1. What is continence?
The word “continence” refers to self-control and now taken to mean the ability to hold back bodily functions. Not everyone is so lucky to have full control and needing to get the toilet in a hurry and wanting to go to the toilet often are common problems that affect approximately 1.1 million New Zealanders.
2. What is the role of pelvic floor muscles in continence?
The bladder itself is a hollow, muscular pump. It fills slowly from the kidneys and the pelvic floor muscles sit at the base of the bladder to maintain control of the valve. Strong pelvic floor muscles close off the bowel and bladder outlets to prevent leakage. When the bladder is getting full, messages pass between the brain and the bladder to let you know to pass urine. The pelvic floor muscles then relax and the bladder squeezes the urine out.
3. What are the most common types of incontinence?
Incontinence is the opposite of continence, so there is a lack of control of bodily functions. Urinary incontinence is four times more common in women than men. Stress and urge incontinence are the two most common types. Stress incontinence is the involuntary leakage of small amounts of urine with exertion such as coughing, sneezing, straining or playing sport.
Urge incontinence is when the bladder becomes overactive, contracting when the bladder isn’t full and/or the muscle works overtime causing frequent, strong, sudden urges and bladder leakage. Many people suffer from a combination of the two.
4. What factors affect continence?
- Certain medications
- Chronic cough
- Urinary infection
- Diseases that make it difficult to get to and use the toilet such as arthritis, stroke, Parkinson's disease and dementia
- Prostate gland enlargement in men
5. What can I do to maintain good bladder control?
The good news is that 70% of women with bladder control problems can experience significant improvement of their symptoms. Drink 6-8 glasses of water per day to ensure urine does not become concentrated and limit your intake of tea, coffee, sugar, cola drinks and alcohol. Prevent constipation by increasing your intake of fibre in wholemeal bread, whole grain cereals, fruit and vegetables. Avoid straining while opening your bowels as this can overstretch the muscles of the pelvic floor and may eventually result in weakness occurring. Limit your use of laxatives so your bowel doesn’t get lazy. Avoid becoming overweight, as this puts extra strain on the pelvic floor muscles.
The combination of calcium and magnesium may help prevent bladder spasms, whilst zinc-rich foods, such as fish and dark green vegetables, may help improve bladder function.
Schedule toilet visits to help increase the length of time between passing urine, so the bladder muscle gets stronger and can hold more without emptying. Regularly do pelvic floor exercises by tightening pelvic floor muscles for 3-5 seconds, increasing to ten seconds as the muscle gets stronger. Relax for as long as the muscles were tightened. Do this 5-7 times, three times a day to start and increase to fifteen exercises three times a day.
6. What other options are there?
If these measures aren’t successful, speak to your doctor or continence nurse. They can discuss the options of surgery and medications with you.
7. What if I just want to be sure?
Incontinence pads will catch leaking urine and can be purchased from most pharmacies. Just newly available though, is the Confitex range of underwear with three layers of protection built into lovely fashionable lingerie. The inner layer allows for rapid moisture transfer away from the body into the high-absorbency mid-layer. The outer is waterproof while still being stretchy and breathable. All garments are machine washable and offer grades of absorbency depending on your needs. It such a great advancement to offer peace of mind to many men and women.