One of the largest risk factors for incontinence is surgery of the pelvic or abdominal region. Patients who undergo Caesarian sections, spinal procedures, hysterectomies and hip replacements face a heightened risk of incontinence post-op. For example, hip replacements affect the function of the obturator internus, a major muscle support for bladder and bowel stability, said Janet Hulme, MA, PT, a well known author and lecturer on incontinence. As a result, the majority of total hip patients will come out of the procedure with problems. Educating these patients early, while they are at ease and more receptive to information, can lower the occurrence of incontinence after the procedure.
Pregnant women are also at risk of developing incontinence during and after pregnancy.
Childbirth may damage the pudendal nerve in a majority of women, leading to the possibility of episodes of stress incontinence following delivery. Older patients, especially older women, are perhaps the largest risk group. Hulme explained that while menopause is not necessarily a contributing factor of incontinence in itself, the corresponding depletion of estrogen can contribute to general weakness of the supporting structures of the pelvic musculature. For all of these groups, both Hulme and Downey will usually teach targeted exercises to strengthen the pelvic musculature and combat muscle weakness before it leads to incontinence. Another component to a preventive protocol is general fitness.