Urinary Stress Incontinence

At the bottom of your abdomen (stomach area) sits a muscle called your pelvic floor muscle, this is the muscle that you squeeze when you are forced to hold on and not go to the toilet; it prevents leaking of urine (wee). There are certain things that can put your pelvic floor muscle under “stress”, meaning it has to work harder to stop the leaking of urine. These activities may include coughing, laughing, jumping, and sneezing. We know that people with CF cough more than others. This increased coughing causes increased pressure in your chest, abdomen and on your pelvic floor. This increased pressure can cause you to accidentally leak some urine. This is called urinary stress incontinence.

Urinary stress incontinence is more common in females with CF than those without CF. It has been reported in males with CF but is far less common compared to females.

If you experience stress incontinence try not to feel embarrassed about discussing it with your physiotherapist or a member of your health care team. There are exercises you can do and also some tips to help you.

Your physiotherapist can teach you ways to look after your pelvic floor when performing your airway clearance and coughing, and you can also be referred to a physiotherapist who has special training in pelvic health.

You may have heard of the “knack”, if not talk to your physiotherapist about this. It is something that is helpful to learn from a very young age and should be used when performing airway clearance and in particular any forced expiratory manoeuvres (huff, cough, lung function).

The “Knack”

The knack is encouraged when individuals are performing airway clearance, prior to a cough or huff and may be useful at times during certain exercise or physical activity.

* find a comfortable sitting position when learning and practicing this technique

* lift, squeeze, and hold your pelvic floor, imagine you are in a situation where you want to pass wind but need to hold it in, tighten the muscles around the back passage, vagina and the urethra

* become comfortable with this technique and then practice it bracing before the cough or the huff