URINARY INCONTINENCE

What is urinary incontinence?

Urinary incontinence (or poor bladder control) is a common condition, that is commonly associated with pregnancy, childbirth, menopause or a range of chronic conditions such as asthma, diabetes or arthritis.

Poor bladder control can range from the occasional leak when you laugh, cough or exercise to the complete inability to control your bladder, which may cause you to completely wet yourself. Other symptoms you may experience include the constant need to urgently or frequently visit the toilet, associated with ‘accidents’.

 

There are different types of incontinence with a number of possible causes. The following are the most common:

  • stress incontinence
  • urge incontinence
  • incontinence associated with chronic retention, and functional incontinence

 

Urinary incontinence can be caused by many things, but can be treated, better managed and in many cases cured.  For this reason, it is important to talk to our specialist about your symptoms, in order to get on top of them.

What are the types urinary incontinence?

There are several types of urinary incontinence, including:

  • stress incontinence – when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh
  • urge incontinence – when urine leaks as you feel a sudden, intense urge to pass urine, or soon afterwards
  • overflow incontinence (chronic urinary retention) – when you’re unable to fully empty your bladder, which causes frequent leaking
  • total incontinence – when your bladder can’t store any urine at all, which causes you to pass urine constantly or have frequent leaking

It’s also possible to have a mixture of both stress and urge urinary incontinence.

What are the common causes of urinary incontinence?

Read about the symptoms of urinary incontinence below:

  • Stress incontinence is usually the result of the weakening of or damage to the muscles used to prevent urination, such as the pelvic floor muscles and the urethral sphincter.
  • Urge incontinence is usually the result of overactivity of the detrusor muscles, which control the bladder.
  • Overflow incontinence is often caused by an obstruction or blockage to your bladder, which prevents it emptying fully.
  • Total incontinence may be caused by a problem with the bladder from birth, a spinal injury, or a bladder fistula.
  • Certain things can increase the chances of urinary incontinence developing, including:
  • Pregnancy and vaginal birth
  • Obesity
  • Family history of incontinence
  • Increasing age – although incontinence is not an inevitable part of ageing
Diagnosing urinary incontinence

Talk with our specialist if you are having problems controlling your bladder. We will work with you to find out why. Diagnosis may include:

  • A bladder journal where you keep track of when you urinate, how often, and how much
  • Urine testing to look for signs of infection or other causes
  • A stress test in which you cough as hard as possible with a full bladder
  • Techniques that measure pressure in the bladder and urine flow
  • Ultrasound, a test that uses soundwaves to create a picture of your bladder and the other body parts that help control urination
  • Cystoscopy, during which the inside of the bladder is examined with a small tube that has a camera and light on the end
  • Cystogram, which is an x-ray of the bladder
When to see a doctor?

You may feel uncomfortable discussing incontinence with us. But if incontinence is frequent or is affecting your quality of life, it’s important to seek medical advice because urinary incontinence may:

  • Indicate a more-serious underlying condition
  • Cause you to restrict your activities and limit your social interactions
  • Increase the risk of falls in older adults as they rush to the toilet
Planning Ahead
You may wish to prepare a list of questions to ask before seeing us so that you will not miss out anything important. Ask for the appointment on a day when you know you will not be having your period. Be sure to bring a list of all medications and supplements that you are taking.
Can I walk in for an appointment or service?
We want to make sure we cater enough time for your visit with our doctor. As such, we strongly advise that you make a prior appointment with our staff. Our specialist will then meet you on the allocated time for a detailed discussion. Please call or email us for an appointment.
What are the risk factors involved?

Factors that increase your risk of developing urinary incontinence include:

  • Women are more likely to have stress incontinence. Pregnancy, childbirth, menopause and normal female anatomy account for this difference. However, men with prostate gland problems are at increased risk of urge and overflow incontinence.
  • As you get older, the muscles in your bladder and urethra lose some of their strength. Changes with age reduce how much your bladder can hold and increase the chances of involuntary urine release.
  • Being overweight. Extra weight increases pressure on your bladder and surrounding muscles, which weakens them and allows urine to leak out when you cough or sneeze.
  • Tobacco use may increase your risk of urinary incontinence.
  • Family history. If a close family member has urinary incontinence, especially urge incontinence, your risk of developing the condition is higher.
  • Other diseases. Neurological disease or diabetes may increase your risk of incontinence.
  • Complications
  • Complications of chronic urinary incontinence include:
  • Skin problems. Rashes, skin infections and sores can develop from constantly wet skin.
  • Urinary tract infections. Incontinence increases your risk of repeated urinary tract infections.
  • Impacts on your personal life. Urinary incontinence can affect your social, work and personal relationships.
Tips & tricks for urinary incontinence

Many women manage urinary incontinence with menstrual pads that catch slight leakage during activities such as exercising. Also, many people find they can reduce incontinence by restricting certain liquids, such as coffee, tea, and alcohol.

 

Finally, many women are afraid to mention their problem. They may have urinary incontinence that can improve with treatment but remain silent sufferers and resort to wearing absorbent undergarments, or diapers. This practice is unfortunate, because diapering can lead to diminished self-esteem, as well as skin irritation and sores. If you are relying on diapers to manage your incontinence, you and your family should discuss with our specialist the possible effectiveness of treatments such as timed voiding and pelvic muscle exercises.

Treatment for urinary incontinence

Treatment for urinary incontinence depends on the type of incontinence, its severity and the underlying cause. A combination of treatments may be needed. If an underlying condition is causing your symptoms, our specialist will first treat that condition.

we is likely to suggest the least invasive treatments first and move on to other options only if these techniques fail.

 

Behavioural techniques

We may recommend:

  • Bladder training, to delay urination after you get the urge to go. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet until you’re urinating only every 2.5 to 3.5 hours.
  • Double voiding, to help you learn to empty your bladder more completely to avoid overflow incontinence. Double voiding means urinating, then waiting a few minutes and trying again.
  • Scheduled toilet trips, to urinate every two to four hours rather than waiting for the need to go.
  • Fluid and diet management, to regain control of your bladder. You may need to cut back on or avoid alcohol, caffeine or acidic foods. Reducing liquid consumption, losing weight or increasing physical activity also can ease the problem.
Surgery for urinary incontinence

Below is a comprehensive list of urinary incontinence surgical treatments:

  • Sling procedures
  • Bladder neck suspension
  • If other treatments aren’t working, several surgical procedures can treat the problems that cause urinary incontinence:
  • Sling procedures. Strips of your body’s tissue, synthetic material or mesh are used to create a pelvic sling around your urethra and the area of thickened muscle where the bladder connects to the urethra (bladder neck). The sling helps keep the urethra closed, especially when you cough or sneeze. This procedure is used to treat stress incontinence.
  • Bladder neck suspension. This procedure is designed to provide support to your urethra and bladder neck — an area of thickened muscle where the bladder connects to the urethra. It involves an abdominal incision, so it’s done during general or spinal anaesthesia.
  • Prolapse surgery. In women with mixed incontinence and pelvic organ prolapse, surgery may include a combination of a sling procedure and prolapse surgery.
Related Articles

Laparoscopic Surgery >> United Medical

Book An Appointment