Urinary Incontinence

Urinary incontinence (UI) is a common problem which can affect anyone, though is mainly seen in women over 40. UI is intended as any involuntary leakage of urine. Whilst the condition is not life-threatening, the psychological and social impact on sufferers should not be under estimated.

How common is urinary incontinence?

UI is an extremely common problem affecting people of all age, and it is estimated that 9 million people in the UK experience some form of bladder weakness or incontinence. The problem is particularly common in women over the age of 40, affecting around 1 in 4 women in this group.

Embarrassment is a real factor in addressing the issue, and unsurprisingly many people suffer in silence without ever seeing their doctor for advice. The good news is that urinary incontinence can be both managed and treated, however it is important to establish the type of incontinence and its causes before choosing a course of treatment.

Types of incontinence

Stress Urinary Incontinence – is the most common type of incontinence. It occurs when urine is leaked following a sneeze, laugh, cough or some kind of physical exertion (such as jumping or bending over).

It is caused by weakening of the pelvic floor muscles, for example, following childbirth. The rates of SUI increase with increased age and weight, especially in those who are obese.

Urge incontinence – is another common type of incontinence. The sufferer will feel a strong or immediate need to pass urine and leakage occurs when they do not make it to the loo in time.

It is caused by irregularities in muscle control, when the bladder muscle contracts too quickly for example following a stroke, spinal injury or due to a degenerative disease (like Parkinson’s or multiple sclerosis). These conditions interfere with the way in which the brain signals bladder fullness.

Mixed incontinence –occurs when the patient suffers from urgency and exertion caused.

Overflow incontinence – is a rare type of incontinence. It occurs when urine is blocked from being properly emptied by the bladder. Pressure from behind the obstruction builds up and when it gives the urine is leaked.

Overactive bladder syndrome – is when the bladder contracts suddenly causing the urgency to pass urine regardless of whether it is actually full or not. Unlike urinary incontinence, not everyone who suffers from an overactive bladder involuntarily leaks urine.

Overactive bladder syndrome is characterised by: a high urgency and above average frequency to pass urine. Sufferers may find they need to get up in the middle of the night to use the toilet and others may struggle to make it to the loo in time.

Treatment for urinary incontinence

The treatment you receive will depend on the type of incontinence you have. You may also receive additional care if the symptoms are caused by an underlying condition or if symptoms are particularly severe. It is extremely important to exclude underlying risk factors, before treatment is offered, so as not to mask symptoms of a more dangerous illness.

Pharmacological and surgical treatments must be saved until last, and should only be used if more conservative treatments have already failed.

Treatments which should be tried include:

lifestyle changes
pelvic floor muscle training
bladder training