Bladder and pelvic floor problems

Pelvic floor health

The pelvic floor is a group of muscles inside your body. These muscles act like a hammock or sling, and help hold in place body parts, such as the bladder, bowel and womb. Sometimes these muscles can become weak. This can happen with aging, after having a baby or, sometimes, from heavy lifting.

When the pelvic floor is weak, it can make it harder to hold in urine. It can also cause some body parts, like the bladder, bowel and womb, to move out of place. Some people may feel like they need to go to the toilet very suddenly. These problems are quite common and can make everyday life harder.

Pelvic organ prolapse

Pelvic organ prolapse is when some body parts inside a woman’s body drop when they shouldn’t. These parts can include the bladder, womb or bowel. They can move into the vagina.

Women might feel a lump, a heavy feeling, or like something is slipping down inside them. If it is very bad, it can hurt and make it hard to urinate. These problems can often be helped by doing special exercises to make the pelvic floor muscles stronger. Sometimes, however, exercises are not enough. In those cases, doctors can put a soft support inside the vagina to help hold parts in place, or they may do an operation to fix the problem.

Stress urinary incontinence

Stress urinary incontinence is when a little bit of urine leaks out when laughing, coughing, sneezing or moving quickly. This happens because the muscles that help hold in urine are not strong enough.

This problem can also be helped by doing pelvic floor exercises. Many women find that, after doing these exercises regularly for a few months, the leaking gets much better. If the leaking is severe, some people may need extra help from a doctor.

Overactive bladder and urge incontinence

An overactive bladder is the sudden, strong urge to urinate that’s hard to ignore. Sometimes this causes leaking urine before reaching the toilet.

People with this problem may need to go to the toilet very often, feel like they must go right away or wake up many times at night to urinate.

Doctors don’t always know why this happens, but it is more common as people get older.

Management of pelvic floor and bladder symptoms

There are things people can do to keep their pelvic floor muscles strong and healthy.

Not smoking and keeping a healthy body weight help reduce the chance of having these problems.

The best way to help or prevent these problems is by doing special pelvic floor exercises to make the muscles stronger.

Pelvic floor exercises

Pelvic floor exercises are done by gently squeezing the muscles and then relaxing them. You can do them while standing, sitting down or lying down with your knees bent.

To do the exercise, squeeze the muscles you would use to stop urination or passing wind, then relax them again. Try not to squeeze your tummy or bottom muscles. At first, these exercises may feel hard, but they get easier the more you practise. It helps to do them at the same time every day, like when brushing your teeth.

The exercises should be done three times a day. Each time, do 10 long squeezes and 10 quick squeezes.

• Long squeezes: hold for 10 seconds, then relax for 5 seconds.
• Quick squeezes: squeeze for 1 second, then relax for 1 second.

Constipation

Having constipation can make problems worse. This is because pushing too hard when doing a poo can make the pelvic floor muscles weaker.

Good toilet habits can help keep your body healthy. Drinking lots of water and eating foods with fiber, like fruit, vegetables and whole grains, helps keep stool soft and easy to pass.

When sitting on the toilet, putting your feet on a small stool can help. This helps your body to be in a better position and makes doing a poo easier.

Overactive bladder

Overactive bladder can improve by avoiding things that can irritate the bladder. Drinks like tea, coffee, cola, fizzy drinks and alcohol can make the bladder more active. Smoking can also make symptoms worse.

Another way to help is by training the bladder. This means trying to wait a little longer before going to the toilet, so the bladder learns to hold urine for longer.

If these things don’t help enough, doctors can give medicine or other treatments to help calm the bladder.