Urinary incontinence: effective solutions
Bladder weakness, also known as urinary incontinence, is characterised by an involuntary loss of urine that can occur at any time of the day. This can range from a few drops to all the urine held in the bladder.
- 1 What is bladder weakness?
- 2 The different types of incontinence
- 3 Important consequences in women’s lives
- 4 How do you know if you have bladder weakness?
- 5 Signs that don’t deceive
- 6 Risk factors
- 7 Is bladder weakness irreversible?
- 8 How to prevent leakage?
- 9 The sustainable solution
- 10 They have tested and adopted Emy by Fizimed
- 11 Sources
What is bladder weakness?
Although incontinence remains a taboo subject, it affects nearly 6.5 million women in France. Many people mistakenly believe that only the elderly can suffer from incontinence. However, age, professional and personal circumstances are not good indicators. All women can experience bladder weakness at some point in their lives. This is a real public health issue as 1 in 10 women suffer from urinary incontinence. Most women suffer in silence and do not seek professional help, often because they are embarrassed or ashamed to talk about this issue. In most cases, simple solutions can be put in place to resolve or reduce leakage quickly, even if incontinence has been present for several months or years.
The different types of incontinence
Stress urinary incontinence
This is characterised by a leakage in the form of a stream, not very abundant and without any prior feeling of need, but which occurs suddenly while performing physical effort in daily life (such as performing any sports, carrying a heavy load, etc.) but also when coughing, laughing or sneezing. If the degree of incontinence is high, leakage can occur even with a small amount of effort, such as getting up from a chair. This is the most common type of incontinence in women (50% of cases).
Urge urinary incontinence
Also known as urge incontinence, is characterised by an uncontrollable and urgent need to urinate that cannot be held until reaching a bathroom. Unlike stress urinary incontinence, there are no external triggers. The urge to urinate comes on suddenly and cannot be delayed. However, there are situations that can exacerbate this phenomenon: one of the best known is the “key in the door” symptom, which leads to a sudden and uncontrollable urge to urinate. It is also often referred to as “overactive bladder” because the urge to urinate occurs frequently and with small amounts of urine. This is a rare type of incontinence in women.
Mixed urinary incontinence
This is a combination of the two forms of incontinence mentioned above: stress and urge. One third of women suffer from this form of incontinence, which involves both the urge to urinate during stress and the urge to urinate unexpectedly.
Stress urinary incontinence
This is characterised by a leakage in the form of a stream, not very abundant and without any prior feeling of need, but which occurs suddenly while performing physical effort in daily life (such as performing any sports, carrying a heavy load, etc.) but also when coughing, laughing or sneezing. If the degree of incontinence is high, leakage can occur even with a small amount of effort, such as getting up from a chair. This is the most common type of incontinence in women (50% of cases).
Urge urinary incontinence
Also known as urge incontinence, is characterised by an uncontrollable and urgent need to urinate that cannot be held until reaching a bathroom. Unlike stress urinary incontinence, there are no external triggers. The urge to urinate comes on suddenly and cannot be delayed. However, there are situations that can exacerbate this phenomenon: one of the best known is the “key in the door” symptom, which leads to a sudden and uncontrollable urge to urinate. It is also often referred to as “overactive bladder” because the urge to urinate occurs frequently and with small amounts of urine. This is a rare type of incontinence in women.
Mixed urinary incontinence
This is a combination of the two forms of incontinence mentioned above: stress and urge. One third of women suffer from this form of incontinence, which involves both the urge to urinate during stress and the urge to urinate unexpectedly.
Important consequences in women’s lives
Leakage impacts the quality of life of ⅔ of women who suffer from it: family, social, sexual or professional, the consequences are multiple. For example, women experience a reduction in physical and sporting activities, as well as a repercussion on social and personal activities, but also a psychological and emotional impact or an impact on the quality of sleep and sexual relations.
If the incontinence is not treated, more serious consequences such as organ descent, also known as prolapse, can occur. The pelvic floor, which is too relaxed, can bulge down or descend below the bony outlet of the pelvis, therefore no longer performing its supporting role. Organs can then gradually descend until they end up outside the body.
How do you know if you have bladder weakness?
Causes of urinary incontinence
The bladder is simply a reservoir that is emptied by a contraction to release urine. The sphincter has a complementary role to the bladder. The sphincter contracts to help fill the bladder while it is at rest. Once the bladder is full, the sphincter relaxes and allows urine to pass to promote emptying.
This is a decision that depends on complex neurological functions that generate the action of urinating. While a person is urinating, the sphincter remains open throughout the action. This seemingly natural action, however, requires an effort that can increase abdominal pressure on the bladder.
Unfortunately, when the pelvic floor is weakened, this pressure exceeds the closing intensity of the sphincter and leads to involuntary urine leakage. Being pregnant, overweight or having an hormonal deficit during menopause are key factors that can lead to a weakening of the perineum muscles.
Signs that don’t deceive
Only 10% of women with bladder weakness are aware of incontinence and consider it a problem (Kuhn et al. 2006). These women are usually embarrassed in their daily lives and wear protection. Others consider that they are not incontinent and adapt their activities to avoid “risky” situations. They are unaware that solutions exist that could help them solve their bladder weakness quickly.
It doesn’t matter how often or how much, even the loss of a very small amount of urine is probably related to urinary incontinence! The simple fact of having difficulty holding back urine, gas, lack of sensation and/or pain during sexual intercourse, vaginal heaviness… are signs that should lead to consulting a health professional who will be able to help solve this incontinence problem.
Risk factors
There are many risk factors that can influence the onset of bladder weakness
Sports with jerks or that overtax the pelvic floor
Some sports can put excessive pressure on the abdomen, leading to urine leakage. This is the case for trampolining, gymnastics, athletics, horse riding, volleyball, handball, etc. Health professionals recommend physical activities without shock or jumping such as swimming, walking, cycling or pilates. It is also important to ensure that you always exhale during exercise by contracting your pelvic floor “beforehand”.
Poor lifestyle
An unbalanced diet or too much caffeinated or alcoholic beverages can lead to bladder weakness. If you suffer from incontinence, it is important to stay hydrated by drinking water or herbal tea. Smoking is also an important factor in urinary incontinence. Please note that it is not a direct cause of incontinence but rather an aggravating factor. The chronic coughing associated with smoking puts pressure on the pelvic floor from the abdominal muscles, which can weaken the pelvic muscle.
Bad postures
Poor posture can lead to pressure on the organs that press harder on the pelvic floor. Excessive pressure on the pelvic floor can weaken it and create tension that can lead to pelvic and/or lower back pain. It is important to correct your posture and stand up straight!
Being overweight
Statistically, overweight people are more likely to develop urinary incontinence. Obesity also increases the severity of the condition. It is necessary to adopt a healthy and balanced diet (rich in fibre to promote transit) to maintain a balanced body mass index (BMI), as well as performing sports to keep fit and tone the abdominal muscles.
Pregnancy and childbirth
Pregnancy is probably the most well-known risk factor. The weight of the baby for 9 months on the pelvic floor and the passage of the baby during vaginal deliveries can weaken and damage the pelvic floor. Approximately 15-40% of women will suffer from incontinence after giving birth. It is therefore important to learn how to relax the pelvic floor during pregnancy and to re-educate the pelvic floor after childbirth to restore its tone and avoid urinary leaks.
Repeated abdominal thrusts
Carrying heavy loads, sneezing, coughing or laughing, chronic constipation… all these efforts can be responsible for urine leakage. It is important to remember to contract the pelvic floor at each effort in order to avoid minor accidents.
Decrease in sensation and pleasure during sex
Re-education of the pelvic floor can help with some sexual problems. Thepelvic floor plays a key role during intercourse and particularly while experiencing orgasms. A toned pelvic floor can therefore allow you to experience more sensations and have more intense orgasms
Menopause
The decrease in perineal muscle tone caused by hormonal decline can lead to bladder weakness. Consulting a healthcare professional to find a suitable solution can help, but most of the time by training the pelvic floordaily can solve much of the problem.
Is bladder weakness irreversible?
How is bladder weakness treated?
There are many treatments for urinary incontinence. In most cases, bladder weakness can be reduced or cured with a suitable solution such as a perineal rehabilitation. In the past, stop-piping (interrupting the flow of urine during urination) was recommended as a way of working on the pelvic floor, but it is no longer recommended as a suitable rehabilitation technique. If practised repeatedly, it can lead to urinary tract infections but also to “bad neurological programming during urination”. Urinary disorders can occur as a result of too frequent stop-piping.
Other medical or surgical solutions may be considered depending on the severity and type of incontinence. One thing is certain: incontinence pads and pants are NOT a suitable and lasting solution. Urinary incontinence is not a fatality, it is possible to treat it.
Who should I consult?
Healthcare professionals can help you find a solution to your bladder weakness problems and refer you to specialists. Don’t hesitate to discuss the subject with your general practitioner, urologist, gynaecologist, physiotherapist, midwife, etc. Today, not many practitioners spontaneously discuss this subject with their patients, so don’t hesitate to make the first move
How to prevent leakage?
Strengthen your pelvic floor
The pelvic floor is a muscle like any other in our body. It is true that it is invisible, we cannot see it, and it is even too often forgotten, but this only increases its importance. It is therefore important and above all essential to take care of it and maintain it through one’s life. To avoid the symptoms of incontinence, you simply need to build up your muscles and train your pelvic floor to keep it toned. It’s a bit like doing the same with your abdominal muscles to keep your stomach flat and muscular. There are different methods for re-educating the pelvic floor. There is no age limit to start training your pelvic floor in order to keep it toned and avoid urinary leaks. Even if started several months or years after giving birth, perineal rehabilitation can be beneficial when the pelvic floor is weakened.
The different methods of perineal rehabilitation
Among health professionals
Physiotherapists and midwives are the healthcare professionals who practice perineal rehabilitation. Different methods are generally proposed:
- Manual re-education: the practitioner will, via a vaginal touch, exert light pressure on your pelvic floor to guide its contraction. They can also use visualization techniques to help you become aware of the different areas of the pelvic floor.
- Re-education by electro-stimulation: electrical currents will mechanically stimulate your pelvic floor. You don’t voluntarily contract your pelvic floor. This passive method is particularly suitable for those who have a very weak pelvic floor. It can be complemented by a biofeedback approach.
- Biofeedback rehabilitation: with this approach, it is the woman who voluntarily contracts her pelvic floor. A vaginal probe is used to measure the perineal contractions, which are transmitted to a screen. A visual signal indicates to the woman whether she is contracting correctly. This active re-education technique encourages awareness of perineal contractions and learning.
To maintain the progress of the perineal rehabilitation sessions over time and to keep the muscle toned, healthcare professionals strongly recommend continuing to work the pelvic floor daily at home. It is therefore essential to continue to train your pelvic floor at home.
At home
Health professionals recommend doing self-training exercises at home. Regular training is necessary to maintain pelvic muscle tone and to maintain the work done with your practitioner. Contractions, posture and essential exercises can be used to maintain the tone of the pelvic floor and reduce the pressure applied to it.
Free mobile applications offer exercises to strengthen the pelvic floor. The free application “Emy – Kegel Exercises” is one of them and allows you to do regular exercises and to follow your progress. There are even reminders so that you don’t forget doing your training! You will also benefit from numerous tips written by healthcare professionals to keep your pelvic floor healthy and have access to high quality educational content on the pelvic floor. A good start if you want to start self-training at home!
The sustainable solution
And if you would like to go further, discover Emy, the connected perineal device!
Connected to a fun and easy to use mobile application, the perineal probe is based on the biofeedback principle: the vaginal probe detects your perineal contractions. You then see your effort in real time on your smartphone screen. 20 fun mini-games guide you in controlling your contractions and help you build up your pelvic floor.
This medical device has been developed with healthcare professionals to offer women a simple and effective wireless solution. They can then continue their self-training at home. With the Emy device, you choose when and where you want to do your exercises to train your pelvic floor to prevent bladder weakness. You can follow your progress and your evolution.
Various training programmes are predefined in the application. You can also choose the number and duration of your training sessions yourself. In addition, you can define these parameters with your practitioner. Finally, reminders can be programmed on the app so that you don’t forget your sessions, so you no longer have an excuse!
They have tested and adopted Emy by Fizimed
Emy is a simple method that women can use on their own and that can be of great help to them.
Doctor Sylvain Mimoun, gynaecologist
I use Emy for 5 minutes 3 times a week, and since then my sports sessions have changed radically! There is much less bladder leakage, much less stress when it comes to running with others, and when you have to take a car afterwards.
Sandrine Billaud, marathon runner and Emy user
Since I started using Emy, my pelvi floor has become stronger and I can hold a tampon again!
Johanna, Emy user, 28 years old
Sources
1 Revue Exercer, March/April 2006, Postpartum urinary incontinence: bringing it up in the consultation following childbirth, Isabelle Aubin
2 Evaluation of the prevalence of urinary incontinence among women seen in general medical consultations in France – Report INVS – Inserm – 07/2007, Temml C et al, Urinary incontinence in both sexes: prevalence rates and impact on quality of life and sexual life. Neurourol Urodyn 2000; 19(3):259-71.
3 Société de Formation Thérapeutique du Généraliste. Survey on the psychosocial representations of urinary incontinence. Paris:SFTG; 2003
4 ANAES. Prise en charge de l’incontinence urinaire de la femme en médecins général. Services des recommandations professionnelles; 05/2003, Jundt et al, Long-term efficacy of pelvic floor re-education with EMG-controlled biofeedback. Eur J Obstet Gynecol Reprod Biol. 2002 Nov 15;105(2):181-5