Bladder leakage. Most people don’t want to admit to it, but a third of all women reading this suffers from it! The most common cause for leakage of urine in women is a weak pelvic floor, the muscle group which we know is very important yet a lot of us may not know why or how.
The pelvic floor is a sling of muscles and fascia which support the pelvic organs and help to keep urine stored in the bladder. The bladder fills with urine from the kidneys. Urine is stored in the bladder until a convenient time to go to the toilet. When you do go to the toilet urine is released via a tube called the ureter.
The bladder is actually a hollow muscle called the detrusor. While the bladder is slowly and gradually filling, the detrusor muscle stays relaxed. When your bladder is full enough the detrusor muscle then contracts with the aim to push the urine out of the bladder. The detrusor muscle is something that we do not actually have voluntary control over. This means we cannot choose to contract or relax the detrusor muscle, it does it by itself. This is when we need our pelvic floor muscles to work to hold the urine in and this is something that you are in control of!
The pelvic floor works to do this in two different ways. The urethral sphincter is part of the pelvic floor and is a muscular ring which encircles the urethra. It squeezes the urethra shut and holds urine in the bladder. The second way the pelvic floor works to maintain bladder control is that each time the pelvic floor contracts it fires a reflex which sends a message back to the bladder to tell the detrusor muscle to stop contracting. Therefore urine stays in the bladder until the next convenient time to go to the toilet. This also works in reverse. When you are ready to void urine the pelvic floor relaxes and another reflex fires which now tells the detrusor to contract and expel the urine.
You can see from this that just how much the pelvic floor muscle is in charge of our bladder. Imagine what happens when the pelvic floor muscles are not working properly. Not only are the muscles too weak to squeeze the urethral sphincter closed when you have to cough, laugh or jump. But if you cannot contract your pelvic floor then you will not be able to fire off the reflex that supresses the detrusor contraction. This can lead to stress urinary incontinence or urgency, both very distressing problems which can have a big impact on your quality of life.
The pelvic floor usually weakens after having a baby but problems can start at all stages of your life. Luckily, even if you have already started to experience problems, there is still a lot that can be done to strengthen the pelvic floor and regain control of your bladder. See our blog ‘lift it ladies’ for pelvic floor tips or come in to see our Bend + Mend Sydney CBD Pelvic Floor Physiotherapist, Bonnie.