Bladder Health

What causes urinary incontinence?

There are many reasons for unwanted leaking of urine from the bladder. It can happen to people of all ages and is not a normal part of ageing. Each person needs a thorough assessment to find the cause, so it can be managed effectively. Reasons can include:

• bladder control not fully learned yet in children

• hormonal changes in women (e.g. pregnancy, post-pregnancy, menopause)

• loss of muscle tone in the pelvic floor muscles

• pressure on the bladder

• problems with walking and movement

• enlarged prostate

• medicines

• spinal injuries

• stroke

• dementia

• multiple sclerosis

• diabetes

• Parkinson’s disease

• surgery

What you can do?

1. Complete a bladder diary for a week. This information could help you recognise when and where you need to go to the toilet, and when accidents are likely.
   
   
2. Look for solutions in the tips for managing common bladder problems.
   
   
3. Talk to your doctor. You may need referral to another health professional.
   
   
4. Follow the advice about specific strategies for managing urinary incontinence (e.g. bladder training or pelvic floor exercises).

Bladder Diary

Each time you go to the toilet to pass urine. Write down:

• the time

• the amount of urine (collect in a plastic container and then pour into a measuring jug)

• whether you felt an urgent need to urinate (how urgent?)

• anything unusual (e.g. trickling or flooding, a feeling of not emptying the bladder).

Each time you experience leaking. Write down:

• the time

• the amount of urine (small, large)

• how and when it happened.

Each time you have a bowel motion. Write down: 

• the time of day

Your fluid intake. Write down:

• time of each drink

• type of drink

• the amount.

Tips for managing common bladder problems

How urinary incontinence is managed?

The best option for an individual depends on the cause and other health conditions.

 Strategies include:

• pelvic floor exercises

• bladder training

• adjusting food and drink

• adjusting medicines

• exercises

• surgery

About pelvic floor muscles

Why pelvic floor muscles are important?

For many people, leaking urine is partly caused by pelvic floor muscles not working properly. The pelvic floor is a band of muscles that help support the bladder, bowel and uterus. These muscles can lose tone due to ageing, hormonal changes, pregnancy, being overweight or being physically inactive. Your doctor, physiotherapist or continence advisor can assess your pelvic floor muscles and train you to strengthen them. Exercises can help you regain the use of these important muscles.

How to find your pelvic floor muscles?

You can find your pelvic floor muscles two ways:

• While urinating, try to stop the stream.

• You can use a hand mirror to see an upward movement.

Important: This is just a method of finding your pelvic floor muscles. Don’t try to do pelvic floor exercises while urinating.

Tighten the muscles around your back passage (as if you were trying to hold back wind or at the end of a bowel movement).

Pelvic floor exercises

How to do pelvic floor exercises

1. Stand or lie down with your legs slightly apart. Relax the muscles in your thighs, buttocks and abdomen.

2. Tighten the ring of muscle around your front and back passages, drawing the muscles up inside as strongly as you can.

3. Try to complete up to 10 slow squeezes and up to 10 fast squeezes.

Tips:

• Do pelvic floor exercises as often as possible – aim for more than 4 times each day.

• Make reminders to do the exercises.

• Make every squeeze as strong as you possibly can.

• Breathe while you do your pelvic floor exercises.

• Don’t do pelvic floor exercises while urinating.

• Don’t push down – always squeeze and lift the muscles.

Don’t squeeze your abdomen, bottom and thigh muscle while doing the exercises.

Bladder training

When we go to the toilet when we don’t really need to (e.g. before leaving home and ‘just in case’) we can train our bladders to need emptying more often.

You can retrain your bladder by increasing the length of time that you can hold on and the amount of urine you can hold in your bladder. You can practice at home by drinking more fluids in the daytime (not before bed) and holding on for longer.

Health professionals who can help

• GPs

• Continence nurse advisors

• Physiotherapists with an interest in continence and women’s health or pelvic floor

• Urologists

• Occupational therapists

• Pharmacists

Additional Resources

www.bladderbowel.gov.au

www.continence.org.au

www.toiletmap.gov.au

National Continence Helpline 1800 33 00 66