Winter 2006
Educating, Connecting and Supporting families in Monash
Women's Health
Most of us have had that feeling of needing to 'go to the loo now or I will wet my pants'. Most of the time we make it in time with a sigh of relief. After giving birth many women experience problems with their bladder.
Most commonly, there is a loss of urine when one laughs, coughs or sneezes. This is called stress incontinence.
Some women are unable to 'hang on' when they need to go to the toilet. This is known as urge incontinence. The worst-case scenario is the inability to control the loss of urine at all. This can be due to many different causes.
Your bladder is a located in your pelvis, in front of the uterus. The bladder is balloon shaped and has muscles and nerves.
The bladder has sphincters, like rubber bands, that control the opening and closing of the neck of the bladder. This is called the urethra. The urethra is a thin narrow tube that carries urine from the bladder to the opening. The pelvic floor muscles also help here.As the muscles contract, the bladder, uterus, vagina and bowel lift up slightly to allow the urine to pass easily. Relaxation of the pelvic floor muscles allows using the pass through. When the muscles are weak, the ability to contract and support the internal organs decreases, as therefore it is more difficult to control urine flow.
Most importantly, it you are having problems after your baby is 6 weeks old then please visit your local doctor, obstetrician and physiotherapist for advice and treatment if needed.
The next article talks about what are the common causes of urinary incontinence and how to perform pelvic floor exercises!
Thanks to Claire Sheehan, Monash Medical Student for her contribution to this article.
Plevic Floor Care
Liz Glasgow, Physiotherapist
Causes of Damage to the Pelvic Floor
During Pregnancy- Due to increasing weight
- Due to chronic straining as with constipation
- More than one vaginal delivery
- Baby weighing more than 4kg
- Long labour, especially 2nd stage
- Some tears in and around the vagina and anus
How do I know if I have a problem?
Bladder- Loss of urine with coughing and sneezing
- Strong sensation of needing to pass urine with or without urine loss
- Not being able to control wind
- Bowel urgency - needing to rush to the toilet to open your bowel
- Soiling - bowel accidents
Prevention and Treatment
Pelvic Floor Muscle Exercises (PFM). Recent studies have shown a quicker recovery of the pelvic floor muscles after your baby is born, if your exercises are done regularly during pregnancy.
It is most important- To perform the exercises correctly
- Try to incorporate your exercise program into your daily activities
- Avoid any chronic straining
The Pelvic Floor Muscles form the floor of the pelvis. Their main function is support for the bladder, uterus and lower bladder.
They have an active role in bladder and bowel control helping to stop urine leakage from the bladder and wind and faecal matter from the bowel.
They also have an indirect effect on the bladder and bowel that helps reduce bladder and bowel urgency.
Try to do your exercises regularly two to three times a day gradually increasing until you can hold a contraction for 10 seconds and do 10 exercises at each session. Remember to have a 10 second rest between each PFM contraction to allow the muscle to recover so that it does not become fatigued.
Aim to do ten 'quick' contractions - squeeze and hold for one second and then relax - twice a day.
Develop "the Knack"
Contract the pelvic floor muscles and hold while coughing, sneezing, bending or lifting to help prevent urinary leakage and help prevent prolapse.
Seek help if you are at all concerned with the bladder or bowel control, experiencing any pain or discomfort in the Pelvic Floor area or are unsure if you are exercising the muscles correctly.
Updated: 3 August 2006
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