urinary-incontinence

Urinary Incontinence


Types of Urinary Incontinence

Overflow incontinence

Slow, minor leakage after urinating. This can occur when the urethra is blocked or when the bladder muscles fail to completely empty the bladder.

Urge incontinence

Also known as overactive or spastic bladder, urge incontinence is leakage that results from a strong, immediate urge to urinate.

This happens when a muscle spasm contracting the bladder overpowers the sphincter muscles that regulate the flow of urine through the urethra.

Stress incontinence

This is leakage that is caused by the physical stress of coughing, sneezing, laughing, or exercising.

Stress incontinence is usually due to the deterioration of the tissues and muscles that support the urinary organs.

Mixed incontinence

Exhibiting symptoms of both urge and stress incontinence.


What are Symptoms of Urinary Incontinence?

Women with urinary incontinence can experience symptoms beyond leakage.

It’s important to note which symptoms are affecting you so that you can relay the information to your gynaecologist. Some symptoms include:

  • Frequency – Urinating more often than normal
  • Urgency – The urge to urinate, even if the bladder is empty
  • Feelings of pressure or discomfort in the lower abdomen
  • Dysuria – Pain or burning while urinating
  • Nocturia – The need to get out of bed to urinate several times a night
  • Enuresis – Urinating the bed while asleep

What Causes Urinary Incontinence?

Many different medical conditions may cause urinary incontinence. Some of these conditions are easy to treat while others may require intensive intervention or have long-lasting effects.

Certain medications

Some medications have urinary incontinence as a side effect. These drugs are also known as diuretics. Most patients regain control of their bladder once they are off the medication.

Urinary tract infections (UTIs)

Urinary tract infections are fairly common in women. There are some preventative measures you can take to reduce your risk of a bladder infection or a UTI, and they can usually be treated with antibiotics.

Abnormal growths

Polyps, tumours, and bladder stones may cause urinary leakage, especially urge incontinence. These growths can usually be treated with the help of your doctor.

Abnormalities in the urinary tract

A urinary fistula is an abnormal opening between a urinary organ and another proximal organ. Urine may leak out of this abnormal opening (i.e. through a fistula in the vagina).

Pelvic organ prolapses.

A healthy pelvis contains strong tissue that supports the organs and keeps them in place.

In some patients, these tissues and muscles can weaken and cause the bladder, urethra, uterus, or rectum to prolapse, causing urinary leakage and other problems.

This condition is sometimes treated with surgery, or with a supportive device known as a pessary.

Neuromuscular issues

Urinary incontinence is sometimes caused by a lapse in the brain’s ability to communicate with the bladder and urethral muscles.


How is Urinary Incontinence Diagnosed?

Because urinary incontinence could be an indication of several very different medical conditions diagnosing the cause can be tricky. If you are having difficulty controlling your bladder during the day or night, make an appointment at your earliest convenience. Ensure you maintain a diary of your symptoms noting the time of day and amount of urine you leaked or voided. If you have experienced a leak, write down what you were doing at that time and make note of what liquid intake and medications you are using. At your appointment we may conduct a combination of tests, including:

Pelvic Examination

Your doctor will check for physical abnormalities or any other possible causes of your incontinence.

Stress test

Your doctor will ask you to cough with a full bladder to observe any leakage.

Post void residual volume test

After urinating, your doctor will use ultrasound or a catheter to measure the amount of liquid left in your bladder.

Dye test

We inject a special dye into your bladder whilst you are wearing a sanitary pad. The amount of dye leaked onto the pad helps diagnose the severity of your incontinence.

Cystoscopy

Your doctor inserts a narrow, flexible tube into your urethra. The lens at the end allows your doctor to see inside your urinary tract and bladder.


Urinary Incontinence Treatment Options?

Depending on the cause of your condition diagnosed at London Obs & Gynae Clinic we have several options to treat your urinary incontinence.

Some cases of urinary incontinence (see below) can clear up with a few lifestyle changes:

  • Drinking less fluid, especially caffeinated drinks
  • Quitting smoking
  • Losing excessive weight (for overweight women)
  • Avoiding constipation, though diet changes and supplements
  • Treating stressors such as chronic coughing

Please talk to us about therapeutic and medical interventions, for example:

Physical therapy

Physical therapy for urinary incontinence can include a few different strategies. You may be asked to change your fluid intake and practice Kegel exercises to strengthen your pelvic floor muscles.

Your physical therapist will also show you techniques for bladder training. This is to reduce the frequency of the urge to urinate to normal levels (about every 4 hours during the day and between 4-8 hours at night).

Your therapist may employ a technique called biofeedback to teach you how to monitor your body’s natural signals.

Medication

If urinary incontinence is caused by overactive bladder muscles, then there are some medications that can help keep the muscular contractions under control.

Bulking agents

Bulking agents are substances that are injected into the tissues surrounding the urethra. They can add support and bulk to the tissue, and shrink the urethral opening. This helps stop the flow of urine.

Pessary devices

A pessary is a small, doughnut-shaped device that is inserted into your vagina to help provide support for prolapsed pelvic tissue and organs.

Some devices can put pressure on the urethra, aiding in the prevention of leaks. A pessary is a good choice for women who may not be good candidates for surgery.

Surgery

There are a number of procedures that can improve urinary incontinence. Your gynaecologist can discuss the options that are right for you based on the cause of your condition, your age, and your overall health.

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