Urinary incontinence affects an estimated 1:4 women during their lifetime. In older women it may be one of the main reasons for leaving independent living.
There are a number of different ‘types’ of incontinence, but the main two are known as ‘stress’ and ‘urge’ incontinence.
Stress urinary incontinence (SUI) is characterised by leakage with coughing, sneezing, laughing or exercise. The amount often depends on how much is in the bladder.
Urge urinary incontinence (UUI) is preceded by a sudden need to pass urine that cannot be controlled. If the bladder is full, this can lead to a big and embarrassing leak. This can be especially bothersome as it may be quite unpredictable.
Post-menopausal incontinence Many women with incontinence after menopause have a combination of both UUI and SUI, and this can also be in combination with prolapse and other issues. Therefore the management can be complex, but some improvements can be found for most women.
Stress urinary incontinence often occurs during and immediately after pregnancy; many will improve in the first few months after having a baby, but not all.
Exactly what occurs during vaginal delivery isn’t entirely clear but there may be damage to fine supporting ligaments and areas of muscle that support the urethra (the tube that drains urine from the bladder to the outside) and the back of the pubic bone.
Urge urinary incontinence occurs when the muscle wall of the bladder squeezes when it shouldn’t, and the pelvic floor is unable to react in time to prevent urine leaking out.
Some women have what is known as an ‘overactive’ bladder. In this situation, you need to go more often, go at night, and need to rush to get to the toilet. This can sometimes be associated with leakage.
UUI symptoms can sometimes be caused by infection or prolapse and we investigate these as possible causes.
Infection It is important to make sure there are no signs of infection, or rarely cancer of the bladder, before starting any treatment for an overactive bladder.
Prolapse Occasionally UUI symptoms can be found with a prolapse of the bladder, although just fixing the prolapse may not cure the symptoms and non-surgical approaches should be tried first.
What to do
Luckily there are a number of relatively simple strategies that can make a difference, and for some women, simple surgical procedures can be performed with an excellent chance of making a big difference.
If you are suffering from urinary incontinence you can be sure that you are not alone in this, and that there are a variety of treatments with a good chance of making a difference.
How we can help
- Continence NZ
- Your Pelvic Floor - Overactive Bladder
- Your Pelvic Floor - Stress Urinary Incontinence