• "Prevention, community education and advocacy
    are key to our integrated approach."


    "In many cases, incontinence can be prevented."


    "Incontinence is not a normal process of aging."


    "Incontinence can always be greatly improved or cured
    with treatment."



    The female pelvis

    What is urinary incontinence?

    Urinary incontinence is the complaint of involuntary leakage of urine. Stress urinary incontinence, the most common type, refers to leakage of urine when coughing, sneezing, laughing, or exercising. Urge incontinence refers to a strong desire to urinate and the inability to delay voiding long enough to get to a toilet. Mixed incontinence refers to a combination of both stress and urge incontinence.

    Incontinence facts:

    • Incontinence is a significant public health issue affecting over 3.3 million Canadians.
    • Urinary incontinence affects 50% of women at some point in their life cycle.
    • One third of these women develop regular problems.
    • Urinary incontinence is often linked to childbirth, obesity, menopause and previous urinary or gynaecological surgery.
    • Incontinence can have a profound impact on quality of life, causing depression, isolation, restricted participation in social activities and, in the elderly population, institutionalization.

    The muscles of the abdominal canister .
    (Lee, D. 2006)


    Types of incontinence:

    • Urge Incontinence (UI): Urine loss associated with a strong, sudden urge to void (urgency) that cannot be controlled.
    • Stress Urinary Incontinence (SUI): Involuntary loss or leakage of small volumes of urine secondary to increases in intra-abdominal pressure (e.g. coughing, sneezing, running, jumping, lifting).
    • Mixed Incontinence: A combination of stress and urge incontinence.
    • Overflow Incontinence: Constant loss of small volumes of urine. This is a medical condition, typically secondary to an obstruction or fistula.
    • Functional Incontinence: Urine leakage associated with physical dysfunction (e.g. an individual who is unable to walk to the bathroom) or cognitive impairments.

    What causes incontinence?

    The most common forms of incontinence can occur as a result of one of the following situations:

    • Increased intra-vesical pressure (pressure within the bladder).
    • Decreased urethral pressure (decreased sphincter closure) – secondary to pelvic floor muscle dysfunction, prolapse, multiple births, fibroids, post urinary/gynaecological surgery, etc.

    As well, weak muscles of the abdominal ‘canister’ or ‘core’, lumbo-pelvic dysfunction and behavioral factors (e.g. excessive intake of coffee/tea/coke, poor bladder habits, etc…) all may contribute to the development of incontinence.

    What do the Assessment and Treatment involve?

    • The initial assessment is 1 hour and will involve a detailed history-taking, an internal vaginal/anal exam and lumbo-pelvic orthopaedic assessment. The internal pelvic exam is necessary to assess the function of the pelvic floor muscles. The client will also be asked to complete a 3-day voiding diary and an incontinence questionnaire.
    • Subsequent treatments are 1 hour long and may involve the following: internal vaginal/anal techniques (to restore pelvic floor muscle tone, release fascial tension/scars, improve strength and coordination of the pelvic floor); manual therapy; exercise instruction and progression; electrotherapeutic modalities as needed and instruction regarding breathing, posture, diet, voiding strategies, etc.

    Do I need a doctor’s referral?
    No, a physician’s referral is not necessary.

    How many visits will be necessary?
    On average, you will require 6-8 treatments, however this number will vary depending on the extent of deficits and other co-existing factors. A successful outcome requires a serious commitment on the part of the client, as the daily exercise component of the program is key!

    For more information, please contact Killens Reid Physiotherapy
    Tel: 613.594.8512 Fax 613.594.0213 Email: killensreid@rogers.com