When we talk about incontinence we are talking about both faecal and urinary incontinence. They can occur in men and woman but it tends to be a lot more common in women, particular urinary incontinence – largely as a manifestation of injury to the pelvic floor which inevitably happens with delivering a baby vaginally.

The pelvic floor is a series of muscles that are slung from the inner aspect of the pelvis and are designed to keep the pelvic organs within their strict anatomic confines. In the female, this amounts to the rectum posteriorly, the bladder and urethra anteriorly and the vagina and uterus between these two structures.

When a baby passes through the middle compartment, the vagina, during child birth there is inevitably some damage to the muscles holding these three structures nicely in place. As a consequence, later in life – compounded by the wear and tear that one expects from advancing years, this allows the anterior and posterior compartments to encroach upon the central compartment. The inevitable consequence is failure to control faeces in the posterior compartment resulting in faecal incontinence and failure to control the outlet of the bladder in the anterior compartment, resulting in urinary incontinence.

The other factor that comes into play of course is what is happening above the pelvis both from a pressure aspect and a simple mechanical effect based upon weight. So, if the abdominal contents are increased dramatically then it is obvious to see that the pressure within the pelvis and pelvic floor and pelvic organs will exacerbate incontinence.

In the overweight individual and certainly one who is suffering from obesity there is a significant increase in the volume of intra-abdominal fat and there is also an increase in the pressure in the lower abdomen. It therefore goes without saying that the first line of management of the patient who presents with incontinence is to deal with their obesity. No amount of reparative surgery is going to compensate for this, and in fact achieving your biological optimum weight through the Nysteia formula is your best way of avoiding any intervention in the form of a surgical procedure in the first place.