Urinary incontinence is an issue that some sufferers may feel embarrassed about, but might be relieved to hear is more common than they realise. It is also usually very treatable – with treatments ranging from exercises, to various surgery options or medication, depending on the nature of the condition and its cause.
Urinary incontinence refers to involuntary leakage of urine, and is a condition that may affect around 15% of men and 37% of women at some stage of their lives. In a healthy bladder, urine passes from the kidneys to the bladder via the two ureters, and then is passed out of the body through the urethra. In a normal situation, the person is able to tighten the urinary sphincter muscle that surrounds the urethra – therefore having some control over the flow of urine out of the body. When this muscle is weakened, incontinence may happen. In some cases, incontinence can occur when the pelvic floor muscles have become weakened.
There are a number of different types of urinary incontinence, including what is known as stress incontinence.
Contrary to what you might think, the term stress incontinence does not refer to emotional stress (although it may well cause emotional stress for some people!). It is a condition where urine leaks out when the sufferer sneezes, coughs, laughs, lifts something, plays sport or does exercise. These activities create an increase in pressure in the abdomen, which then pushes down on the bladder causing the leakage.
It is more common in women and is often caused by pregnancy and childbirth, due to the weakening of the pelvic floor muscles that support the urethra. The condition can also occur in menopausal women due to a drop in the hormone oestrogen (which helps to maintain the thickness of the lining in the urethra), and in men after prostate surgery.
Treating stress incontinence
Treatment of stress incontinence may not necessarily involve surgery. Post-childbirth women may benefit greatly from pelvic floor strengthening exercises, enabling them to manage the condition. If the condition occurs due to a urinary tract infection, it can often be successfully treated with antibiotics.
For weakness in the sphincter muscle, there are a number of surgical treatment options:
- Sub-urethral sling surgery – available for both genders. The sling forms a ‘cradle’ for the urethra which helps to reduce leakage. This procedure requires minimal surgery and usually only involves a short day or overnight stay at the hospital. The treatment has a very high success rate in reducing urinary leakage and improving the quality of life for patients. There are several types of sling available, and patients need to have a discussion with their surgeon about the options that would suit their particular condition.
- Artificial sphincter (males) – this treatment involves implanting a biocompatible silicon device that is composed of a reservoir, cuff, and pump – with the cuff acting as a replacement sphincter. This may suit men with a moderate-to-severe incontinence problem, and usually requires a 24-hour stay in the hospital.
If you have a urinary incontinence problem, it’s important to see your doctor, who may refer to specialist urologist for test and treatment.