Miss Farah Lone, Consultant Uro-Gynaecologist | 24/02/2021

Your urinary incontinence questions answered

Urinary incontinence (UI) is a common symptom that can affect women of all ages. While rarely life-threatening, incontinence can seriously influence the physical, psychological and social wellbeing of those affected. Urinary incontinence and bladder problems will affect most women at some point in their lives, and the likelihood of urinary dysfunction can increase with age.

Urinary incontinence is of various types-stress urinary incontinence, overactive bladder, mixed urinary incontinence are the common ones. Others include overflow and functional urinary incontinence.

Symptoms of common types of urinary incontinence

Stress urinary incontinence presents are leakage of urine on provocation such as coughing, laughing, sneezing etc. Overactive bladder presents as increased frequency of passing urine with or without sense of urgency or leakage of urine.

Common causes/risk factors for urinary incontinence

Conditions causing pelvic floor relaxation
  • Vaginal childbirth
  • Aging
  • Genetic factors
Conditions causing chronic increases in intra-abdominal pressure
  • Constipation
  • Chronic coughing
  • Chronic heavy lifting
  • Obesity
Conditions that weaken the urethral closing mechanism
  • Estrogen deficiency
  • Scarring
  • Denervation
  • Medications

 

How does urinary incontinence commonly present?

Urine is produced by the kidneys and passes into the bladder where it is stored until it is convenient to go to the toilet. The bladder can hold about 500 ml of urine. As it gradually fills it sends messages to the brain to make us aware of this - if it is not a good time to go we can override this urge.

In overactive bladder, this ability to override the bladder messages is reduced. This results in more frequent visits to the toilet, often quite urgently and sometimes not getting there in time.

In stress Urinary incontinence, urine leaks on certain activities or in certain change of positions. Both types are treated with different options. These can be lifestyle modifications, weight reductions, medications, devices (plugs) or surgery.  The treatment you receive for urinary incontinence will depend on the type of incontinence you have and the severity of your symptoms.

When and how to approach your GP

If you need to wear a pad, if you have stopped doing something you enjoy because of your bladder or if you have lost confidence in your bladder and it is affecting the quality of your day-to-day life, it is time to talk to your GP.

It is never too late to talk to your doctor. You should not feel embarrassed about your problem and your doctor will be happy to talk about possible treatments. You may prefer by starting the conversation with the practice nurse. You may be asked how often you go to the toilet (more than 8 times per day is abnormal) and if you need to regularly get up during the night to pass urine.

They may also ask about any leakage when you cough, laugh or exercise, and they should also enquire about symptoms of infection or passing any blood in urine.

What can be done to aid urinary incontinence without resorting to surgery?

There are several kinds of minimally invasive therapies for urinary incontinence which can change the lives of those with bladder problems.  As soon as you have discussed your bladder issues with your doctor and received a diagnosis, you will be able to discuss possible treatments.

Lifestyle Changes- Often some lifestyle changes such as performing regular pelvic floor exercises and avoidance of bladder stimulants and reducing weight, if over-weight,  can make a big difference.

Medications- Medications can often be helpful especially to treat urinary frequency and urgency of passing urine. 

Surgery- If surgery is ultimately required after other therapies have been tried without considerable success, there are surgical treatments that can help treat stress urinary incontinence. 

Mesh use is not recommended to treat urinary symptoms. 

By Miss Farah Lone, Consultant Uro-Gynaecologist

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