Bladder control problems are very common. Approximately 1.1 million New Zealanders do not have full bladder control and experience leakage of urine, in amounts that vary from a few drops to large volumes, twice or more a month.

Urinary incontinence is more common in women than men, with a ratio of 4:1. Two out of three women who suffer from bladder control problems do not seek help, as they see this as a normal female problem and think nothing can be done.

Seventy per cent of women with bladder control problems can become dry or experience significant improvement.

Incontinence is a symptom that one of the mechanisms, that keeps us dry, is not working correctly. How incontinence presents itself varies according to the cause.


Types of Incontinence
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The two types of incontinence most common in women are:
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Stress Incontinence
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The involuntary leakage of small amounts of urine with exertion such as coughing, sneezing, laughing, straining, lifting or playing sport, in the absence of any desire to go to the toilet, is called stress incontinence.

Urge Incontinence
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Urgency is a sudden, overwhelming urge to pass urine. If a person is unable to get to the toilet in time, and experiences an involuntary loss of urine they are said to have "urge incontinence."NB: Many women suffer from a combination of urge and stress incontinence.

Some factors that contribute to bladder control problems:
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1   Pregnancy and childbirth
2   Constipation
3   Medications
4   Chronic cough
5   Urinary infection (consult your GP)
6   Diseases which affect the nervous system and muscular control
7   Diabetes
8   Obesity
9   Reduction in hormones after menopause (change of life)


For good bladder control

Boss your bladder
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Do not allow yourself to become controlled by your bladder - you should be controlling it. Adults usually pass urine 4 -6 times during the daytime, and sometimes get up once during the night.
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Fluids
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Drink an adequate amount of fluid (This includes tea, coffee, milo, soup etc.). Assuming there are no other medical problems 6-8 glasses per day is the amount to aim for. This amount ensures urine does not become concentrated and that there is enough available fluid to keep bowel motions moist and soft, therefore avoiding constipation. It is advisable to limit intake of bladder irritants such as tea, coffee, cola drinks and alcohol.

Diet
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Pay attention to your diet. Make sure it contains fibre roughage every day in the form of whole meal bread, whole grain cereals, fruit and vegetables. Fibre adds bulk and attracts fluid to the waste matter in the bowel motion.

Bowels / laxatives
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Avoid straining while opening your bowels as this can overstretch the muscles of the pelvic floor and may eventually result in weakness occurring. Do not take laxatives unless advised by your doctor. The bowel becomes reliant on laxatives if they are taken over a long period of time and eventually will not function without them.

Medications
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Some medications prescribed for other medical conditions can affect bladder control. Check with your doctor.Weight:Avoid becoming overweight, as this puts extra strain on the pelvic floor muscles.

Pelvic Floor Muscles
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The pelvic floor muscles support all pelvic organs, especially in standing. All women, men and children should be taught how to do these exercises.For instruction in the correct way of doing these exercises, see brochure entitled 'Pelvic Floor Muscle Training in Women. If not satisfied with your progress in doing these exercises, you should consult your GP, a physiotherapist (with training in continence) or a continence advisor.

Normal bladder control
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The production of urine is not under our voluntary control, but as adults, we have acquired the ability to recognise when our bladder is full and to be able to hold on to urine until we reach a toilet. We therefore have control over when and where we will pass urine. This control is possible because of messages passing between the brain and the bladder, and our ability to interpret these messages. We can learn to use this mechanism to delay passing urine.

What to do about your incontinence
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The good news is that seven out of ten women with stress incontinence can become dry, or significantly improved doing pelvic floor exercises. Only a small number of women require surgery.

Most urge incontinence can be helped by bladder training, which is sometimes combined with medication.

How to seek help
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There are health professionals qualified to help you with bladder control problems.

Ask your GP for advice or phone the free phone helpline. 0800 650 659
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This document has been developed by, and remains the property of, the Continence Foundation of Australia © Continence Foundation of Australia 2015
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