Although incontinence is something we usually think is light years away, increasingly it's plaguing more and more younger women.

Australia's growing obesity epidemic and the biggest baby boom in decades are triggering more cases of stress incontinence than ever.

During pregnancy, the pelvic floor muscles that support the urethra can be stretched and weakened. So when a new mother coughs, laughs, sneezes or even lifts her baby, she can easily leak.

Dr Anna Rosamilia, a urogynaecologist in Melbourne, says: 'Incontinence is very common during pregnancy due to the uterus and baby pressing on the bladder, and also due to circulating hormones such as progesterone and relaxin. The hormones make the connective tissue and ligaments in the pelvic area soft and stretchy to help during delivery - but this can also predispose women to leakage.'

And unfortunately for many women, even once they've delivered the baby, the incontinence can remain.

Increasingly, obesity is also a risk factor for incontinence, with more Australian women putting on weight around the stomach area, adding extra pressure to pelvic muscles around the bladder.

Contiform

If incontinence is sending you potty, Contiform is the very latest intra-vaginal device. Inserted like a tampon, it's cheap, there are no apparent side effects and it works.

Already being used in some Australian hospitals, Contiform is shaped like a large hollow tampon and it's inserted and removed in much the same way. However, initially women need to be shown the correct insertion and removal technique by a continence nurse.

According to the International Urogynecology Journal, a study of 37 women found that 54 per cent of previously incontinent women were completely dry on a 24-hour test pad the day after using the Contiform device.

'Contiform is excellent for women who leak when they play sport, go walking, or even when they sneeze or laugh,' explains Wendy Allen, a continence nurse from St George Hospital.

'It's also ideal for people who are in the middle of having families and don't necessarily want to have surgery yet. It can also help keep them dry until they're ready to have surgery.'

A quick price comparison with pads and Contiform shows the latter may be cheaper too.

'Using three pads a day would cost around $1. Contiform, used every day, would only cost 71 cents,' says Lee Borg, from Medical Industries Australia which supplies the device.

'A new Contiform kit costs $32 - used every day for most of the day, it should last about 45 days. However for women who just use it for an hour or two a day as they go to the gym, it could last them anywhere up to six months.'

Contiform must be taken out and cleaned once a day. Wash with lukewarm water and leave to dry naturally. When not in use, store in a dry container. For more information, visit www.medind.com.au

Botox

Highly popular as an anti-ageing treatment, Botox has been used for years to turn back the clock. But today it's also proving to be a useful tool in tackling embarrassingly overactive bladders that can make long car trips or those spontaneous office meetings a living hell.

During randomised trials in the UK, women with overactive bladders had Botox injected into the bladder wall. The Botox relaxed the taut bladder muscles so they couldn't squeeze together as hard. This stopped the women from having to urinate as frequently or as unexpectedly.

'Botox has been useful in some people when nothing else has worked for their severe bladder overactivity,' Dr Rosamilia says.

'In situations where pelvic floor exercises to strengthen the bladder muscles and medications to relieve the problem haven't worked, Botox can often help.'

Stem cells

According to a study conducted by the Medical University of Innsbruck in Austria, stem cells may help women get rid of stress incontinence.

Researchers injected women with myoblasts and fibroblasts cells. Myoblasts are a type of muscle stem cell and fibroblasts are stem cells that form a scaffold for body tissues.

In the Austrian study, 38 out of the 42 women who were given stem cell injections were continent after a year. The thickness of the muscle that contracts the urethra increased by 59 per cent and the ability of that muscle to contract - and so stop urine leakage - increased by a considerable 268 per cent.

Doctors says the results are promising for millions of women plagued by the frustrating problem, but further research is needed before stem cell injections will become available.

Did you know? 

• According to the Australian Bureau of Statistics more than four million Australians suffer from incontinence.
• If left untreated, urinary incontinence can have a negative effect on self-esteem, sexual function and social interaction.

Back to basics

For many women, one of the most effective ways to minimise incontinence is by doing pelvic floor exercises. A study carried out by Dr Patricia Neumann, a physiotherapist at the Pelvic Floor Rehabilitation and Continence Clinic in SA, found about 80 per cent of women with stress urinary incontinence who did proper pelvic exercises were cured.

'Training the pelvic floor muscles has to be very specific if it is going to help with urinary incontinence,' Dr Neumann says.

'A lot of women do their "pelvic floors" at the traffic lights and wonder why it doesn't help. There are lots of studies showing that at least a third of women don't always get the technique right.

'Pelvic floor training aims to actually improve the function of the pelvic muscles to keep the urine from leaking out. It can address tone, strength and speed or whatever your physiotherapist advises.'

So if you feel you may be seeing the early signs of urinary incontinence, talk to your GP and also arrange to see a physiotherapist who can teach you how to look after your pelvic floor correctly.

Top tip

• Drink to ensure a urine output of one to two litres a day. Don't assume what you put in one end will come out the other. Dehydration makes incontinence worse.
• Only go to the toilet when your bladder is full - about 250ml or more.
• Maintain a healthy weight and aim to lose any excess weight, especially if it's around the stomach and pelvic area.
• Treat the cause of chronic coughing or sneezing, such as asthma or hay fever.
• Fix constipation - straining can aggravate incontinence.
• Limit your caffeine and alcohol intake.
• Avoid smoking

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