Stress incontinence can be helped, and in many cases corrected, by pelvic-floor exercises, which strengthen the sphincter muscles that surround the urethra. These are sometimes called PC exercises in honour of the most important of these muscles, the pubo-coccygeus. By strengthening the pelvic floor with PC exercises, surgery can be avoided in up to 70 per cent of women with stress incontinence.

Pelvic-floor exercises can also prevent problems from arising, so it is important to start them before the first pregnancy and continue them during antenatal exercise programmes.

If you have mild stress incontinence you could try the exercises as a self-help measure. If your incontinence persists after you’ve followed the exercise programme conscientiously for three months (it takes this long for any exercise-strengthening programme to take effect), see your doctor. Other causes may be contributing to the problem.

If you leak a lot of urine each time the pressure in your abdomen increases, it’s wise to see a specialist in urology who will advise you whether exercise alone is likely to correct your incontinence, or whether you may need an operation to tighten those muscles that are too stretched to be sufficiently toned up by exercise, and to lift the bladder and hold it in its proper position.

If muscles are badly weakened or damaged, it’s best to learn the exercise routine from a physiotherapist or nurse to make’ sure that you’re using the right muscles. Even if you need surgery, the results will be better and your convalescence shorter if your muscles are in good shape.

Other measures that are important in correcting stress incontinence are weight control, correction of constipation or chronic cough, and prompt treatment of any urinary infection.

If surgery is advised, your doctor should explain what will be done and what the operation can achieve, as well as how long your stay in hospital will be, length of convalescence, any possible complications, and costs. The results of surgery in the right circumstances are generally very good, but don’t let yourself be rushed into it: if you have any doubts, seek a second opinion.

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