Bladder Leaks are no Laughing Matter… a Common but Unspoken Problem

Written by Jodi Boucher

1 in 3 women who have ever had a baby have stress urinary incontinence (SUI). This type of incontinence is the leakage of urine during physical activity such as sneezing, coughing, laughing or lifting. This can be an embarrassing problem.

“There are a number of options available to women with stress incontinence,” says Dr. Magali Robert, Calgary urogynecologist and co-author of several national guidelines for the treatment of incontinence. “This includes pelvic floor (Kegel) exercises preferably with the direction of a pelvic health physiotherapist.” The pelvic floor is a hammock of muscles that stretch across the bottom of the pelvis. It is attached to the pubic bone in front and to the tailbone behind.

Find your pelvic floor

There are a few ways for you to feel your pelvic floor working. Can you stop or slow the flow of urine halfway through emptying your bladder? (This is just a test to find where the muscles are and should not be used as an ongoing exercise). Can you tighten the muscles around your anus as if stopping gas? As you tighten all of the pelvic floor muscles, do not tighten your legs, bottom or tummy. Do not hold your breath. Focus on the full relaxation of the muscles after the contraction!

Exercise your pelvic floor

The pelvic floor muscles need to be exercised in a couple of ways for optimal function. We all know that athletes train for speed and for endurance. Similarly, your pelvic floor muscles need two types of training to address incontinence:

1. For a slow and sustained contraction, squeeze and lift slowly and work up to a 10-second hold time. Relax completely for 10 seconds between each contraction. Repeat 10 times.

2. For a quick and short contraction, squeeze and lift as quickly as possible holding for one second and then releasing. Repeat 10 times. Practice these exercises regularly three times a day thorough all stages of your life. It may take six to eight weeks to notice improved pelvic floor function.

These exercises can be very effective in reducing or eliminating bladder leaks. If you are not sure if you are using the right muscles, see a pelvic health physiotherapist. Your physiotherapist will provide you with a detailed examination and treatment program. Biofeedback may be recommended to monitor your progress and provide you with feedback. Electrical stimulation is another treatment option to improve your pelvic floor awareness.

Exercise and what else?

Dr. Robert also states that “pessaries in the vagina to give support can help many women.” A pessary is a device that can help support the urethra and prevent your bladder from leaking. They come in a variety of sizes and shapes. Some physicians or Nurse Continence Advisors will have a selection of pessaries to ensure a comfortable fit.

Surgery may be another option for treating SUI. “We do not recommend surgery until childbearing is finished but we do offer bulking agents. These ‘plump’ the urethra and help with continence,” says Dr. Robert. This is a procedure offered at some specialty urogynecology clinics.

Dr. Robert advises that “the best strategy is to prevent the problem by actively doing pelvic floor exercises before incontinence begins. This should be a lifelong habit that is started early.”

A great place for you to start is to attend the ‘Exercising Your Pelvic Floor Class’ offered through the Women’s Health Resource Centre here in Calgary. These low-cost classes for women teach you where your pelvic floor is, what it does and how to properly exercise it. It is open to any women wanting to learn more about exercising the pelvic floor. It is a great class to attend to help with the prevention or treatment of stress urinary incontinence. It is also helpful for those with pelvic organ prolapse, bowel incontinence or those looking to prevent pelvic floor problems. Look on the Women’s Health Resource Centre website for class registration details at calgaryhealthregion.ca/clin/women or call 403-944-2260.

Other resources

Canadian Continence Foundation - www.canadiancontinence.ca
National Association for Continence - www.nafc.org
Alberta Physiotherapy College and Association - www.physiotherapyalberta.ca
Canadian Physiotherapy Association - www.thesehands.ca


Jodi is a physiotherapist, clinician at the Calgary Pelvic Floor Clinic, graduate student at the University of British Columbia and mother of three elementary school children! She is passionate about women’s health and pelvic health education.