Living with Urinary Incontinence
“Soon, you will walk with confidence”, the therapist said to Manisha. A housewife, and a mother of two, Manisha has lately been suffering from an overall bodily weakness. Apart from this, she has been terribly upset and insecure as she is not able to control her urge to urinate. The occasional leaking of urine when sneezing or coughing to the strong, uncontrollable urge that has her racing to the toilet, has left her feeling very embarrassed.
Manisha’s condition, urinary incontinence, caused by underlying physical problems or changes, is a form of muscular dysfunction affecting half more women than men worldwide. There are several types of this condition affecting people to varying degrees. These include temporary, persistent, stress, urge, overflow, and functional urinary incontinence. Common precipitating factors for this condition include pregnancy, childbirth, changes with age, menopause, hysterectomy, frequent urinary tract infections, enlarged prostate, obstruction of the bladder and neurological disorders.
While it is true that urinary incontinence isn’t always preventable. Yet, one can decrease their risk of developing the condition and prevent it from worsening.
- Maintain optimal hygienic condition of the pelvic area.Maintain a healthy optimal weight according to your height. This will ensure that the pressure stays off your pelvic floor.
- Practice pelvic floor exercises along with other exercises and especially after child birth.
- Do not hold the urine pressure unnecessarily. That is not an exercise! Neither try and cease the flow while urinating. It confuses the brain’s functioning. Always practice pelvic floor exercises with an empty bladder.
- Focused breathing techniques/concentrated breathing exercises helps in stress management which in turn helps in lowering the intra-abdominal pressure, thus, no abnormal build-up of pressure on pelvic floor muscles.
- Try and avoid bladder irritants like caffeine, alcohol and acidic foods.
- Include more fibrous foods in your daily diet to prevent constipation, a cause of urinary incontinence.
- Don’t smoke, or seek help to quit smoking.
A safe and non-invasive way of treatment, physiotherapy is the first line of treatment for uro-gynecological conditions like urinary incontinence. After reviewing you thoroughly, your physiotherapist teaches you how to get started with pelvic floor exercises.
Prescribed ways of strengthening the pelvic floor muscles include Kegels, electrical stimulation therapy, and bowel movement re-training. However, Kegels remain the most common form of treatment, and its efficacy is significant. But it’s also important to learn to use the “right” muscles to be exercised.
Here’s how to do Kegels the correct way:
Identify the right muscles:
Mid-stream control Test: If you are able to stop urination in midstream, you have succeeded in finding the right muscles. It’s advised to not to repeat this test for more than once in 6 months. It takes time for these muscles to develop on strength.
After you have located your pelvic floor muscles, performing Kegels is easy and can be done in any position. The easiest way to do them is by lying down at first. Make sure you are relaxed and not using other muscles while performing Kegels.
Master the technique: Tighten your pelvic floor muscles, hold the contraction for up to the count of five, and then relax for five seconds. Repeat this process four or five times in a row. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions.
Consistent practice and focus for best results: Tightening only your pelvic floor muscles is critical for best results. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises.
Perform Kegels up to three times a day: Aim to do at least three sets of 10 repetitions a day.
Realize that this problem is common, get the confidence to approach a doctor/physio, and work on it consistently to get an increased control over it.