Urinary incontinence (UI) is the loss of bladder control and the involuntary passing of urine. This is a very common condition that affects millions of people in the UK but is thought of as an embarrassing subject for many patients. Due to the stigma around this condition, many go without a diagnosis or treatment, even though most forms of UI can be easily managed or corrected.
Urinary incontinence is when a person urinates involuntarily. This is because their urinary sphincter (the muscular structure that regulates the outflow of urine) is weak, or when their bladder muscle is over active.
The unique health events encountered by women – such as menopause, pregnancy and childbirth – mean that the urinary tract and its surrounding muscles can be affected. This makes urinary incontinence more common in women than men.
Although many people associate bladder weakness as a symptom of old age, you can experience bladder problems at any age for a range of different reasons.
In the UK, an estimated five million adults have an overactive bladder, and it is estimated that as many as 9.6 million women have some form of bladder problem. Our expert urologists are on hand to provide discreet treatment options to help you gain your confidence back.
There are several different types of urinary continence, each with its own characteristics. These include:
Urge incontinence is the sudden and uncontrolled need to urinate. Urine either unexpectedly leaks at this moment, or some time afterwards. Urge incontinence is one of the main symptoms of genitourinary syndrome of menopause (GSM); the hypoestrogenic changes (estrogen deficiency) that occur during menopause, involving the bladder, urethra, vagina and other sexual organs.
This is when the bladder leaks under strain, such as when you sneeze, cough, laugh or lift heavy objects. When oestrogen levels decrease during menopause, stress incontinence symptoms can develop. As menopause is understood to have an adverse impact on musculoskeletal health, muscles can get weaker during menopause. This makes it harder for some women to prevent urine leakage under strain. Women can also experience a mixture of urge and stress incontinence.
Overflow incontinence is also known as chronic urinary retention. When you have overflow incontinence, you aren’t able to empty your bladder and can leak urine regularly. For the same reasons as the types of urinary incontinence outlined above – including a drop in oestrogen levels and weakened pelvic muscles – menopause can cause overflow incontinence. It is especially prevalent in women who have a blocked urethra or damaged bladder.
Total incontinence occurs when your bladder is unable to store urine, which results in the constant passing of urine or frequent leakage. This can be caused by trauma or injury to your spinal cord, congenital bladder issues, or a bladder fistula (a small hole that forms between the bladder and an area close by, like the vagina).
Common symptoms of urinary incontinence include:
There are various precipitating factors for urinary incontinence for both men and women. Certain habits, conditions or problems may cause temporary urinary incontinence, and others may cause persistent urinary incontinence. For this reason, we’ll split up the causes into temporary and persistent:
“Many treatments are available for urinary incontinence. The treatment recommended to you is likely to depend on the type and severity of the condition that you have.”, explains Mr Azar Khunda, consultant gynaecologist and subspecialist urogynaecologist. “It’s good to seek a diagnosis and speak to a medical professional before exploring different treatments as they will advise you on the best course of action.”
Some lifestyle changes may help to reduce urinary incontinence symptoms, such as:
Kegel exercises are used to strengthen the pelvic floor and reduce or prevent symptoms of urinary continence. They involve clenching your pelvic floor muscles and holding them, before relaxing. In order to start the exercises, you need to be able to find your pelvic floor muscles. You can locate them by trying to stop the flow of urine when going to the toilet by contracting your muscles. The tension you should feel will be emanating from your pelvic floor muscles.
Once you have located your pelvic floor muscles, sit comfortably and begin to squeeze the muscles 10 to 15 times. Try holding each squeeze for a few seconds but take a break between sets of squeezes. As time goes on, you should be able to add more squeezes. Try performing these exercises every week. After a few months, you should start noticing results.
You can also train yourself to hold more urine by only urinating at certain times of the day. Don’t go whenever your bladder tells you to, only go when you plan to. This will help build up a tolerance and train your bladder to hold urine for longer.
A urologist may provide pads and other products to help with urinary incontinence or recommend you purchase some. These may include tampons, pads and pull-up pants, appliances and bedding.
The type of medication you may be prescribed will depend on the type of urinary incontinence you suffer from. This includes:
Depending on the type of UI you suffer from, there are a variety of procedures for urinary incontinence that may be recommended by a urologist as a last resort. These include:
If you suffer from urinary incontinence, our experienced gynaecology team can provide diagnosis and potential treatment. Book an appointment by emailing firstname.lastname@example.org or calling 020 7188 5197.