Continence

Problems controlling your bladder or bowel are common, affecting over 5 million Australians, including one in three women who have had a baby.

What causes continence problems?

Pelvic floor muscle weakness is a common cause of many continence problems, along with changes to the nerves that control the bladder, bowel or pelvic floor.

Sometimes other health problems such as diabetes can cause incontinence.

Common risk factors include:

Pregnancy and childbirth
Menopause
Being overweight
Chronic coughing
Constipation
Frequent lifting of heavy objects e.g. children, weights at the gym
Pelvic or abdominal surgery
Some medications.

Symptoms of incontinence

If you have problems with bladder control you may experience:

A need to pass urine often, including overnight.
An urgent desire to pass urine – e.g. as soon as you put the key in the door.
Poor urine flow.
Straining to empty your bladder.
Leaking urine when you exert yourself e.g. sneeze, cough, laugh or jump.

If you have problems with bowel control you may experience:

An urgent need to open your bowels.
Leaking from the bowel.
Being unable to control wind.
Straining to empty your bowels.

Diagnosis

To diagnose continence issues, a doctor will take your medical history and conduct a physical examination. They may ask you to keep a diary to track when you go to the toilet. Urine specimens can also be taken to check for infection.

Management and treatment

Lifestyle and dietary actions can often help manage incontinence. These can include healthy lifestyle choices and pelvic floor exercises. Your Family Planning doctor can advise you on these.

Other treatments include:

Pelvic floor exercises/rehabilitation.
Oestrogen therapies and other medication.
Fitting a vaginal pessary.

FPT continence services

Family Planning offers the following continence services:

Continence assessment – medical history and examination and tests if required.
Continence management plan which may include:
- Lifestyle measures
- Medication
- Pessary fitting – insertion of a ring pessary to hold up the bladder neck
- Ongoing pessary care
- Recommendation/referral to a pelvic floor physiotherapist
- Referral for surgery