Urinary incontinence is a problem that can be brought under control when its type and cause are correctly identified and it is dealt with early. Treatment starts with weight control, fluid balance and pelvic floor exercises; in suitable patients, vaginal laser, medication or surgery may follow. Putting off seeking help can allow the problem to progress and make treatment more difficult.
Urinary incontinence can affect work, social life and sleep. Many patients come to us after years of managing with pads. Yet with an accurate diagnosis and the right treatment, this problem can be largely brought under control.
Who Is Affected?
Urinary incontinence can affect both women and men at any age. It is more common in women after childbirth and around the menopause, and in men who have had surgery for prostate cancer. Strenuous physical activity, hormonal changes and operations can also trigger leakage.
Types
In stress incontinence, urine leaks when pressure inside the abdomen rises, for example when coughing, sneezing, laughing or lifting something heavy; the main cause is usually weakness of the pelvic floor muscles. In urge incontinence, a sudden, strong need to pass urine comes on and you may not reach the toilet in time; it is linked to uncontrolled contractions of the bladder and may come with getting up at night to pass urine.
The two types can also occur together (mixed incontinence). Other forms include night-time incontinence, incontinence due to neurological conditions and incontinence that develops after surgery. Classifying the incontinence correctly has a direct effect on how well treatment works.
Diagnosis
At the first consultation, you will be asked in detail how and when the symptoms occur, how much fluid you drink during the day, what medicines you take, your history of childbirth and any previous illnesses. If needed, more advanced tests that measure bladder function are carried out. In this way the type, severity and cause of the incontinence are established, and unnecessary treatments are avoided.
Treatment Options
Lifestyle and exercises
The first step is usually weight control, adjusting fluid balance and pelvic floor exercises. Vaginal laser may also be effective for mild to moderate leakage.
Medication
For some types of incontinence, medicines that regulate control of the bladder muscle are used.
Surgery
Surgery carried out with careful patient selection can bring long-term relief. For the surgical options used for stress incontinence in women, see the sling surgery (TOT/TVT) page.
Because putting off seeking help can allow the problem to progress and make treatment harder, it is best to come in once you notice symptoms. For all the options, see the urinary incontinence treatment page.
