WHAT IS URINARY INCONTINENCE?

Urinary incontinence is the condition in which there is uncontrolloble leakage of urine causing a social or hygienic problem.

What are the types of urinary incontinence in women?

There are four types of urinary incontinence in women:

1.Stress incontinence

Stress incontinence is the commonest type of urinary incontinence in women. It can occur in young women, during pregnancy, after childbirth and around the menopause (when the menses end). In these women there is uncontrollable leakage of small amounts of urine when they cough, sneeze, laugh, excersise and sometimes even during sex.

2.Urge incontinence

In this type of incontinence a woman feels a strong urge to pass urine that she cannot control; resulting in a continuous leakage of urine, usually until the bladder is empty. Sometimes coughing, the sound of running water or hand/dish/clothes washing may trigger off urge incontinence. Poor toilet training eg. the habit of passing urine very often may lead to this type of incontinence when the brain cannot control the bladder.

3.Overflow incontinence

In overflow incontinence the bladderis not functioning because its nerve supply is impaired. This results in a distended bladder which leaks urine whenever the bladder becomes overfilled: such women do not feel the urge to pass urine. The bad habit of delaying the need to pass urine in certain occupations (eg. shop assistants, factory assembly line workers), medical conditions like diabetes and spinal injuries can cause this type of incontinence.

4. Continuous' incontinence

In this very uncommon type of incontinence there is leakage of urine more or less all the time without any warning.  'Continuous' incontinence is caused by urinary tract abnormalities which may be congenital (since birth) or resulting from childbirth (rare these days), pelvic surgery (eg. complicated hysterectomy, radiation treatment (for cancer of the cervix or uterus) or advanced cancer within the pelvis.

I have urinary incontinence, how can my doctor help me?

Your doctor will have to find the cause of your incontinence first. This may include:

A list of questions about factors which may affect your urinating habits.

A record of the amount of fluid you drink, the amount and timing of urination and leakage of urine.

Your medical history.

A physical and pelvic examination to detect any condition that might be linked to incontinence.

A pad test to determine how much urine you leak.

Laboratory tests to detect urinary tract infection.

Special tests to determine the capacity and control of the bladder, the pressure within the bladder and urethra, the way you pass urine, and what the inside of your bladder and urethra look like.

Note: Not all these tests are required in every patient. Your doctor will then select the most appropriate treatment for you.

What are the treatment options available for my incontinence?

These would depend on the precise cause of your problem:

Antibiotics to treat infection.

Drugs to control abnormal bladder contractions (for urge incontinence).

Drugs to help your overdistended bladder to contract (for overflow incontinence).

Hormone replacement therapy for menopause and stress incontinence.

Pelvic floor exercise to strengthen the muscles that surround the openings of the urethra, vagina and anus in stress incontinence. Read about Kegel Exercises.

Electrical stimulation of the muscles around the bladder and urethra in stress and urge incontinence.

Surgery to correct pelvic support defects in stress incontinence, urinary tract abnormalities or to remove abnormal tumours eg. uterine fibroids pressing on the bladder.

Urinary incontinence is a very common problem in women. If you are bothered with symptoms of urinary incontinence, or if they affect your daily living, tell your doctor. A complete and thourough examination is needed to find the cause of the problem. In most cases urinary incontinence can be treated with success.

An insight into the urinary tract:

The urinary tract is made up of kidneys, which produce urine; tubes called ureters that carry urine to the bladder, a sac- like muscular organ, where it is stored; and the urethra, a small, muscular tube about 5cm long that channels urine from the bladder to the outside of the body.

The cause of your incontinence will first have to be established by the physician, and then they can offer you the most appropriate treatment taking into consideration your age, occupation, lifestyle and home environment.