Pregnancy and Your Pelvic Floor

Understanding Stress Urinary Incontinence: Causes, Symptoms, and Treatment Options Stress urinary incontinence (SUI) is a common yet often misunderstood condition that affects millions of people worldwide. It can impact anyone, but it’s more prevalent among women, especially those who have had children, are aging, or are experiencing hormonal changes. Despite its name, SUI is not about emotional stress but refers to the physical stress or pressure placed on the bladder that leads to involuntary leakage of urine. In this blog post, we’ll take a closer look at what SUI is, its causes, symptoms, and available treatment options. What is Stress Urinary Incontinence? Stress urinary incontinence occurs when the pelvic floor muscles and the tissues surrounding the bladder weaken, leading to leakage of urine during physical activity or moments of increased abdominal pressure. These activities include sneezing, coughing, laughing, exercising, or even lifting heavy objects. The pressure on the bladder can overwhelm the muscles responsible for holding urine in, leading to an unintended release of urine. While it’s a condition that many find embarrassing to talk about, it is also highly treatable, and understanding it is the first step toward seeking effective solutions. Causes of Stress Urinary Incontinence SUI usually results from a weakening or dysfunction of the pelvic floor muscles, which provide support to the bladder, urethra, and other pelvic organs. These muscles can weaken for a variety of reasons, including: Childbirth : Vaginal delivery, particularly if it’s difficult or involves a large baby, can stretch and weaken the pelvic floor muscles. This is one of the most common causes of SUI in women. Aging : As women (and men) age, the muscles in the pelvic floor lose some of their strength and elasticity. The decrease in estrogen levels after menopause can also contribute to weakening of the tissues in the pelvic area. Obesity : Excess weight puts additional pressure on the bladder and pelvic floor muscles, which can contribute to SUI. Chronic Coughing or Sneezing or constipation : Conditions such as chronic respiratory issues or allergies that cause frequent coughing or sneezing can increase pressure on the bladder and trigger leakage. Pelvic Surgery or Radiation : Previous surgeries, particularly those involving the reproductive organs, or radiation therapy can damage or weaken the pelvic floor muscles, leading to incontinence. Genetics and hypermobility : Some people may be genetically predisposed to a weaker pelvic floor or hypermobility, which can lead to SUI. Symptoms of Stress Urinary Incontinence The primary symptom of SUI is the involuntary leakage of urine during moments of physical exertion. The severity can vary depending on the individual and the underlying causes. Some common signs and symptoms include: Leakage during physical activity : Any activity that increases abdominal pressure, like running, jumping, or even lifting a heavy object, may trigger leakage. Frequent leaks with coughing or sneezing : Many people with SUI experience accidents when they cough, sneeze, or laugh. Feeling of urgency : Some individuals may feel a sudden and strong need to urinate, especially when combined with physical activity. It’s important to note that while stress incontinence is the most common type of urinary incontinence, it is different from urge incontinence, which is caused by an overactive bladder. Management Options for Stress Urinary Incontinence The good news is that there are many effective treatments for SUI, ranging from conservative measures to surgical interventions. The best treatment depends on the severity of the condition, the underlying cause, and the patient’s overall health. Pelvic Floor Exercises (Kegel Exercises) The first line of treatment for SUI is usually pelvic floor exercises, commonly known as Kegel exercises. These exercises involve repeatedly contracting and relaxing the muscles that control urination. Regular practice of Kegels can strengthen the pelvic floor muscles and improve bladder control. Biofeedback Pelvic floor physical therapy uses a combination of techniques, including biofeedback, electrical stimulation, and manual therapy, to help strengthen the pelvic muscles. A trained therapist can guide you through these exercises and monitor progress. Surgical Treatments For more severe cases of stress urinary incontinence that don’t respond to conservative treatments, surgery may be necessary. Common surgical options include: Sling Surgery : A sling made of mesh or other materials is used to support the urethra and prevent leakage. Colposuspension : The bladder neck is lifted and secured to reduce leakage. Artificial Urinary Sphincter : This implantable device can help control urine flow in cases of severe incontinence. At Pelvic Health Melbourne, our physiotherapists can help using these management techniques and work closely with surgeons to ensure optimal recovery if surgery is indicated. Stress urinary incontinence is a manageable condition, and with the right treatment plan, individuals can regain control over their bladder and improve their quality of life. If you’re experiencing symptoms of SUI, don’t hesitate to speak with a healthcare provider. Early intervention can help prevent the condition from worsening and lead to effective relief. Remember, you are not alone in dealing with this issue, and there are numerous options available to help you feel confident and comfortable again. Take the first step today and seek the support you deserve.

At Pelvic Health Melbourne (PHM) we are sensitive to the long and ongoing physical and emotional journey gender affirming surgery can entail. Your ongoing commitment to hormonal management, adjusting to the physical change, enduring the surgeries and the recovery process as well as the ongoing emotional journey and counselling required to help you along the way. Some of the components an individual may experience on their gender affirming journey may include: 1. Hormone Replacement Therapy (HRT): Estrogen (typically the primary female hormone) is used to develop female secondary sexual characteristics like breast development, redistribution of body fat, and skin changes. Anti-androgens (such as spironolactone or finasteride) block the effects of testosterone, which is important for reducing male-pattern hair growth, deepening of the voice, and other masculine features. Testosterone (typically the primary male hormone) is encouraged to promote features such as hair growth, muscle growth, voice changes and others. Ongoing contact with an experienced Endocrinologist - to monitor and adjust hormonal therapy to balance the ongoing changes of affects and side effects of hormonal therapy as we age. 2. Surgical Procedures: Breast Augmentation: While HRT can cause breast development, some individuals may opt for surgery to achieve a fuller chest. Orchiectomy (orchiedectomy) and penectomy: Surgical removal of both testes and the penis. Vaginoplasty: A common surgery for creating a neovagina, allowing for sexual function and appearance that is consistent with female anatomy. Vulvoplasty: surgery for creating a neovulva (vulva without a vagina) with the external appearance of female anatomy. Facial Feminization Surgery (FFS): Some transgender women may undergo surgery to soften facial features to achieve a more feminine appearance. Voice Feminization Surgery: This can alter pitch and resonance, though voice therapy is often used alongside or instead of surgery. 3. Psychological Support: Transitioning involves significant psychological changes and challenges, so counselling or therapy with a provider knowledgeable about transgender issues is often recommended. This helps with mental health, body image, and managing potential dysphoria during the transition. Your transition will be unique and we hope you have the support team helping you to navigate the bumps in the road, and provide resources and treatment you may need. At PHM we support individuals surgically transitioning with a prehab and rehab routine. Our prehab session involves receiving bladder, bowel, intimacy, and pelvic floor muscle baseline function to address any pelvic health concerns before surgery. Post-surgery we assist with vaginal dilators to maintain the vaginal space, advice and massage for wound healing, and return to exercise and life. We can also support you with pelvic pain conditions such as; vaginismus, vulvodynia and endometriosis. For all our community we can help with pelvic and/or intimacy pain. This may involve symptoms in the abdomen, hips, groin, and intimate areas.

Jaw, jumping and jellyfish all start with the letter J and are all related to pelvic health. How can we help?