Female Urinary Incontinence

Female urinary incontinence can affect women of any age and needless to say it is an embarrassing problem for most women to talk openly about. It could be that for this reason a little known fact is that approximately a staggering 24% of women under 44 suffer from urinary incontinence, and approximately 23% of women over 60.

Some women only experience the problem when they laugh, cough or sneeze, whilst others leak when they are performing activities such as having sexual intercourse, lifting heavy objects or exercising. In really bad cases the urine can be leaking constantly unless the women frequently goes to the bathroom to empty her bladder. In fact the various types of urinary incontinence are individually categorised as follows:

Stress Leakage of small amounts of urine during physical movement (coughing, sneezing, exercising).

Urge Leakage of large amounts of urine at unexpected times, including during sleep.

Overactive Bladder Urinary frequency and urgency, with or without urge incontinence.

Functional Untimely urination because of physical disability, external obstacles, or problems in thinking or communicating that prevent a person from reaching a toilet.

Overflow Unexpected leakage of small amounts of urine because of a full bladder.

Mixed Usually the occurrence of stress and urge incontinence together.

Transient Leakage that occurs temporarily because of a situation that will pass (infection, taking a new medication, colds with coughing).

The good news is depending on your individual circumstances, there are treatments available. First of all you will need to make an appointment to see a urologist, ideally one who specialises in the female urinary tract, alternatively a urogynecologist can look at the possibility of pelvic problems associated with urination.

Initially your Doctor will ask you lots of questions about the problems you have been experiencing. He may even ask you to keep a diary of the problem for a number of days. This will all help him to determine what kind of urinary incontinence you are suffering from in order to recommend the right treatment. If he has any doubts as to the cause of your specific type of urinary incontinence he will examine you to see if there are any obvious physical problems that may be responsible, e.g. pelvic growths, a weak pelvic floor or a prolapse of either your bladder or vagina.

Some other tests your Doctor may perform include:

Bladder stress test—You cough vigorously as the doctor watches for loss of urine from the urinary opening.

Urinalysis and urine culture—Laboratory technicians test your urine for evidence of infection, urinary stones, or other contributing causes.

Ultrasound—This test uses sound waves to create an image of the kidneys, ureters, bladder, and urethra.

Cystoscopy—The doctor inserts a thin tube with a tiny camera in the urethra to see inside the urethra and bladder.

Urodynamics—Various techniques measure pressure in the bladder and the flow of urine.

Some of the treatments your Doctor recommend may include the following:

Injectables, e.g. Bulking agents such as collagen, Carbon-coated zirconium beads or Coaptite. are injected into tissue surrounding the urethra to help keep the urethra closed and reduce urine leakage.

Nonsurgical treatments, e.g. Kegel exercises (pelvic floor exercises). These are designed to strengthen the muscles that allow you to hold the urine within your bladder. By practicing contracting and releasing these muscles over a number of weeks for gradually increasing amounts of time, your ability to hold in, or stop the flow of urine should improve.

Bladder training, is used to treat urge incontinence. With bladder training you increase how long you can wait before having to urinate, gradually extending the lengths of time before urination after you get the urge to go.

Medications, e.g. Anticholinergic medicines relax the bladder and increase bladder capacity. Examples include oxybutynin and tolterodine.

Certain antidepressant medicines may also be used to treat urge or stress incontinence.

Surgical treatments, e.g. A Sling procedure — the most common surgery to treat stress incontinence — uses strips of your body's tissue or synthetic material or mesh to create a pelvic sling or hammock around your bladder neck and the tube that carries urine from the bladder (urethra). The sling provides support to keep the urethra closed — especially when you cough or sneeze. Slings typically have high rates of effectiveness and low risks of complications.

Intermittent Self-Catheterization is a safe procedure that can help bring your urinary symptoms under control. Many people self-catheterize and report that it has helped to improve their overall quality of life. A catheter will allow you to keep your bladder healthy, completely empty your bladder at regular intervals, protect your kidneys from infection, and eliminate the need for wearing a continuously draining catheter.

This is by no means a comprehensive article on female urinary incontinence and I have aimed to provide a general overview of the condition, as well as some ideas for what areas of the problem you might want to research next if you are looking for answers and potential solutions.

The links I have provided should help you greatly in any search for further information, both on the symptoms and the treatment options available.