Urinary incontinence is the involuntary or uncontrollable leakage of urine. It can happen
for different reasons. There are two broad types of urinary incontinence.
One is what we call urgency incontinence and this is the leakage of urine when you have a sudden urge
to pass urine which you can’t control. The other type of incontinence is called stress
urinary incontinence. This type of incontinence is more commonly seen in women and typically
happens after childbirth. This is the type of incontinence that happens when you're moving
or physically active or leakage of urine when you’re coughing or sneezing or laughing.
Urine incontinence is a very common condition. In fact, it affects millions of people worldwide.
Lots of studies have shown that it affects anywhere between 10 to 15% of all people.
It’s commonly thought of as a condition of women only but in fact, it’s equally common in
men, women and children.
Urinary incontinence can be caused by a number
of different things and it depends really on the type of incontinence that we’re talking about.
Urgency incontinence which is the involuntary leakage of urine when you have a sudden urge
to pass urine can often be caused by a number of conditions that affect the bladder. It’s
important that if you have these symptoms of passing urine very frequently or going
to pass urine at night time or having leakage of urine because you can’t control the urge,
that you have your bladder checked. The commonest causes are things like urinary
tract infections, diabetes, and in men we commonly see enlarged prostates that can cause
these overactive bladder symptoms. A lot of the time, we don't know what causes the incontinence.
Sometimes people can have problems with the nerves supplied to their bladder. Things such
as multiple sclerosis or Parkinson's disease and that can also cause these kinds of overactive
bladder symptoms. And very rarely, people can have abnormalities inside the bladder
such as cancers or stones which can trigger these symptoms so it’s very important if
you have symptoms of urgency incontinence or passing urine very frequently, that you
have a full evaluation by a urologist.
Stress incontinence which is the leakage of
urine on coughing or any physical movement is most commonly caused by childbirth.
The higher the number of children a woman has had, the higher the risk of weakness of the
pelvic floor muscles and this can lead to incontinence. There are other things that
can cause stress incontinence. We know that increasing age, being postmenopausal and being
overweight can also increase your risk of having leakage of urine on any physical movement.
In men, urinary incontinence can also result after surgery for any kind of treatment on
your prostate, either enlarged prostate or prostate cancer. They can again, lead to symptoms
of leakage of urine on coughing, sneezing or moving. If you have any of these symptoms,
it’s important to have this checked as there a number of underlying potential causes and
there are lots of treatments that can really improve your quality of life.
Overactive bladder can be very successfully treated. There are a number of things that
we can try to improve these overactive bladder symptoms and we often start with the simplest measures.
First of all, we would perform modification of your fluid and lifestyle and so this would
involve a detailed assessment of what type of fluid you drink, how often you drink, and
at what times you drink throughout the day. This can then enable us to modify your fluid
intake to reduce your risks of frequency and urgency of urine.
Commonly, caffeine and alcohol can increase your risk of overactive bladder symptoms and
so reducing these can make a significant difference to your symptoms. We often advise performing
bladder training and pelvic floor muscle exercises. This should be done with a trained and medical
professional or physiotherapist and can significantly improve symptoms in high number of patients.
This is also especially recommended during pregnancy to reduce your risk of incontinence
and helps to strengthen the pelvic floor muscles.
For overactive bladder symptoms, if this hasn’t
worked, there are a number of medications that we can try to help relax the bladder.
These are again often very successful although some patients do experience side effects and
so there are a number of other treatments we can use.
We can inject botox into your bladder which is a short procedure that helps relax the
bladder and improve the symptoms of going very often to pass urine or waking up a lot
at night time to pass urine. It can also improve incontinence symptoms. The other option is
to implant a pace maker like device into the skin under your lower back. This technique
is called sacral nerve stimulation. This device sends electrical impulses to the nerves that
supply the bladder and thereby relaxes the bladder and improve the symptoms of incontinence
of urine. If this doesn't work, there are other surgical procedures that can be performed
and a doctor will talk to you about these depending on how bad your incontinence is
and how much it’s affecting your quality of life.