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