
I think it's sad that we're living in 2020 and countries like France and the UK are so much further ahead of us in their approach to the treatment of incontinence. Do I think it should be fully funded? Absolutely. Is it going to happen anytime soon? Absolutely not. So unfortunately, it is our responsibility to make treatment decisions. I understand that for many of us to make those financial decisions, it’s hard, but this is your health you're talking about. And if you are someone in their 30s or 40s suffering from incontinence, always wearing black pants, never jumping on the trampoline, not running, not participating in all the things their friends are participating in for the fear of having an accident, or worse living with the potential of getting worse…you really need to stop and think. The choice is yours. You have all the power to make change in your life.
Although having incontinence doesn't limit the length of your life, it limits the quality of life you live. There are options out there. And there are excellent physiotherapists available to help you.
Before you end up taking medication or having surgery, please reach out to us❤️
Nicola Robertson
Registered Physiotherapist
Reference:
https://www.evidentlycochrane.net/incontinenceisntfunny/
https://www.healthinaging.org/blog/its-not-normal-urinary-incontinence/