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As a company, we (Win Health) manufacture incontinence protection products and supply medical devices that can help men and women suffering with pelvic floor related problems urinary problems. We promote self awareness and basic knowledge about incontinence and what can be done to prevent it and what to do after it develops. Self help guides and educational aids by renowned authors, such as Professor Pauline Chiarelli and Professor Grace Dorey form an important part of our Pelvic Floor Health portfolio.

We often talk to people of both genders and spectrum of ages that are absolutely desperate to reverse their pelvic floor related problems, such as incontinence and prolapse in women and erectile dysfunction and post micturition problems in men. People are often traumatized by their experiences and find life after the onset of symptoms miserable and difficult. Frequently, the sufferers have little initial understanding of the roots of their problems and are not able to cope well with day to day situations. Feeling of emotional isolation from family and friends is common. Daily lives are disturbed and a greater social isolation often follows.

It is obvious that incontinence is ruining lives, despite that much can be done to correct it.

There is abundance of information about incontinence and how to get help. Health centres, book shops and the internet all have valuable and useful resources. Most people will find that easy to follow self help guides written by healthcare professionals offer sound advice and effective practical solutions that help with daily life. Importantly, such self help guides also advise, when it is appropriate to consult a doctor for professional help.

As with other health related problems, taking early action and being in charge is always the best option and gives the highest rate of success. Delays will only make matters worse!

If you have incontinence problem, you should know that it is never too late to do something positive about it!

Incontinence is common and you can rest assured that you are not alone. Incontinence is often the main reason for admission to care and permanent loss of independence at the later age. Although incontinence is more common in older people, it should never be perceived to be just age related inevitability.

Incontinence affects both men and women, but it is more common in women and can strike at any age. For many women, incontinence starts at the time of first pregnancy and, if not immediately addressed, it worsens with time.

Women and incontinence

If you are a woman, you have at least one chance in three to develop a problem with your waterworks at some point in your life. Misery, sadness and loneliness define the lives of many thousands of women, who share a common secret of wetting themselves. And because a stigma is attached to incontinence, silence and denial flourish. Many choose not to seek help for the fear of humiliation.

Day after day, the silent sufferers try to exist with their awkward problem. When they sneeze or cough, bend or lift, walk, run, jump or exercise, the urine leaks.

Most of us are familiar with the ‘crossed legs syndrome’. Even if it does not apply to us personally just yet, invariably we know someone, to whom it does!

Stress incontinence is the most frequently seen type of urinary incontinence in women. Stress incontinence is a urine leakage experienced on straining.

Stress incontinence is defined as an involuntary loss of urine. Experts believe that there are as many as 4 million women affected by stress incontinence in the UK.

Stress incontinence is not the only type of urinary incontinence women endure. Stress incontinence is just the initial stage of urinary incontinence. Stress incontinence is important as, if not managed and cured, it can escalate and give a platform for other more severe urinary problems to develop.

The other types of urinary incontinence are urge incontinence, frequency and mixed incontinence.

I describe them briefly here:

Urge incontinence is a sudden strong need to pass urine without any delay. Definition says that urge incontinence is an intense urge to urinate followed by almost immediate discharge of urine from the bladder. You must urinate virtually immediately or you will wet your pants. The gap between the feeling of the urge to pass urine and the actual urination taking place is often not sufficiently long to get you to the toilet on time. Urge incontinence can even make you wet yourself during sleep.

Frequency is simply a frequent need to empty the bladder. It is characterized by very short gaps between visits to the toilet. If you have frequency, you will know all the toilets on your route to the shops and you would frequent them regularly without a doubt. You will become a perpetual ‘toilet hopper’.

Many women experience mixed incontinence, which has elements of stress, urge and frequency symptoms presenting together.

There are a number of reasons that can cause a woman to lose control of her waterworks. However, most often, the loss of urinary control is linked to the problem of having a weak pelvic floor.

Stress incontinence develops, when pelvic floor that supports the bladder and other pelvic organs is compromised by events, such as pregnancy, childbirth and hormonal decline at the time of menopause. Additionally, pelvic floor weakness can be exacerbated by common ailments, like chronic cough, long term constipation and excessive weight. Natural aging and lack of exercise cause the muscles in our bodies to weaken. Equally, pelvic floor muscles weaken with age and when not exercised.

Pelvic floor consists of muscles that run like a hammock from the tip of the tailbone at the back of the body to the pubic bone at the front of the body. Pelvic floor supports the bladder and urethra as well as other pelvic organs. Pelvic floor also helps to keep the bladder shaped well and correctly positioned for optimum functionality.

Hence, it is easy to see that losing control over your waterworks is most likely caused by your pelvic floor losing its tone and strength and ceasing to support your bladder and urethra as well as all other pelvic organs effectively.

Urine collects in the bladder and is contained in it by the naturally tightening pelvic floor muscles. When you want to urinate, your brain has to give permission for the bladder to empty. The bladder muscle contracts, whilst pelvic floor and urethral sphincter relax. The urine is pushed out from the bladder through the open urethra.

You can visualize voluntary passing of urine in the following steps:

1. the bladder is full of urine and you make a conscious decision to void it

2. your pelvic floor muscles and urethral sphincter relax

3. the bladder muscle contracts and pushes the urine out through the urethra

4. your pelvic floor muscles and urethral sphincter tighten, closing the urethra

5. voluntary passing of urine is completed

You can see clearly, how crucial your pelvic floor is for the mechanism of voluntary urine voiding to work. It is important to appreciate that pelvic floor muscles must be strong and fit to keep the urine contained in the bladder and to control urine voiding by enabling it only, when conscious decision to urinate is made. When pelvic floor weakens, it becomes inefficient and unable to function correctly. Weak pelvic floor cannot always keep the urine in the bladder and cannot prevent involuntary leaks of urine from happening in certain circumstances.

You can see from the steps of voluntary urination described above that the urethral sphincter muscle holds the urethra closed between voluntary voiding. Urethral sphincter is like a string in a drawstring purse – it tightens to close the urethra and it relaxes to open it. Good functionality of urethral sphincter is closely dependent on well functioning pelvic floor. Healthy sphincter and strong pelvic floor tighten automatically by reflex, just a split second before straining, such as laughing or sneezing. The tightening reflex also acts as a feedback mechanism that stops the bladder from contracting and from forcing the urine out.

When the pelvic floor and the sphincter are weak, the sphincter cannot stop the urine from escaping, because the urethra is not held shut. Weak pelvic floor muscles do not tighten sufficiently. And additionally, because the weak pelvic floor muscles do not support the bladder well enough in its optimum position, the bladder shifts slightly downwards towards. Misplaced bladder exacerbates the weakness of the pelvic floor further.

Weak pelvic floor is most apparent during events that cause abdominal straining, such as coughing, sneezing, lifting or running. Straining increases pressure in the abdominal cavity and places greater stress on pelvic floor muscles. Weak pelvic floor fails to tighten under increased stress, whilst compromised sphincter mechanism does not close the urethra. The bladder contracts and pushes the urine out through the open urethra. Involuntarily loss of urine – stress incontinence – occurs and repeats time after time again, when similar circumstances arise.

Stress incontinence is a debilitating and unpleasant condition. It embarrasses and depresses the women sufferers. It contributes to depression, loss of confidence and low self esteem. It often destroys relationships and robs the sufferers of normal life.

Stress incontinence - a silent problem

Stress incontinence is a common complaint; yet, many women suffer in silence for years. Problems with waterworks can be far too embarrassing to admit. In the minds of many, urine leakage signals humiliation and decline.

Have you ever asked yourself, how would stress incontinence make you feel? What would you do, if faced with stress incontinence?

My advice to all women is as follows:

It is important to remember that help is available. Many women can become continent again, if appropriate action is taken and relevant recommendations are followed. Often simple self help measures are sufficient to see improvements and better pelvic floor health. Equally – preventive approaches can ensure that incontinence does not arise at all.

Onset of stress incontinence is usually gradual, but if you do not act immediately, simple stress incontinence may progress further and you may find yourself experiencing not only stress incontinence, but also urgency, frequency or a frightening mixture of all possible urinary symptoms.

Professionals, such as continence advisors, continence physiotherapists, obstetricians, midwives, urologists, GPs and nurses play important roles in the management and prevention of incontinence. Medical professionals can offer you their guidance at times of increased pelvic floor vulnerability, such as during pregnancy and childbirth or at the menopause. They can also investigate your problems in depth and to exclude or address other underlying problems.

Continence physiotherapists can carry out assessment of your pelvic floor and suggest the best ways of pelvic floor rehabilitation. Pelvic floor exercises using pelvic floor exercisers with biofeedback to monitor your progress or neuromuscular stimulators delivering effortless pelvic floor training may be recommended.

You should also appreciate that for majority of women experiencing stress incontinence simple self help measures and small lifestyle modifications may suffice.

I am not a trained expert on incontinence and I can only speak as a woman with common sense and good self awareness. I stay abreast of potential problems by taking active interest in matters that may one day take hold of my life. Staying in control is not as complex or impossible as many women imagine. Staying in control is about seeking information and acting upon it before it is too late!

You can help yourself by raising your self awareness of your body, its functions, what can go wrong and how to prevent problems from happening. In this instance, you should take steps to improve your pelvic floor and once improved, you should be disciplined enough to maintain its good condition. Your abilities to control your waterworks depend on your abilities to operate your pelvic floor muscles.

It is important to remember that pelvic floor muscles are like other muscles in our bodies – they respond to exercise and you can train or re-train them! Pelvic floor exercises will make your pelvic floor stronger and healthier, preventing incontinence and other pelvic floor related problems (i.e. genital prolapse) and give you an extra bonus of improved sexual responsiveness.

As a woman you have a duty to yourself to look after your pelvic floor and perform your pelvic floor exercises routinely and regularly. Your age is immaterial - you should perform regular pelvic floor workouts at any age! Sticking to a pelvic floor routine will pay long term dividends – keeping you continent and sexually responsive for life. For most of us, effective pelvic floor exercises need not to take more than 10 minutes per day!

Learning how to perform pelvic floor exercises is not difficult. It needs only a little understanding of your body and perhaps a little guidance. Importantly, you will need discipline and commitment to stick to a regular long term regime after you have learned to perform your pelvic floor work out. Good pelvic floor self help guides are often sufficient to guide you. Nurses, midwives or physiotherapists can also provide guidance and practical advice.

Popular pelvic floor guides, such as ‘Womens Waterworks – Curing Incontinence’ by Dr Pauline Chiarelli or ‘Pelvic Floor Exercises for Women’ by Dr Grace Dorey are readily available. They give easy to follow step by step guidance on performing pelvic floor work out. Chiarelli’s Womens Waterworks also provides a wealth of useful information about incontinence and how to prevent it or reduce it by simple lifestyle measures.

Upon noticing the symptoms of stress incontinence, stay positive and endeavour to take control of your problem. Your waterworks can be influenced, but you must take action! If you are desperate and need immediate relief from stress incontinence, perhaps you should consider the IncoStress that controls stress incontinence immediately.

Important point to remember – prevention is always better than cure, so take charge of your waterworks today!

Hope you have enjoyed reading this blog. Your comments are most welcome! Your contribution may help fellow women!

Labels: pelvic floor, prolapse, stress incontinence, womens waterworks