Stress
incontinence Do you suffer from Stress Incontinence?
*Do you leak
when you cough, sneeze, exercise or laugh?
*Do you have to hurry to the toilet and don't always make it in
time?
*Do you have to pass urine more often than you used to?
*Do you leak urine in your sleep?
*Does your bladder wake you up more than twice a night?
*Do you feel that you can't empty your bladder completely?
*Does your urine stream stop and start, and is the flow slower than
it used to be?
*Do you have trouble controlling your bowels?
**For men, see also Prostrate
Stress Incontinence
is more common than you think
Stress incontinence is the most common form of urinary incontinence
and it’s estimated that approximately 3 million people in
the UK are regularly incontinent, this is a about 4 in every 100
adult’s, over half of these are due to stress incontinence.
Stress incontinence becomes more common in older women and its thought
as many as 1 in 5 women over the age of 40 have some degree of stress
incontinence.
What is stress incontinence?
Stress incontinence comes about because of a sudden extra pressure
or stress on your bladder. Urine then leaks because your pelvic
floor muscles and urethra cannot withstand the extra pressure. Stress
incontinence develops because the pelvic floor muscles are weakened
and small amounts of urine may leak, occasionally it may be quite
a lot and causes embarrassment. This may happen when you cough,
laugh, or when you exercise.
What are the causes of stress incontinence?
The most common reason for the pelvic floor muscles to become weak
is pregnancy and childbirth. Stress incontinence is more common
in women who have had several children. Age is also a major factor
as the muscles become weaker. Women who are obese are more likely
to suffer from stress incontinence.
What are the treatments for stress incontinence?
The first step to consider is to strengthen the muscles, by improving
your pelvic floor muscles. Approximately 6 out of 10 cases can be
cured or much improved with this treatment. Surgery may be advised
by your GP if the problem continues.
Pelvic
Floor
Why do I leak when I jump on the trampoline?
It may not be the trampoline it could be just when you sneeze or
laugh, a cough or you notice when you have to do a sudden moment
like running or jumping for exercise. The truth is that it’s
estimated that 1 in 5 women suffer from stress incontinence, and
these are the ones that have asked for help. There are many more
women who haven’t asked for help because they are embarrassed,
and lets face it no-one wants to admit to ‘weeing’ a
little when they laugh, it’s just not funny.
Many women suffer from stress incontinence at sometime in their
life, either during or after pregnancy or late on in their late
50’s when lack of muscle tone and exercise cause the pelvic
floor to collapse. Many women who are overweight are beginning to
suffer because they don’t exercise and because the weight
is putting so much pressure on their pelvic floor area.
Occasionally some women have health problems and find that Stress
Incontinence is a side effect of surgery, illness or medications,
in these instances your GP or Consultant should always be able to
offer help and advice or refer you on to a Continence Nurse or specialist.
There is help out there and it’s not uncommon as you might
think.
So Ok I leak a little why?
In most cases as said before the Pelvic Floor muscles have become
weakened, and like all muscles they need to be exercised and worked
to be effective, most women don’t know where to find these
muscles (see exercise) or how they are important so the following
diagram should help.
As you can see it’s a group of muscles that lie horizontal
underneath the bladder, rectum and uterus, often for women the additional
weight of baby and fluids puts additional strain on the Pelvic Floor
Muscle and causes them to become weak and less effective, women
who are active often exercise this muscle without realising it and
of course in older women muscle tone in general become weaker.
I have Stress Incontinence now what?
There are a great many products on the market and they are very
helpful in the initial stages prior to getting pelvic floor fit,
and often its just a few months of exercise that can make a huge
difference to your life, once you have mastered them it’s
easy to fit them into your daily routine almost without thinking.
However if you are unsure then do consult your GP or Practice Nurse
for advice, there are many types of incontinence but Stress Incontinence
is the most common one. Urge Incontinence the second most common
and is a condition where you feel the need to go suddenly and may
not make it in time, this is due to an over active bladder.
As said before there are a large number of products available to
help in the initial stages of getting fit, these are generally in
the form or disposable pads much like Sanitary ones however they
are specially designed to contain urine flow and may have odour
inhibitors for that extra sense of security, rather than a menstrual
many women will find that Sanitary Towels simply don’t work.
Another product is specially designed underwear, totally normal
looking but with a built in pad to help contain urine, and manufacturers
are realising that Stress Incontinence is a condition that affects
many young women not older ladies requiring ‘big pants’,
the advantage of washable pants is the overall cost, whilst initially
they might be expensive compared to using pads several times a day
over a period of time they could work out cheaper, they also have
the advantage of peace of mind after you have got Pelvic fit!
I can see on the picture where the Pelvic Floor is but I can’t
feel it!
Like all muscles you need to physically know where it is then you
know if you are exercising the right ones, there is no point in
trying till you locate it first!
Finding the right muscles to exercise
1. Sit in a chair such as a kitchen or office chair
with your feet flat on the floor and your knees slightly apart.
Imagine you are trying to stop wind escaping from your back passage,
you will need to squeeze the muscle that is just above your bottom,
you should feel the muscle tighten but do not move your bottom or
legs.
2. Imaging now that you are weeing and want to stop,
you will find that the muscle near the front tighten slightly and
it’s these that you will need to strengthen. You will also
find if you are sat on the toilet and attempt to stop mid stream
you will find these muscles tighten, if you are unable to stop completely
consider doing some pelvic muscle exercises.
3. If you still aren’t sure you are exercising
the right muscles, try to put a couple of clean fingers into your
vagina. You should feel a gentle squeeze when doing the exercises.
You can also practice this exercise during sex, your partner will
be surprised.
Found them! When to do these exercises?
Everyday, whilst doing your hair, washing up, watching
TV, standing making the tea, you can do them anywhere, though its
best to practice at home first as you may be pulling a few strange
faces which might scare the kids or fellow passengers till you have
the knack.
Do them at least once a day but preferably several
times, and continue doing them for at least 3 months to obtain best
results. You will know if you are getting better when you can stop
mid stream when sitting on the toilet!
So what do I do?
The Slow Pull Up
Sit, stand or lie with your knees slightly apart.
Slowly tighten your pelvic floor muscles under the bladder as hard
as you can. Hold to the count of five then relax. Repeat at least
five times.
The fast Pull Up
Then do the same exercise quickly for a second or
two. Repeat at least five times. These are called fast pull-ups.
Repeat these two exercises alternating between the
fast pull up and the slow pull up for five minutes. Try to do these
once a day but for outstanding result at least 3 five minute sessions.
Perhaps if you are about to embark on a new fitness regime you could
do these as a gentle warm up or wind down.
As you get better and your muscles get stronger
try to lengthen the time you hold the slow pull up, 10 seconds is
doing very well.
Be sure that you are pulling the right muscles,
and remember to check, if you still aren’t sure ask your GP,
Practice Nurse or Physiotherapist for help.
I’ve done the exercises and its no better
All is not lost, there are many reasons why, the most common is
that despite your best efforts you just aren’t finding the
right ones and they aren’t easy to locate as you have discovered.
It could be that you have an undiagnosed infection which can be
irritating the bladder or Urethra , it could be that you need to
call in your very own personal trainer in the form of your Practice
Nurse or Specialist Nurse/Physiotherapist.
And what will as specialist do for me?
They can offer a range of products and methods to help you find
the right muscles or to stimulate the muscles into working properly.
• Electrical stimulation. Sometimes a special
electrical device is used to stimulate the pelvic floor muscles
with the aim of making them contract and become stronger this isn’t
at all painful and is extremely effective, sometimes you are able
to use this at home for a period of time to help get Pelvic Floor
fit again.
• Biofeedback. This technique will help you
to locate and to make sure you are exercising the correct muscles.
A physiotherapist or continence advisor may insert a small device
into your vagina whilst you are doing your pelvic floor exercises.
When you squeeze the right muscles, the device makes a noise or
signal to the computer screen to let you know that you are squeezing
all the right muscles, at this time we are unaware of a home device.
• Vaginal cones. These are a set of small
plastic cones that you insert into your vagina for approx 15 minutes,
twice a day. These come in a set of different weights, starting
with the lightest cone first (as with all muscle building) You then
use your Pelvic Muscles to keep the cone in place, this helps you
locate and thus exercise them and as with all weight training you
gradually build up till you can hold the heaviest one for 15mins
or so twice a day. These are extremely effective and discreet enough
to use at home without anyone realising. These can also be obtained
from some chemists and on-line.
• Other devices. There are many other devices
available all with the same basic principle of inserting them inside
your vagina with the aim of helping the pelvic muscles to exercise
and squeeze. Like many products its best to do some research first
as there is very little research evidence to show how well they
work, there are no quick fixes.
It should always be remembered that these should
be used along side the general and free exercises rather than instead
of.
And if all that fails?
There is the option for surgery but this is usually only offered
when all else has failed to help. This kind of surgery like all
others carries certain risks which would be discussed with you by
your specialist. The operation’s aim is to tighten the muscles
and support structure just under your bladder, and is often very
successful.
There has been some reports that the drug Duloxetine
used to treat depression may have some benefits towards the treatment
of Stress Incontinence because of the way it helps stimulate the
chemicals that affect the nerves around the muscle near the Urethra
that causes it to contact more strongly however as yet we are unaware
of any UK studies that prove this.
As with all conditions, you should always consult
your GP and consider making changes to your lifestyle if they impact
on your well being. It is considered that doing regular pelvic floor
exercises from early teens and onwards may help prevent the incidences
of incontinence.
For more information
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here
Your
Prostate
What is the
prostate?
The prostate is a fleshy organ, which is wrapped around the neck
of the bladder like a ring doughnut or like a thick collar open
at the front. It is made of glands and muscle. When a man has an
orgasm, the prostate muscle squeezes fluid from the glands into
the semen where it seems to energise the sperm.
Why do men get prostate trouble?
In boys and young men the prostate is tiny but for unknown reasons
it gets larger later in life. The amount of enlargement varies from
man to man, as do the problems that it causes. In most men this
is an entirely benign process, which is so common that it can almost
be considered a normal part of getting older. In a very small number
of men there maybe a cancerous growth of the prostate. Because of
its position, the enlarging prostate can throttle the outlet from
the bladder (like tightening a collar) until it interferes with
the flow of urine through the bladder outlet (urethra).
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