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BLADDER HEALTH 101: Tips To Improve Bladder Control

Bladder health 101: tips to improve bladder control

We all have one. Yet the health of our bladder isn’t something many of us give much thought to – at least, not until something goes wrong with it!

It’s important to know how to take care of your bladder, and to get the right advice for your age and life stage. Throughout your life, your daily habits and practices can put you in a better position to avoid bladder leakage or loss of bladder control, also known as urinary incontinence.

Here, Jean Hailes’ own bladder guru, continence and pelvic floor physiotherapist Janetta Webb, explains how to treat your bladder well at every life stage.

For young women (and all women needing to know the basics)

Don’t go to the toilet if you don’t need to go. Many girls and young women are taught to empty their bladders before they go out, before long car trips, or when they arrive at their destination. Instead, listen to your body’s messages and pay attention to your natural urges. Your bladder works best when it can tell you when it needs to be emptied, rather than the other way around!

You can’t get an infection from a toilet seat, so please sit down. Your bladder empties itself much better when you are seated and relaxed on the toilet. If you need to, use a disposable toilet seat cover, but don’t get into the habit of hovering over the toilet.

Don’t strain to empty your bladder. When urinating, relax, take your time and let your bladder set the pace.

Any bladder leakage in young women and girls shouldn’t be ignored. If you (or your daughter) get any sort of bladder leakage – for example, when playing sport, laughing, sneezing or jumping on a trampoline – visit your GP and get it treated early.

Bowel health affects bladder health. Being constipated is a common cause of urinary incontinence in girls and young women. Keep your bowels in check by staying hydrated, eating a diet rich in fibre and whole foods (such as fruits, vegetables and wholegrains) and exercising regularly.

How much water should you be drinking? Unless instructed otherwise by your doctor, aim to drink 1.5-2 litres of fluids every day. This includes everything that you drink, not just water. There is no evidence to support that drinking more than this is healthier. If leakage is an issue, switch to decaffeinated coffee and tea.

For pregnant women

Up to half of pregnant women experience urinary incontinence, so special attention needs to be given to your bladder (and urinary system) during this time.

Dedicate a daily session to your pelvic floor. To avoid incontinence in pregnancy, learn how to correctly exercise your pelvic floor muscles (the ‘sling’ of muscles that support the bladder, bowel and womb). Set aside a dedicated time to do your pelvic floor exercises every day, while doing nothing else.

Squeeze at pressure points. Additionally, get into the habit of squeezing your pelvic floor muscles while doing activities that put more pressure on your bladder; for example coughing, sneezing, bending or lifting.

Change is normal. It’s normal for pregnant women to urinate more frequently and to need to use the toilet during the night. But watch out for constipation, which is common during pregnancy (see tips above regarding bowel health and fluid intake).

Don’t ignore pain. Lower back pain or pelvic joint pain during pregnancy can impact your pelvic floor. Seek a referral to a physiotherapist who specifically treats these conditions – find one by visiting the Australian Physiotherapy Association website.

Keeping fit is key. However, make sure it’s pregnancy-appropriate exercise.

For postpartum women

The first few days and weeks after birth are a crucial time for your pelvic floor. While you’re in hospital after the birth, lie down and rest as much as possible. Start your pelvic floor exercises as soon as you can do so comfortably, without any pain.

Get some extra support. Postnatal compression garments give extra support. Additionally, when first using your bowels after giving birth, and in the first few weeks after, support your perineum with your hand.

Exercise caution with heavy loads. Try to avoid lifting anything heavier than your baby in the first six weeks after birth.

Return to a healthy fitness as soon as you are comfortable. One of the best exercises is walking. But if you experience bladder leakage with any exercise (such as jogging or gym workouts), it’s your body telling you that you are not yet ready for that particular form of exercise. Again, seek treatment for leakage early.

A note for breastfeeding mums. Breastfeeding keeps your levels of the hormone oestrogen low. As oestrogen supports bladder control, you will therefore rely even more on good pelvic floor strength.

For menopausal & postmenopausal women

Incontinence issues often arise in menopause. This is due to the falling levels of oestrogen, which can impact bladder control. Incontinence is also more common after gynaecological surgery.

Night-time bladder habits. If you wake during the night because of insomnia or night sweats, don’t just go to the toilet for ‘something to do’, or to help you get back to sleep. Empty your bladder only when needed.

Urinary tract infections are more common in midlife women. This is because of the reduction of oestrogen. Seek advice from your GP.

Tips for healthy ageing

Maintain your levels of fitness. The fitter you are, the better your flexibility, strength and endurance will be. This not only means you’ll be more able to maintain pelvic floor strength, but also helps with the practicalities of making it to the toilet in time.

Get back pain and hip pain treated. Don’t allow pain to limit your mobility.

Learn more about bladder health and urinary continence by visiting the Jean Hailes Bladder & bowel webpages.

Published with the permission of Jean Hailes for Women’s Health
jeanhailes.org.au
1800 JEAN HAILES (532 642)

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WORLD BREASTFEEDING WEEK 1/8/2017 – 7/8/2017

Just a gentle reminder to our Mothers-to-be, this week is World Breast Feeding Week. It marks the 25th anniversary of this event. The World Alliance for Breastfeeding Action (WABA) has declared this year’s theme as Sustainable Partnership and the Rule of Law. This event will be held and celebrated in most health facilities that look after pregnant women.

At the start of pregnancy, 9 months or 40 weeks seems like a long time. However, with the dynamics that come and go with pregnancy it passes very quickly and soon the baby arrives with all it’s needs, demands and “attitudes”. Feeding is one of the top needs that a baby comes along with.

The scientific community has clear and conclusive evidence that breastfeeding is the best nutrition for the newborn with lots of benefits to both mother and baby as well as to the economy and environment. For the newborn to maximally benefit from breastfeeding, it should start immediately following birth and continue exclusively till around six months. Introduction of solids can be started between 4 to 6 months of age when the baby is developmentally ready. Let us remind ourselves of the benefits of breastfeeding to both mother and baby:

Advantages of Breastfeeding to Mother:

  1. Skin to skin (kangaroo care) promotes bonding/mother-baby attachment, breastfeeding behaviour and latching. Breastfeeding puts the mother in control of nutritional needs of their newborn.
  2. Breastfeeding stimulates the release of hormones which promote contraction of the womb, hence less blood loss following delivery. Some of the hormones lead to relaxation and calmness to the mother.
  3. Exclusive breastfeeding leads to cessation of periods on average 6 – 8 months offering temporary contraception, however back up methods are recommended as well.
  4. Mother has less time off work due to infant illness when she resumes work.
  5. Breastfeeding is cheap and convenient.
  6. In the long term, the mother has less risk of breast cancer, ovarian cancer, endometrial cancer, coronary heart disease, osteoporosis and obesity.

Advantages of Breastfeeding to Newborn:

  1. Breastmilk offers complete,sterile nutrition for the baby. Colostrum has good proteins that are easily digested and absorbed by the body and brain. It helps gut maturation and confers passive immunity to the newborn.
  2. Mother’s milk has saturated, unsaturated fats and cholesterol which are easily digested and valuable for brain and nerve development resulting in good cognitive development.
  3. Breastfeeding confers protection against various infections such as ear infections, urinary tract infections, gastroenteritis and respiratory infections.
  4. It reduces the risk of Sudden Infant Death Syndrome (SIDS) by almost half.
  5. It reduces the risk of Type 1 and 2 Diabetes, Coeliac disease, Crohn’s disease and childhood cancers as well as the risk of mental health issues later in life.
  6. Breastfeeding can reduce the incidence of allergic disorders and risk of obesity as well.
  7. Breastfed babies respond better to vaccines; they also experience less nappy rash, thrush, stomach upsets and constipation.
  8. Breastfeeding promotes proper development of jaws and teeth with less cavities.

For those who are politically inclined, breastfeeding is good for the economy as it saves billions of dollars and is good for the environment as there is no waste nor green house gases.

As we celebrate this event, let us remember this sacred activity at the centre of development and growth of humankind. As you go through your pregnancy, if you have any concerns in this area please ask for advice from the midwives and doctors taking care of you. Most facilities have antenatal and postnatal breastfeeding advice and assistance programs in place which are ready to offer help. Dr Anwar Fazal, Chairperson and Director of WABA has put this world initiative very nicely in these words, “world breastfeeding week is a vibrant global movement for action to promote, protect and support breastfeeding by anyone, anywhere and at any time. It expands and connects the power of one with the power of many. Only by working together can we make the change we need”.

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Why full bladder and ultrasound: What you need to know

Please allow me to kindly remind you to present for your ultrasound examination with a “full bladder” thanks.

This is a common phrase from the receptionist whenever one books for a pregnancy or gynaecological ultrasound examination. What is the medical science behind this simple but sometimes uncomfortable request?

How ultrasound machines function:

Ultrasound equipment generates and receives sound waves. Ultrasound waves are at very high frequency that can’t be heard by the human ear.

Once the ultrasound probe is placed on or in your body, it transmits sound waves through your body. The sound waves travel through your body to organs and structures along their path of transmission. Sound energy and light energy have lots of similarities. Both can be reflected and in the case of sound, giving an echo as a result or it can be refracted leading to a change in transmission path.

Sound waves which are reflected or bounced back (echo) are very important in ultrasound examinations. We rely on the echo to make a diagnosis. The ultrasound machine can amplify and process these echoes and by using a special computer can generate an image of the body part that is getting scanned on a video screen which can be saved e.g. baby parts, uterus, ovaries etc. Once the computer has assessed these echoes it is possible to determine the distance, size, shape and consistency of the target organ.

In summary, an ultrasound machine functions in this cycle of: sound transmission, reception of echoes, analysing and processing of echoes and image display.

What is the Advantage of a Full Bladder:

The primary objective of every examination is to transmit as much sound energy as one can, so that we receive a good echo which may lead to better images. The use of ultrasound gel helps to maximise transmission of sound. Body tissues or organs have their own different inherent tendencies to sound transmission. Fluid filled body cavities have good transmission of sound whereas gas filled organs e.g. bowel and lungs have poor transmission of sound. In fluid filled cavities, there is better transmission and good echoes and in gas filled organs there is poor transmission and weak echoes.

A full bladder helps the sonographer in several ways:

  1. Sound transmitted through the bladder results in more sound energy at the target organs e.g. baby, cervix, uterus ovaries etc. This results in good echoes and better, more crisp images on display as the round trip of sound energy has little resistance to transmission.
  2. Air is a very strong ultrasound beam reflector. Bowel tends to fill up with intestinal contents and gas. This makes it almost impossible to get good transmission of sound to target organs if bowel is along the pathway as almost all the sound will get reflected before reaching the region of interest. A full bladder helps by pushing bowel out of the pelvis allowing transmission of ultrasound to target organs.
  3. Most women have an anteverted (tilted forwards) womb which unfortunately in some cases doesn’t present the ideal angle to the sound transmission pathway. A full bladder tilts the womb backwards hence presenting a more favourable angle to the transmitted sound energy which results in better images.

How much fluid should one take:

Bladder capacity and behaviour varies with individuals. Ideally, drink as much fluid to make your bladder comfortably full. If your bladder is not adequately full or is very full and causing great discomfort, both may impact negatively on the examination.

Depending on the service provider you may not need a full bladder for all examinations. Most early pregnancy ultrasound scans and up to 22-24 weeks will need a full bladder but thereafter possibly not. Gynaecological scans performed using the vaginal approach generally don’t need a full bladder as the ultrasound probe is much closer to the region of interest. When booking for an ultrasound scan, the reception staff will advise you accordingly depending on the indication for the scan on your referral.

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Welcome to our new website

At Specialist Ultrasound for Women Blacktown, the care of our patients is very important to us.  That care includes providing excellent patient education, so that you know what is happening at every step of the way.  In addition, we make it as easy as possible to book your scans as well as offering a full range of services, so no need to go elsewhere for more specialised tests.

With your care as our aim, we developed a user-friendly website that you can access via your desktop computer, your iPad or your mobile phone.

Our new website contains information on health conditions and types of scans and tests relating to being pregnant and for women’s gynaecology needs.  This information is easy to understand and to be used as a guide only, it doesn’t replace your doctor’s advice.

In addition, we have created a nifty Pregnancy Calendar to work out the estimated date of when your baby will be due as well as a Scan Calculator, to assist you with dates of when you should have your ultrasound scans during your pregnancy.

There are also a range of 3d and 4d scans of babies in our Scan Gallery.

We hope you will enjoy what our website has to offer.  We look forward to meeting you and assisting you with any of the services we offer, including:

Pregnancy ultrasounds

  • 7 week ultrasound
  • 1st, 2nd and 3rd trimester ultrasounds
  • Pregnancy complications scans
  • 3D and 4D imaging

Gynaecology Ultrasounds

  • Pelvic Scans
  • Infertility tests
  • Ectopic pregnancy/miscarriage

Specialised tests

  • First trimester screening for aneuploidy followed by counselling of results
  • Detailed 18-20 week morphology scan
  • Foetal heart echocardiography, Foetal Growth scans and follow up, Foetal Doppler studies
  • HYCOSY for Fallopian tube patency and Antral follicle counting
  • Sonohysterogram for endometrial cavity pathology
  • Chorionic villus sampling and amniocentesis
  • Ovarian cancer screening

 

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Think you might be having twins?

If you think you may be about to experience ‘double the trouble and twice the pleasure’ then it may be a good idea to learn more about having twins.

The incidence (rate) of multiple pregnancy is rising.  Twin birth rate increased from 19 per 1000 live births in 1980 to 32 per 1000 births in 2006 (ISOUG Guideline 2016). In Australia, twin pregnancies represent 1.4% of all births (Australia Bureau of Statistics, 2013).

Twins are two offspring produced by the same pregnancy. Twins can either be:

  • Identical (monozygotic): these comprise one third of twins and the majority (80%) are monochorionic diamniotic (MCDA); these share the same placenta but have different amniotic sacs. Very very few are monochorionic monoamniotic (MCMA); these share a placenta and amniotic sac.
  • Non-identical (dizygotic): these comprise two thirds of twins and are referred to as dichorionic diamniotic (DCDA). Non-identical twins carry less risk compared to the identical type.

There are some additional risks to having twins, so it is important to follow your doctor’s instructions for the safe management of your pregnancy, such as:

  • Twin pregnancies should have a dating scan between 11 and 13 weeks 6 days of gestation.
  • DCDA (non -identical twins): require first trimester screening for chromosomal problems; detailed 18-20 week scan and thereafter scans every 4 weeks.
  • MCDA/ (MCMA) – (Identical twins): require first trimester screening for chromosomal problems and then should be scanned every 2 weeks after 16 weeks to detect possible complications.
  • Screening for chromosomal problems in twins e.g. Downs Syndrome can be done in the first trimester using maternal age, nuchal translucency (NT) and hormonal blood results.
  • Structural anomaly scan should be done at 18-21 weeks.

It can be challenging for parents as more medical investigations are necessary than when you are having one baby.  By listening to advise from midwives and obstetricians and being sure to attend all medical appointments, you may lessen any risks and have a good health outcome, or two healthy outcomes that is!

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