Physiotherapy for Stress Urinary Incontinence

What Is Stress Urinary Incontinence?

Stress urinary incontinence is the uncontrollable loss of urine when you cough, sneeze or laugh. Any activity that results in an increase in pressure in the abdominal cavity may contribute to stress urinary incontinence. This happens when pelvic floor muscles have been weakened and the bladder has slipped lower. Stress urinary incontinence is a common medical condition and is treatable. Physiotherapy may be tried first, failing which surgery may be necessary.

What Are The Causes:

The commonest cause of stress urinary incontinence is due to hypermobility of the bladder neck and the proximal urethra, which result in the failure of transmission of the increased intra-abdominal pressure to the proximal urethra, preventing maintenance of closure of the urethra. Intrinsic sphincter deficiency - where a scarred, chronically open urethra is present, can also cause stress urinary incontinence.

Common Precipitating Factors Are:

Pregnancy and vaginal delivery
Repeated lifting of heavy objects
Prolonged coughing
Obesity
Repeated straining during urination or bowel movement
Menopause

What Do I Need To Do To Prevent Worsening Of Stress Urinary Incontinence?

Do:

Keep body weight within healthy limits. By doing so, the weight of the abdominal contents pressing against the pelvic floor is lessened and prevents the pelvic floor from weakening further.
Eat a diet rich in fibre and drink between 1.5 - 2 oz of fluids per day.
Seek early treatment for prolonged cough, and stop smoking preferably.
Tighten up your pelvic floor before lifting heavy objects, changing positions, coughing or sneezing - this can be taught by our hospital physiotherapists.
Pelvic floor exercises especially during and after deliveries.

Don't:

Lift heavy objects repeatedly.
Strain when moving your bowels.

Physiotherapy For Stress Urinary Incontinence

It includes the following :

Pelvic Floor Exercises are prescribed to strengthen the pelvic floor muscles and may involve the use of vaginal cones and biofeedback.
Electrical Stimulation Therapy makes use of electrical currents to strengthen pelvic floor muscles. It may be recommended if pelvic floor exercises have reduced effect.
Bowel Movement Retraining teaches passing motion without straining the pelvic floor muscles.

The physiotherapist will review you on a monthly interval or less, to monitor progress. You will be prescribed a home exercise program of pelvic floor exercises. You can stop treatment after you have achieved optimal results as determined by your physiotherapist.

Your physiotherapist will assess your condition through an assessment and a physical examination.

The physiotherapist will interview and ask you questions related to your urinary leakage problem. This is to determine the severity of the condition and your perception of it. After that, the physiotherapist will do a physical examination to measure the strength of your pelvic floor muscles.

Based on the findings, your physiotherapist will tailor therapy that best suits your needs.

Rehabilitation Department

The Rehabilitation Department offers a wide range of therapy services for both women and children. Our team of dedicated activity therapist, occupational therapists, physiotherapists and speech language therapists strive to deliver high quality specialised services to all patients.

Physiotherapy

Physiotherapy is the first line of treatment for some urogynaecological conditions like urinary and pelvic organ prolapses. Physiotherapy treatment is safe and non-invasive and it can be an option before surgery is considered. Patients are often referred to the physiotherapist by the gynaecologist or urogynaecologist.