Much of the attention given to urinary incontinence is from a biomedical point of view. The perspective of surgical intervention neglects attention to social and psychological factors in women's lives that could improve prevention and treatment options for incontinence. It is clear that development of muscles in the pelvic floor area that assist bladder control have beneficial effects for urinary incontinence (see box on Kegel exercises).

Among the physical factors that affect the viability of the pelvic floor in urine retention are:

* Pregnancy and childbirth. Women frequently experience temporary incontinence at the end of pregnancy, as a result of stretching and overloading of pelvic muslces, episiotomy, or forceps delivery. Traumatic childbirth can have lasting consequences for bladder control.

* Child care. Likewise, bending, carrying and lifting small children, particularly in conjunction with poor posture, can stretch the pelvic floor with negative consequences for urinary retention.

* Hormones. Hormones have a cyclical impact upon muscle tone during menstruation that make it more difficult to control muscles of the pelvic floor, a condition that becomes more permanent after menopause.

* Weight. Obesity constitutes an extra burden upon the pelvic floor muscles, particularly as women age.

* Clothing. Corsets and girdles that circumvent the use of abdominal muscles are less used now, but have been and still are used by older women. Tight pants have similar effects and are commonly worn by younger women. Weakened stomach muscles lessen voluntary control over pelvic floor muscles. High-heeled shoes also militate against abdominal strength and good posture.

* Household work. The physical effort involved in making beds, hauling laundry and groceries, gardening, home repair and other domestic labor, particularly along with posture that does not enhance stomach muscle control can exacerbate problems with weakened pelvic muscles.


A self-confident and self-respectful attitude is associated with straight posture, strengthening the muscles in the pelvic floor and enabling control of abdominal muscles. For daily works, women should prepare best wireless earbuds for working out for themselves to relax any time they doing their housework. Because of the ways in which we internalize sexism, and because of cultural embarrassment about sexuality, women frequently avoid attending awarely to our own bodies. Therefore, development of awareness and control of the muscles in the pelvic floor requires special effort and encouragement.

A research program that focuses upon the importance of the factors common in women's lives in the development and prevention of urinary incontinence should include:

• Epidemiology - prevalence and incidence of the condition in particular groups;
• Ergonomics - the effects of household and other occupational environment and labor;
• Psychology - how women's attitudes towards their bodies, and urinary function in particular, affects the effectiveness of preventive and treatment measures;
• Medicine - indications for therapy, postoperative measurement of outcomes, and relapse rates; and
• Prevention - development and evaluation of exercise training programs for women, as well as information programs for health providers, including physical therapists.