Urinary Incontinence and Your Nerves

Background

Many women experience daily urine leakage which is also referred to as urinary incontinence and the most commonly reported among women is stress urinary incontinence, which is defined as the involuntary loss of urine during an exertion, cough, or sneeze. Pelvic floor muscle exercises supervised by a pelvic floor physiotherapist can improve the symptoms of stress urinary incontinence, however, only half of the women who complete the intervention are cured. One of the key goals of the research in our laboratory is to better understand why some women’s symptoms improve more than others with pelvic floor muscle exercises. While we know that the sensory and motor nerves can experience strain during childbirth and that there is some evidence of this damage in women who suffer from stress urinary incontinence, these injuries have not been studied very much. In particular, there has been very little research on the role of motor and sensory nerve alterations in exercise-based interventions.

As such, through this study, we plan to assess the presence of motor and sensory nerve changes in women with stress urinary incontinence and to determine if sensory or motor changes may be responsible for the failure of pelvic floor exercises to alleviate symptoms of incontinence in some women.

Eligible Participants

• Group 1:
  • Female, >18 years
  • Not currently pregnant or have given birth within the last 6-months
  • No pelvic surgeries within the last year
  • Received 2 COVID-19 vaccinations
  • Not currently experiencing (<6months):
    • Regular leakage of urine or stool
    • Sexual or pelvic pain
    • Pelvic organ prolapse
• Group 2:
  • Female, >18 years
  • Not currently pregnant or have given birth within the last 6-months
  • No pelvic surgeries within the last year
  • Received 2 COVID-19 vaccinations
  • Currently awaiting or have only completed 1-2 physiotherapy sessions for the management of urine leakage
  • Currently experiencing urine leakage during:
    • Exertions
    • Coughing
    • Sneezing
• Group 3:
  • Female, >18 years
  • Not currently pregnant or have given birth within the last 6-months
  • No pelvic surgeries within the last year
  • Received 2 COVID-19 vaccinations
  • Completed pelvic floor physiotherapy for urine leakage symptoms within the last 2 years
  • Urine leakage generally occurred with exertions, sneezing, or coughing
  • Not currently experiencing pelvic pain

Participation

If eligible, you will be asked to complete four online questionnaires and attend 2 laboratory sessions at the Motor Function Measurement Lab at the University of Ottawa. The first lab session will be 2.5 hours and the second session will be 2 hours in length and will be scheduled no more than 10 days apart. Once completed, those who are attending physiotherapy will attend at least 4 of their sessions and then complete 2 final questionnaires 12-weeks after the start of their physiotherapy intervention. Please note that there is no compensation offered to participants and that this study does not include compensation for the physiotherapy intervention.

The first laboratory assessment includes a short pelvic exam, examining your awareness of your pelvic floor muscles and how well you can control them, and a pudendal nerve assessment.

The second laboratory assessment includes an examination of your genital sensation using single-use nylon filaments across 5 different testing sites. This will focus on the smallest filament that you can reliably feel and does not include any pain testing.

For a quick one-minute summary of this study, please watch the video below. This video was created by Kaylee Brooks, Ph.D. Candidate at the MFM Lab and was a finalist in the uOGRADflix 2021 competition.