Urinary Incontinence

It’s something that one in three women will experience in their lifetime – urinary incontinence. It can be very embarrassing, but don’t feel that you’re the only one with this problem. The good news is that there are treatments available that can be highly effective.

There are several types of urinary incontinence, each with different causes and treatments. Let’s look at each of them individually.

Stress incontinence is the involuntary leakage of urine that occurs during an increase in abdominal pressure, and is most likely to happen when you sneeze, laugh, cough, walk rapidly, go jogging, jump or lift heavy items. It’s usually the result of disruption of the support mechanisms at the bladder-urethra junction, or weakness of the muscle at the bladder opening (sphincter muscle) and loss of elasticity with aging.

Urge incontinence is when you have a strong sensation to pass urine. This is sometimes known as ‘overactive bladder’. It can be due to the bladder muscle contracting when it should be relaxed, or an irritation within the bladder, often caused by an infection.

Mixed incontinence is a combination of urge incontinence and stress incontinence.

Overflow incontinence is when your bladder does not empty normally. It then becomes overfull and leaks. This type of incontinence is not common.

There are several factors that increase the risk of developing urinary incontinence.

  • It is more common in women who have had children (particularly if you have had a forceps delivery or a difficult vaginal delivery).
  • ncontinence may become worse after menopause, which weakens the bladder and urethral tissue. • Age is a factor with stress incontinence, with a greater risk in your 40’s and 50’s. 
  • Smoking and some medications can increase the risk of incontinence. 
  • Caffeine can irritate the bladder, exacerbating incontinence problems.
  • Constipation, constant heavy lifting or chronic coughing can lead to an increase in abdominal pressure and aggravate stress incontinence. 
  • Other conditions such as diabetes, obesity, hyperthyroidism or chronic lung disease can increase your risks.

Remember that bladder infection can mimic the symptoms of stress or urge incontinence, and should be detected and treated if appropriate. Often a special investigation to check bladder function is needed to confirm whether the problem is stress or urge incontinence

There are several ways to treat urinary incontinence. Many women find that pelvic floor exercises are an excellent treatment. This involves learning how to contract your pelvic floor muscles correctly and strengthening them over time. .

Another treatment that is used to improve urge incontinence is bladder training. In conjunction with a continence therapist, you will learn how to control your bladder, reducing the frequency of urination and the urgency to do so.

Your GP or gynaecologist may suggest electrical stimulation of the pelvic floor. Used to treat stress or urge incontinence, this approach strengthens the pelvic floor muscles by using gentle electrical stimulation. A specially designed chair is used, and involves 18 – 20 sessions, 20 minutes each, spaced over 6 to 9 weeks.

Antispasmodic medications (drugs that relax the bladder muscle) can reduce urge incontinence, and some antidepressants (at less than dosages used to treat depression) have demonstrated benefits for both stress and urge incontinence.

The final options for stress incontinence treatment are surgical. There are many operations which can be carried out to treat urinary incontinence. In general these procedures aim to lift and support the mid or upper urethra, placing a tape or “sling”, which keeps the urethra closed when coughing or sneezing. They can be very effective, but of course, every operation comes with risks, so it’s best to speak with your doctor to see if one of the less invasive treatments may achieve your aims.

If you suffer from urinary incontinence don’t be embarrassed. Don’t feel that you just have to put up with it forever. The important thing is to speak to your doctor about it. They see this kind of condition on a regular basis and can help find the appropriate treatment for your situation.