Urinary Incontinence

Urinary Incontinence - King's College Hospital Dubai

Female Urinary incontinence is a very common problem. One in three women might be affected by these problems at any one point in their life causing:

  • Psychological distress
  • Reduced social and personal activities
  • Overall decreased quality of life
  • Fear of coughing and sneezing
  • Fear of odour
  • Limitations of choice of clothing
  • Unwilling to take part in exercise or even sexual activity

There is good evidence to suggest that it might take up to 5 years before a woman seeks help and the main reasons cited was that it was deemed to be part of aging and women are embarrassed to talk about this.

Asking the right questions

  • Do you go to the toilet more than 6 times a day?
  • Do you often wake up during the night needing to go to the toilet?
  • Do you have to hurry to make the toilet in time?
  • Do you often not reach the toilet in time?
  • Do you leak when you cough/sneeze/run to catch a bus?
  • Do you get frequent urinary tract infections?
  • Do have difficulty in passing urine?
  • Do you feel you do not empty your bladder properly and must go to toilet a second time?

Common Causes of Urinary incontinence

  • Urinary tract infections
  • Obesity
  • Increased intake of tea and coffee
  • Chronic cough
  • Pregnancy and childbirth
  • Chronic constipation
  • Certain neurological conditions like Parkinson’s disease and Multiple sclerosis

Types of incontinence

  1. Urge urinary incontinence (UUI) is the complaint of involuntary leakage accompanied by or immediately preceded by urgency.
  2. Stress urinary incontinence (SUI) is the complaint of involuntary leakage on effort or exertion, or on sneezing or coughing.
  3. Overflow incontinence – where there is constant dribbling of urine due a bladder that is not emptying properly.
  4. Functional incontinence – when there is incontinence secondary to mobility restrictions ie as in severe arthritis
  5. Mixed incontinence – when there is a combination of the above.

Urinary Incontinence Treatment

Urinary Incontinence Treatment - King's College Hospital Dubai

Non-surgical treatments

The doctor will assess your symptoms and after a thorough history and clinical examination, a urine test will be performed. The treatment might include –

  • Lifestyle modifications – reducing weight, stopping smoking, healthy living and exercise is discussed.
  • Fluid management – advice on drinking the right type and right amount of fluids will be given
  • Bladder retraining – advice will be given on how to retrain your bladder to listen to you by scheduled voiding regime, urgency control mechanism and positive reinforcement
  • Pelvic floor physiotherapy – at Kings specialist physiotherapist will assess your pelvic floor muscle and give appropriate advice on how to achieve best possible outcomes in management of urinary leakage
  • Medication — there are lot of medications available to treat urgency and incontinence following urgency and these will be discussed in detail and tailor made to your care

Surgical treatments

For stress urinary incontinence – a mid-urethral sling or tape procedure can be performed after failure of conservative treatment.

For urgency incontinence – after failure of medical treatment, injection treatment to the bladder is advised and offered.

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