Urinary Incontinence Consultation

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What is Urinary Incontinence?

Urinary incontinence (UI), is the loss of bladder control. It is a common and distressing problem, which may have a large impact on quality of life. 

Pelvic surgery, pregnancy, childbirth, and menopause are major risk factors. Urinary incontinence is often a result of an underlying medical condition but is under-reported to medical practitioners.  

There are four main types of incontinence:

  • Urge incontinence due to an overactive bladder
  • Stress incontinence due to poor closure of the bladder
  • Overflow incontinence due to either poor bladder contraction or blockage of the urethra
  • Functional incontinence due to medications or health problems making it difficult to reach the bathroom

Treatments include surgery, pelvic floor muscle exercises, bladder training, and UI laser therapy.  Urinary Incontinence is more common in older women.

You may feel uncomfortable discussing incontinence with a professional, but if incontinence is affecting your quality of life, it's important to seek medical advice. UI may indicate a serious underlying condition or cause you to restrict your normal daily activities, which may affect your social interactions.

Underlying Conditions-

  • Pregnancy due to the increased weight of the fetus;
  • Childbirth by vaginal delivery can weaken muscles needed for bladder control;
  • Changes with age due to muscle decrease;
  • Menopause because of less estrogen levels, a hormone that helps keep the lining of the bladder and urethra healthy;
  • Hysterectomy surgery may damage the supporting pelvic floor muscles; 
  • Neurological disorders which includes, Multiple sclerosis, Parkinson's disease, a stroke, a brain tumor or a spinal injury which may interfere with nerve signals involved in bladder control.

 How to prevent Urinary Incontinence?

UI can't always be  prevented, however the risks can be reduced.

  • Healthy weight;
  • Exercises;
  • Avoid bladder irritants, such as caffeine, alcohol and acidic foods;
  • Eat enough fiber, to prevent constipation;
  • Don't smoke.

Treatments available:

  • Urethral inserts: A woman inserts the device before activity and takes it out when she wants to urinate.
  • Pessary: A rigid ring inserted into the vagina and worn all day. It helps hold the bladder up and prevent leakage.
  • Radiofrequency therapy: Tissue in the lower urinary tract is heated. When it heals, it is usually firmer, often resulting in better urinary control.
  • Botox (botulinum toxin type A): Injected into the bladder muscle, this can help those with an overactive bladder.
  • Bulking agents: Injected into tissue around the urethra, these help keep the urethra closed.

Other treatment options:

  • Urinary Catheter;
  • Absorbent pads

Surgery treatment options:

Surgery is an option if other therapies do not work. Women who plan to have children should discuss surgical options with a doctor before making the decision.

  • Sling procedures: A mesh is inserted under the neck of the bladder to help support the urethra and stop urine from leaking out.
  • Colposuspension: Lifting the bladder neck can help relieve stress incontinence.
  • Artificial sphincter: An artificial sphincter, or valve, may be inserted to control the flow of urine from the bladder into the urethra.
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