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Care for WOMEN by WOMEN

Urinary Incontinence

Leaking of urine can be an embarrassing situation. It can restrict your daily activities, at any age, but especially for those wanting to live an active lifestyle after 50 years of age. However, you are not alone- research indicates that 1 in 3 women suffer from incontinence of varying severity.

Generally, Incontinence is caused due to weakening of the urethral closure mechanism and main contributing factors for incontinence are vaginal child birth and natural ageing. It is good to know that effective treatment is available in many cases.

Symptoms of bladder continence problems

Women with bladder control problems may experience:

  • Leaking urine with coughs, sneezes or exercise
  • Leaking urine on the way to the toilet
  • Passing urine frequently
  • Rushing to the toilet (urgency)
  • Getting up twice or more at night to pass urine
  • Wetting the bed when asleep
  • Feeling their bladder is not completely empty
  • Having poor urine flow
  • Straining to get the bladder to empty
  • Frequently having urinary tract infections (UTIs).

Types of Urinary Incontinence

Urinary incontinence and continence problems may include:

  • Stress incontinence – leakage of small amounts of urine with exertion.
  • Urge incontinence – leakage following a sudden urge to urinate.
  • Overflow incontinence – leakage because the bladder does not empty well and overfills.
  • Mixed incontinence – combination of urge and stress incontinence
  • Functional incontinence – leakage of urine because a person was unable to get to or use the toilet due to a physical disability.

Diagnosis of Incontinence

Dr Joshi conducts a special test- “URODYNAMICS” to detect the exact problem, so that correct treatment can be started.

Depending upon the results of URODYNAMICS, Dr Joshi will discuss whether non-surgical or surgical management is required.

Treatments for Incontinence

Non-surgical Management:
For Urge Incontinence, medications and bladder training offer relatively good relief. Neuromodulation is an innovative treatment providing significant relief, in the event medications do not produce desired results.

For more details re each treatment, please refer Urgent PC.

For Stress Incontinence there are some treatments available.

Surgical Treatments

For Stress Incontinence, surgical procedures like Mid-urethral sling offers a good relief. A sling is a small tape which is anchored below the mid-urethra to provide support to the urethra. These surgeries are performed through a small cut in the vaginal wall. As the mid-urethral tape procedure is fairly new, long-term success rates are being monitored.

Periurethral Injections- bulking agent – collagen or silicone – is injected into the tissues of the urethra to create cushioning effect.

Burch colposuspension or bladder neck elevation – the operation to eliminate the neck of the bladder outlet back to its normal position. It is considered one of the best operations with a high success rate about 75 to 85 out of hundred patients.

Laparoscopic Burch colposuspension- Burch colposuspension performed laparoscopically.

For Urge Incontinence, surgical treatment options include Botox injections to bladder muscle and Sacral Neuromodulation.

 

All surgical procedures have their own risks and some risks can be life-threatening. Patients are encouraged to ask as many questions to understand the risks involved.