Female Urinary Incontinence

This refers to leaking urine involuntarily. Temporary causes include urinary tract infection (UTI); in many women, incontinence can be long-term.
There are different types of urinary incontinence and many women can suffer from more than 1 type.

Stress urinary incontinence (SUI)

Leaking urine during physical activity e.g. coughing, sneezing, laughing, exercising.

Urge urinary continence (UUI)

Leaking urine shortly after feeling a strong urge to pee. Many women with overactive bladder who visit the toilet frequently due to urgency) may have UUI.

Mixed urinary incontinence (MUI)

Having both SUI and UUI. Usually one type will have worse symptoms than the other.

Overflow incontinence

This happens when you do not empty your bladder properly due to certain medical conditions and urine leaks out.

What are the causes of urinary incontinence?

Some major causes include:

  • Weakened pelvic floor muscles: because of damage sustained during pregnancy and childbirth, weakening from ageing and menopause, obesity
  • Weakened bladder muscles: from ageing and nerve damage
  • Medicationse.g. certain blood pressure or heart medications

Things that can worsen urinary incontinence include:

  • Drinking caffeine e.g. tea, coffee, alcohol
  • Medical conditionse.g. asthma, chronic cough, poor diabetes control, previous stroke, dementia
  • Smoking

Many women with urinary incontinence may also have pelvic organ prolapse – a condition where there is sagging of the bladder, uterus or rectum into or beyond the vagina due to weak pelvic floor muscles.

What should I do if I have urinary incontinence?

You should consult a urogynaecologist to determine what type of urinary incontinence you have, its severity and your treatment options. Your doctor will take a detailed medical history and perform a pelvic examination to check for any pelvic organ prolapse and pelvic floor muscle tone.
Depending on your symptoms, you may require a pelvic and bladder ultrasound, urine tests and/or urodynamic study (this is a test to check for your bladder function and bladder muscle stability).

What is the treatment for urinary incontinence?

It depends on what type of urinary incontinence you have. Often, lifestyle changes are sufficient to improve symptoms. These include:

  • Maintain a healthy body mass index (BMI)
  • Adjust your diet or fluid intake
  • Cut down on caffeinated drinks
  • Bladder training
  • Take scheduled toilet breaks
  • Quit smoking
  • Improve control of medical conditions e.g. diabetes, asthma, or changing medications
  • Avoid constipation
  • Pelvic floor (Kegel) exercises

The treatment of stress urinary incontinence usually involves conservative and surgical options, while the treatment of urge urinary incontinence mainly revolves around conservative and medical options. If you have mixed urinary incontinence, treatment starts on the predominant type that bothers you the most – your urogynaecologist will be able to discuss these in further detail with you.

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