Bladder

Bladder conditions can be embarrassing, burdensome and affect a women’s quality of life. Urinary incontinence affects up to 37% of Australian women (Australian Institute of Health and Welfare, 2006).

Bladder dysfunction can present in a number of ways including:

• Urinary incontinence is the accidental or involuntary loss of urine from the bladder.
• Often this occurs with coughing, sneezing, walking, lifting or playing sport.
• Sometimes this is known as stress incontinence.
• Urinary urgency is when there is a sudden and compelling desire to pass urine, which is difficult to defer or put off. Sometimes it can be associated with certain locations or circumstances such as putting the key in the door, seeing a toilet of being near running water.
• Urinary frequency which is the complaint by a person who thinks that they void or go to the toilet too often. Normal voiding or toileting is about every 3-4 hours or 4-7 times per day.
• Nocturia is when a person has to wake up at night to pass urine. If this happens more than twice a night, it can be a problem.
• Incomplete emptying or dysfunctional voiding
• Repeated urinary tract infections
• Painful bladder is felt just above the pubic bone and usually increases as the bladder fills and may persist after emptying the bladder

Management of bladder conditions includes:

• A thorough assessment of the condition, medical history and current health, including diet and fluid intake, exercise levels and mobility, all the medicines you are currently taking, and any other factors that could affect bladder function
• Physical assessment of the pelvic floor function, strength and endurance
• Rehabilitation which may include pelvic floor muscle exercises, otherwise known as Kegel exercises, bladder retraining and changes to lifestyle and bladder habits and pain management.
• Use of Real Time Ultrasound to facilitate rehabilitation
• Assistance with continence aids such as pads and pants.

Outcomes from treatment may include:

• 84% cure rate with continence and pelvic floor physiotherapy for mild stress incontinence
• Correct pelvic floor muscle exercises can increase the size, strength and length of the pelvic floor muscles.
• Decreased leakage, reduced usage of pads, improved control and reduced urgency.
• Increased confidence and reduced financial burden
• There is the highest level of evidence in research for using pelvic floor muscle exercises in the treatment of stress urinary incontinence and mixed incontinence in women.