Urinary incontinence is a common problem most often seen in older women however it can be experienced by women of all ages. It is the unexpected and involuntary leakage of urine which can be an extremely distressing and upsetting occurrence.
It is estimated that as many as 1 in 5 women over the age of 40 years in the UK have some element of urinary incontinence. Embarrassment often prevents women divulging this information to their GP and therefore the true number affected is likely to be much greater. There is a misconception that incontinence is a normal part of the aging process which is unfortunate as successful treatment options can be implemented and a cure achieved in many cases.
There are several different types of urinary incontinence:
- Stress Incontinence is the most common and occurs when the bladder leaks small amounts of urine when under pressure due to coughing, laughing, and sneezing or when exercising. Contributing factors to this condition include weakened pelvic floor muscles or nerve damage occurring during pregnancy and child birth, obesity, straining when constipated, chronic coughing, heavy lifting and the menopause.
- Urge Incontinence (unstable or overactive bladder) is the second most common condition and is urinary leakage accompanied by an overwhelming need to go to the toilet with no advanced warning often resulting in increased daytime frequency and a disturbed sleep pattern. The bladder muscle contracts too early and the normal control is reduced. The cause is often unknown.
- Mixed Incontinence is the combination of both stress and urge incontinence.
Diagnosis of the cause of incontinence requires a detailed history, physical examination and investigation with a bladder diary and Urodynamic studies. These studies require the insertion of catheters to the bladder and back passage to measure the pressure being exerted inside the bladder during filling and in the abdomen, in addition to flow rates.
There are a number of management options for urinary incontinence which are specifically tailored to the more dominant symptom; these can range from simple lifestyle measures to dedicated pelvic floor physiotherapy, medication and surgery in severe cases with up to a 90% cure rate.