Continence and micturition involve a balance between urethral closure and detrusor muscle activity. Urethral pressure normally exceeds bladder pressure, resulting in urine remaining in the bladder. The proximal urethra and bladder are both within the pelvis. Intra-abdominal pressure increases (from coughing and sneezing) are transmitted to both urethra and bladder equally, leaving the pressure differential unchanged, resulting in continence.
Prevalence of urinary incontinence was 51.5% (men 51.4%, women 51.5%) and was found to rise with increasing age. At the time of admission, 37% (men 43%, women 34%) were urinary incontinent.
Treatment is keyed to the type of incontinence. The usual approaches are as follows: • Stress incontinence - Surgery, pelvic floor physiotherapy, anti-incontinence devices, and medication • Urge incontinence - Changes in diet, behavioral modification, pelvic-floor exercises, and/or medications and new forms of surgical intervention • Mixed incontinence - Anticholinergic drugs and surgery
According to the researchers, fun is a recipe for success. “Compliance with the program is a key success factor: the more you practice, the more you strengthen your pelvic floor muscles.