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MSK Health
Brighton & Hove and West Sussex
Brighton & Hove and West Sussex
Many bladder problems are caused by weak or overstretched pelvic floor muscles. In addition, lifestyle and other factors in our environment have a role to play. Up to a third of all women experience a problem with their pelvic floor muscles during their lifetime.
The most common types of bladder problem are:
Stress urinary incontinence (SUI) is the leakage of urine on activity and is the most common type of leakage. During coughing, sneezing, laughing, changing position, or exercise, your diaphragm (directly under your lungs) moves downwards. This increases the pressure in your abdomen, which in turn presses down on the bladder. This can force the bladder to leak urine. The pelvic floor muscles help to counteract this pressure. If the pelvic floor muscles are weak then they are unable to do this and leakage happens.
Urgency is the sudden urgent desire to go to the toilet immediately. If you leak on the way to the toilet, this is called urinary urge incontinence.
Having these symptoms with a very full bladder is normal. You will have experienced your bladder signalling that it was getting fuller and fuller, and have put off going to the toilet. But having these symptoms with just a small amount of urine in your bladder is abnormal and can be treated.
Normally, adult women can comfortably hold 300-400ml in their bladder. The first signal from the bladder is normally sensed at approximately 150-200ml. If you are anxious or stressed, this sensation is heightened and can become an urgent “need to go” feeling. This causes us to pass urine, usually before the bladder is actually full.
Sometimes triggers, such as the sound of running water, cold weather, or putting a key in the front door, can cause the bladder to involuntarily contract, resulting in leakage before reaching the toilet. A vicious cycle may then develop. You go more often because of urgency and the worry about leaking. Over time, the bladder gets used to storing only small amounts of urine and is not stretching to its normal capacity. As your bladder is now used to the smaller capacity, you experience the first signal at smaller and smaller volumes, making you go to the toilet more frequently.
Faecal incontinence is the leakage of gas, solid or liquid from the back passage. Leakage can range from a smearing of underwear to the loss of a full bowel motion. Faecal urge incontinence happens when you are not able to get to a toilet quickly enough. Passive faecal incontinence is when you are unaware of any leakage. The most common causes of faecal incontinence are weak muscles, making it difficult to hold on, or having loose stools that are difficult to hold on to.
It may be useful to discuss medication with your GP or Pharmacist. There are several types of medications which act in different ways to help relieve bowel symptoms.
Specific devices are available which are designed to help you feel more confident with your bowel management. Containment products such as anal plugs/inserts can reduce the risk of faecal leakage and are sometimes the best option with severe ongoing leakage problems. Your physiotherapist will discuss this with you further if needed.