Urinary Incontinence: What You Need to Know

This impacts 3.3 million Canadians of all ages and gender1.

It is defined as a complaint of involuntary loss of urine2.  It is important to note that urinary incontinence is not a disease but rather a symptom of something else going on in the body. Often there are many things that can be worked on to either resolve or drastically improve the impact this condition can have on an individual’s quality of life!

Let’s review different classifications of incontinence:

Stress urinary incontinence: “Complaint of involuntary loss of urine on effort or physical exertion including sporting activities, or on sneezing or coughing.” 2 During these scenarios, there is a decreased closure of the urethra (tube that carries the urine from the bladder to outside the body) in response to the increase in pressure internally.

Urgency urinary incontinence: “Complaint of involuntary loss of urine associated with urgency (sudden, compelling desire to void)”2

Mixed urinary incontinence: “Complaints of both stress and urgency urinary incontinence, i.e. involuntary loss of urine associated with urgency and also with effort or physical exertion including sporting activities or on sneezing or coughing”2

Overflow urinary incontinence: “Complaint of urinary incontinence in the symptomatic presence of an excessively (over-) full bladder”2 This occurs when the bladder does not empty fully and becomes very full. This commonly presents as a secondary symptom in conditions such as diabetes, Parkinson’s Disease, stroke, radiation therapy to the pelvis region-though this list is not exhaustive.

Impaired cognition urinary incontinence: “Complaint of periodic urinary incontinence that the individual with cognitive impairment reports to have occurred without being aware of it”3

Impaired mobility urinary incontinence: “Complaint of inability to reach the toilet on time for voiding because of physical or medical disability”3

Urinary incontinence is a result of a variety of underlying conditions. As such, treatment options vary for each person. Some therapy options include: pelvic floor muscle training, bladder training, diet modifications, medications, hormone replacement, injections and/or surgery1.

While some of these treatment strategies require an in-person and hands-on approach, many do not. A great place to start is to collect a bladder diary for yourself. This is the first place I start with clients as it provides a detailed look into a client’s urinary habits and helps to identify causes of incontinence if needed. A bladder diary will also serve as a tool to monitor one’s progress.

If urinary incontinence is a concern, complete a bladder diary for 3 consecutive days, like the one below. Then reach out to your healthcare team for specific steps to address your needs.

 

 

 

Example:

Time

Void Size

(count in seconds for length of stream)

Fluid Intake (type & amount)

Strong Urge?

(Yes/No)

Did a leak occur?

(Yes/No)

Cause of leak?

7am

12 seconds

 

Yes

No

 

7:30am

 

Water, 1 cup

 

 

 

7:45am

 

Coffee, 1 cup

 

 

 

8:30am

10 seconds

 

Yes

yes

sneeze

Etc.

 

 

 

 

 

 

References:

  1. Canadian Continence Society. Acquired via: https://www.canadiancontinence.ca/EN/what-is-urinary-incontinence.php
  2. D’Ancona CD, Haylen BT, Oelke M, Herschorn S, Abranches-Monteiro L, Arnold EP, Goldman HB, Hamid R, Homma Y, Marcelissen T, Rademakers K, Schizas A, Singla A, Soto I, Tse V, de Wachter S. An International Continence Society (ICS) Report on the Terminology for Adult Male Lower Urinary Tract and Pelvic Floor Symptoms and Dysfunction. Neurourol Urodyn. 2019 DOI: 10.1002/nau.23897. Acquired via: https://www.ics.org/glossary
  3. Gazewski JB, Schurch B, Hamid R, Averbeck M, Sakakibara R, Finalli Agro E, Dickinson T, Payne C, Drake MJ, Haylen BT. An International Continence Society (ICS) Report on the Terminology for Adult Neurogenic Lower Urinary Tract Dysfunction (ANLUTD) Neurourol Urodyn 2017 Nov 17 DOI: 10.1002/nau.23397. Acquired via: https://www.ics.org/glossary

 

About the Author

Simone Fleet is a Licenced Physiotherapist in Edmonton, Alberta specializing in Pelvic Floor Physiotherapy.  In addition to Pelvic Floor Physio, Simone also treats musculoskeletal issues in men and women.  Simone is passionate supporting women throughout the lifespan with a biological, psychological and social perspective.  She was born and raised in Edmonton, is a mom of two boys, and is a very talented Ukrainian dancer.

We specialize in Pelvic Floor Physiotherapy at Pine Integrated Health Centre and have practitioners that can support women and men with urinary incontinence through the lifespan.