After years of silence around pelvic floor health, the stigma is slowly but surely being erased. Finally, women who experience leakage or “peeing a little” have materials to educate themselves and they’re learning that incontinence is common, but not normal.

The first step to building an appropriate and effective treatment plan is understanding the nuances of your individual issue. Now, let’s talk about the major types of incontinence.

1. Stress urinary incontinence (SUI)

A mechanical problem requiring a mechanical solution. To understand this issue, you need to know that we have two sphincters that help us control our urethral closure. Mind blown, right? The internal sphincter is autonomic, which means that it’s not within our control. The second is external and controlled by your pelvic floor. SUI can become a problem if your second sphincter gets torn or damaged, which can happen during childbirth. With only one sphincter operating properly, it’s no wonder you might experience leakage.

Solutions will vary but they’re all mechanical in nature, meaning you need to re-empower that muscular sphincter that isn’t working so well. This is most effectively sorted out by pelvic floor muscle training and other “adjuncts” to enhance pelvic floor fitness development. However, using a continence pessary may work better for some women in certain instances. If conservative care doesn’t work, surgery could be considered.

2. Urge incontinence (UI)

This common type of incontinence is a physiological problem that develops from an overactive or hyperactive bladder. In these cases, the bladder is more likely to randomly contract—to turn on and stay on—which is when urine comes out. Common symptoms include having to pee too frequently (such as every hour) or getting up frequently at night to pee. The overactive bladder means people feel the sensation to urinate when their bladder is not actually full, or their bladder will just contract on them when they are least expecting it.  So, this really is more of a bladder muscle problem. There are pharmaceutical treatments for urge incontinence, but all experts agree that these should not be tried until conservative options have been tried, since these are safer and much more effective.

3. Mixed incontinence

As the name suggests, mixed incontinence is when there’s a combination of stress and urge issues, meaning lack of pelvic floor fitness and hyperactive bladder muscle.  Women with “mixed”incontinence are often in a habit of “peeing just in case” to micromanage a pelvic floor that is not as fit and functional as it used to be.  Pelvic floor muscle training along with behavioural modification are quite effective for those with mixed incontinence.

4. Overflow incontinence

The involuntary release of pee without feeling an urge, due to the bladder having filled beyond capacity. This type of incontinence is primarily associated with men and changes in their prostate gland.

5. Functional incontinence

In these cases the incontinence has more to do with a person’s general mobility and ability to get to a toilet on time rather than pelvic floor or bladder health. Those who suffer from functional incontinence may have accidents simply because they could not get to a bathroom in time. 

Surgery is NOT your only option

If you’ve discovered that you have a pelvic floor health issue, it can be tempting to look for a “quick fix”. While surgery might be an option, it is also by definition “invasive” and may carry with it risks and complications. The good news is that there are numerous non-surgical strategies that are supposed to be tried first…and typically nothing further is needed.

Common Recommended Alternatives

All these options work to help restore your pelvic floor fitness. To be effective, all these treatments need to be undertaken with the guidance of a healthcare provider or pelvic health physiotherapist. 

Incontinence Pessary 

• A silicone-based device inserted into your vagina to prevent incontinence by providing some extra support around the place in your pelvic floor that needs abit of a boost
• Minimally invasive, a pessary can improve your quality of life without undergoing major surgery
• It can also be selectively used for those specific times you might need some support, such as running or doing jumping jacks

Vaginal Cones/Weights

• Held inside the vagina, these are used to strengthen your pelvic floor muscles
• Great addition to your personal training program for your pelvic floor if the issue is related to weakness of the pelvic floor

Electric Muscle Stimulation 

• Low-grade electrical current can be used for any muscle of the body, including the pelvic floor, to stimulate and strengthen the muscle

The Emsella Chair

• An entirely non-invasive technology that is showing promising results
• Uses high-frequency electromagnetic stimulation to increase your pelvic fitness capacity
• Least invasive and most innovative tool for pelvic health fitness
• Some studies are even beginning to suggest that it may produce fitness effects beyond what is achievable with any of the options listed above

This Thursday, Apr 28th, join us for a webinar hosted by Dr. Sinéad Dufour, an academic clinician and pelvic health physiotherapist. We will be breaking down the guidelines for returning to running postpartum and providing all the tips and tricks on how to support your pelvic floor when getting active.

Register here!