Stress Urinary Incontinence or SUI is defined by the International Continence Society as “involuntary loss of urine on effort or physical exertion, or on sneezing or coughing”. Many women may know it as leakage of urine when you laugh, cough, run, jump or even pick up your kids.
When you do any of these things there is an increase in the pressure inside your abdomen and an increase in pressure pressing on your bladder. This increased pressure in the bladder will cause any urine in the bladder to be pushed out unless it is stopped by the urethra. As mentioned in a previous blog “Get that control back”, the urethra is the exit tube from the bladder and the pelvic floor helps to keep the urethra entrance closed and keep urine in the bladder.
The pelvic floor muscles are always helping at a low level to keep the urethra closed for the majority of the time. However during certain times of the day there will be an increase in the pressure on the bladder (e.g. when coughing, sneezing, running) and it is at these times that we need a bit of extra work from the pelvic floor.
The pelvic floor does this by acting as a strong wall behind the urethra to help keep it closed. If the pelvic floor is strong, when the increased pressure (from laughing, running etc) reaches the urethra it will cause the front of the urethra to be squeezed shut against the strong wall of pelvic floor behind it. Imagine when you step on a hose and the hose is squeezed closed against the ground underneath it and the water stream is stopped. The same sort of the thing happens at the urethra if the pelvic floor does the extra squeeze to support against the pressure.
If the pelvic floor muscles are not functioning correctly then when that increased pressure from the cough or sneeze reaches the bladder it will not help to keep the urethra closed and leakage of urine will occur. Fortunately, the extra squeeze that the pelvic floor needs to do can be re-trained and is what we do here at our Bend + Mend Physio + Pilates Sydney CBD clinic. This is called “the knack” and you can find out more about this in the following blog coming soon.