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A Wii problem

Triggers for urinary incontinence vary, but there is a solution, says Gill Brook

Working in women’s health for over 20 years, I’ve met a lot of women with stress urinary incontinence.  And on asking patients when and why their symptoms started, I’ve seen several ‘themes’.

In the 1990s a common culprit was the bouncy castle, prevalent at children’s parties at the time. What parent could resist a go? But the combination of bouncing and laughing on a woman’s pelvic floor could highlight a weakness of which she wasn’t aware; even worse after a glass or two of wine.

A decade later, and attention had moved to the trampoline; a common sight in many a back garden. Again, it was not rare for women to cite this as the trigger for their referral to physiotherapy.

Since the late noughties, there has been a new kid on the block in the shape of the Nintendo Wii. I have met several women with a similar story - bought their child a Wii for Christmas or birthday, whole family joins in, lots of merriment, Mum makes her apologies and leaves in a hurry...

Stress urinary incontinence - leakage of urine with physical activity, coughs and sneezes, among other things - affects around one in four women at some time, and can have a major effect on quality of life, often leading to low mood and social isolation.

The success of physiotherapy and pelvic floor muscle training for the majority of women with stress urinary incontinence has been proved; the challenge lies in making treatment available and accessible to the women who need it.

In times of financial restraint within the NHS it’s not easy to justify some physiotherapy services, but here’s one that is not only evidence based and supported by NICE, but may also reduce costs elsewhere by decreasing the workload of consultants and reducing the need for surgery.

Whatever craze comes next, after bouncy castles, trampolines and games consoles, there should be ready access to continence physiotherapy services, so women can continue to get involved and enjoy it.

Gill Brook is therapy co-ordinator for women’s health at Bradford Teaching Hospitals NHS Foundation Trust.

For a free copy of the CSP’s Physiotherapy works briefing on urinary incontinence, go to


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