Incontinence is involuntary loss of urine which is social and hygienic problem. It is common and undertreated problem as patients are usually reluctant to initiate discussions about their symptoms due to embarrassment, lack of knowledge about treatment options, and/or fear of surgery.
Incontinence is not a normal part of aging nor is it a disease.
Overall prevalence of urinary incontinence among non-pregnant women aged 20 years and above has been reported at 10-17 %; however, in women aged 65 and older, the prevalence rates is reported to be over 50%.
Urinary incontinence after childbirth
Compared with women who have had a caesarean section, women who have had a vaginal delivery are at higher risk for stress urinary incontinence. However, caesarean delivery does not protect women from urinary incontinence.
The relationship between urgency incontinence/overactive bladder and mode of delivery is less certain.
What are the risk factors of urinary incontinence?
- The prevalence and severity of urinary incontinence increase with age
- Obesity is a strong risk factor for incontinence.
- The risk of urinary incontinence, particularly urgency incontinence, may be higher in patients with a family history.
- Smoking has also been associated with an increased risk of incontinence
- Stress urinary incontinence has been associated with participation in high-impact activities.
- Urinary incontinence is associated with depression and anxiety, work impairment, and social isolation.
How does urinary incontinence effect women?
Urinary incontinence adversely impacts quality of life in nursing home residents as well as those who live independently. Overactive bladder sufferers might restrict social activity outside the home for fear of leaking urine or because of the frequent need to use a toilet. Urgency incontinence had greater negative impact on sexual function compared with urgency or frequency without incontinence.
Medical morbidities associated with urinary incontinence include perineal infections from moisture and irritation as well as falls and fractures.
What are the different types of urinary incontinence?
There are different types of urinary incontinence but the most common ones are: stress incontinence, overactive bladder, mixed incontinence, overflow incontinent and fistula which is abnormal connection between the urinary system and other systems.
Treatment for urinary incontinence
The initial treatment of urinary incontinence in females is modifying contributory factors/ Lifestyle modification: weight loss, dietary and fluid changes, manage constipation, and smoking cessation. The following 3 steps are important as first line management:
- Pelvic floor muscle (Kegel) exercises
- Bladder training
- Topical vaginal estrogen
The main treatment for stress incontinence treatment is surgery which different types tailored according to patients needs.
For urgency/overactive bladder incontinence treatment includes:
- Initial and complementary therapies
- Pharmacological therapy: Botulinum toxin/ Percutaneous tibial nerve stimulation/ Sacral neuromodulation/ surgery
The most importance step is to seek medical advice as early as possible to evaluate the symptoms and start management options in the stepwise strategies.
Treatment for urinary incontinence at Oaks Hospital
At Oaks Hospital we offer our patients fast access to diagnosis and treatment of urinary incontinence problems. Our expert gynaecologists are experienced in diagnosing and treating patients with women's health issues.
Our caring and friendly staff respect our patient’s needs and their privacy. We offer flexible appointment times without waiting, convenient and free on-site parking, and comfortable recovery areas and private en-suite rooms as required.
Contact us to arrange an appointment today.
Article written by Consultant Gynaecologist, Mr Fadi Alfhaily.